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Kejin CHEN,Jianwen LIU,Xuefei YANG,Joe King Man Fan 대한내시경복강경외과학회 2018 Journal of Minimally Invasive Surgery Vol.21 No.3
Purpose: Our aim is to compare 3-dimensional mesh fixation using titanium tacks combine with n-butyl cyanoacrylate glue (NBCG) (COMBINE group) versus NBCG only (NBCG group) in totally extraperitoneal inguinal hernioplasty (TEP).Methods: This is a retrospectively study of patients diagnosed with unilateral inguinal hernia and underwent TEP with 3-dimensional configured polyester mesh fixation using titanium tacks combine NBCG or NBCG only at the University of Hong Kong-Shenzhen Hospital with data prospectively collected. Operative details and outcomes were compared including: operating time, size of defect, total hospital cost, post-operative pain scores and recurrence.Results: From 08.2013 to 03.2016 a total of 219 patients were included. There was no significant difference between COMBINE group and NBCG group in mean age (52.5 years versus 48.2 years), mean size of defects (2.4 cm versus 2.6 cm), and operating time (121 mins versus 111 mins). There were significant differences between COMBINE group and NBCG group in total hospital cost (3035 USD versus 2022 USD), post-operative pain score on day 2 to day 4 (VAS: 1.4 versus 1.0, 1.0 versus 0.4, 0.5 versus 0.2). There was one recurrence in COMBINE group (p=0.276) with overall recurrence of 0.46%.Conclusion: Patients with inguinal hernia underwent TEP with 3-dimensional configured polyester mesh with NBCG fixation only having comparative surgical outcome to COMBINE group. A recurrence of 0.46% can be achieved with this combination. Tacks fixation may cause more post-operative pain and increase hospital cost. Use of N-butyl cyanoacrylate glue in TEP is safe and effective in our clinical series.
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Park, Yongbee,Kwon, Byungjoon,Heo, Juyeon,Hu, Xuefei,Liu, Yang,Moon, Taesup Elsevier 2020 Environmental pollution Vol.256 No.-
<P><B>Abstract</B></P> <P>We apply convolutional neural network (CNN) model for estimating daily 24-h averaged ground-level P <SUB> M 2.5 </SUB> of the conterminous United States in 2011 by incorporating aerosol optical depth (AOD) data, meteorological fields, and land-use data. Unlike some of the recent supervised learning-based approaches, which only utilized the predictors from the location of which P <SUB> M 2.5 </SUB> value is estimated, we naturally aggregate predictors from nearby locations such that the spatial correlation among the predictors can be exploited. We carefully evaluate the performance of our method via overall, temporally-separated, and spatially-separated cross-validations (CV) and show that our CNN achieves competitive estimation accuracy compared to the recently developed baselines. Furthermore, we develop a novel predictor importance metric for our CNN based on the recent neural network interpretation method, Layerwise Relevance Propagation (LRP), and identify several informative predictors for P <SUB> M 2.5 </SUB> estimation.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Convolutional neural network (CNN) accurately estimates daily averaged PM2.5. </LI> <LI> Layerwise relevance propagation (LRP) is used to obtain predictor impor-tance list. </LI> <LI> Exploiting spatial correlation of nearby predictors boosts the estimation accuracy. </LI> <LI> Weighted average feature of PM2.5 is useful even when CNN is used. </LI> <LI> CNN can generate smooth annual prediction map of PM2.5 for the con-terminous US. </LI> </UL> </P> <P><B>Graphical abstract</B></P> <P>[DISPLAY OMISSION]</P>
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Joe King Man FAN,Jeremy YIP,Matrix Fung,Oswens Siu Hung LO,Jianwen LIU,Xuefei YANG,Kejin CHEN,Wai Lun LAW 대한내시경복강경외과학회 2017 Journal of Minimally Invasive Surgery Vol.20 No.3
Repair of lower abdominal incisional hernia is always a surgical challenge. TAPE technique has been described for the repair of supra-pubic midline incisional hernia with satisfactory outcome. Its indication can be extended for treatment of non-midline lower abdominal hernia. Peritoneal incision is created just below the hernia defect with pre-peritoneal dissection to expose supra-pubic preperitoneal space with Cooper’s ligament exposed. Non-adhesive mesh then placed over preperitoneal space and partially intra-peritoneally, and cover the whole extra-peritoneal space prepared to ensure enough overlapping. Mesh is fixed by tackers for intra-peritoneal part, most inferior fixation points were at peritoneal incision line. Extra-peritoneal part of meshes is fixed at the safety zone and covered up by the peritoneal flap to avoid mesh migration. Fixation of the meshes at the lateral aspects were facilitated by the peritoneal flap and subsequent fibrosis and adhesion to the extra-peritoneal structures in cases of lateral lower abdominal hernia. Repair of midline and lateral lower abdominal incisional hernia with this novel modified technique with prosthetic mesh is safe and effective. A larger case series and longer follow-up is required for validation of this technique.
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