The real-time transmission of the electrocardiogram (ECG) in urgent situations can improve the ch... more The real-time transmission of the electrocardiogram (ECG) in urgent situations can improve the chances of the patient. However, one of the greatest problems involving this kind of telemedicine application is the leakage of network bandwidth. ECG exams may generate too much data, which makes difficult to apply telecardiology systems in real life. This problem motivated many authors to look for efficient techniques of ECG compression, such as: transform approaches, 2-D approaches, similarity approaches and generic approaches. The present work proposes a new hypothesis: neural networks may be applied together with Wavelet transforms to compress the ECG. In this approach, the Wavelet transform acts as a pre-processor element for a multilayer perceptron neural network, trained with the backpropagation algorithm. The original signal was divided in two parts: the “plain” blocks and the “complex” ones. The “plain” blocks were compressed with a 40:1 ratio while the “complex” blocks were compressed with a 5:1 ratio. The use of both compressors guaranteed a compression rate of 28:1, approximately. The process obtained good grades in the quality aspect: percent root mean squared difference (1.846%), maximum error (0.1789) and standard derivation of errors (0.1044).
BACKGROUND: Pelvic exenteration is the best therapeutic choice for treatment of T4 rectal cancer.... more BACKGROUND: Pelvic exenteration is the best therapeutic choice for treatment of T4 rectal cancer. Although, this operation still presents considerable mortality and high morbidity. AIM: To report on a series of 15 patients with a T4 rectal cancer at a general hospital and describe the outcomes (morbidity, mortality and long-term survival) following pelvic exenteration. METHODS: Complete follow-up data were available on 15 patients who underwent pelvic exenteration for T4 rectal cancer between 1998 and 2006. These subjects comprised seven men and eight women with a mean age of 65 years. All of them presented serious incapacitating complaints. The surgical procedures included: infraelevator exenteration (n = 6), supraelevator exenteration (n = 4), posterior exenteration (n = 3) and, posterior exenteration plus partial cystectomy and ureterectomy (n = 2). RESULTS: The mean duration of surgery was 403 minutes (280-485). The mean blood loss was 1620 mL (300-4.800). The postoperative mortality was 6,66% (n = 1). The overall rate morbidity was 53,3% (n = 8). The pathological examination showed that all resections were R0. Lymph node involvement was present in four patients (26,66 %), and all of them died due to tumor recurrence. The overall 5-year survival rate was 35,7%. CONCLUSION: In spite of its aggressive nature and high morbidity, pelvic exenteration seems justified in rectal carcinoma when the disease extends to the urinary or genital tract. This procedure may offer long-term disease control.
A series of five cases of right-colon adenocarcinoma that invaded the proximal duodenum is presen... more A series of five cases of right-colon adenocarcinoma that invaded the proximal duodenum is presented. All patients underwent successful en-bloc pancreatoduodenectomy plus right hemicolectomy by General Surgery Service of the Teaching Hospital of the ABC Medical School, Santo André, SP, Brazil. The study was conducted between 2000 and 2007. There were two major complications but no mortality. Three patients did not present any recurrence over the course of 15 to 54 months of follow-up. Multivisceral resection with en-bloc pancreatoduodenectomy should be considered for patients who are fit for major surgery but do not present distant dissemination. Long-term survival may be attained.
The real-time transmission of the electrocardiogram (ECG) in urgent situations can improve the ch... more The real-time transmission of the electrocardiogram (ECG) in urgent situations can improve the chances of the patient. However, one of the greatest problems involving this kind of telemedicine application is the leakage of network bandwidth. ECG exams may generate too much data, which makes difficult to apply telecardiology systems in real life. This problem motivated many authors to look for efficient techniques of ECG compression, such as: transform approaches, 2-D approaches, similarity approaches and generic approaches. The present work proposes a new hypothesis: neural networks may be applied together with Wavelet transforms to compress the ECG. In this approach, the Wavelet transform acts as a pre-processor element for a multilayer perceptron neural network, trained with the backpropagation algorithm. The original signal was divided in two parts: the “plain” blocks and the “complex” ones. The “plain” blocks were compressed with a 40:1 ratio while the “complex” blocks were compressed with a 5:1 ratio. The use of both compressors guaranteed a compression rate of 28:1, approximately. The process obtained good grades in the quality aspect: percent root mean squared difference (1.846%), maximum error (0.1789) and standard derivation of errors (0.1044).
BACKGROUND: Pelvic exenteration is the best therapeutic choice for treatment of T4 rectal cancer.... more BACKGROUND: Pelvic exenteration is the best therapeutic choice for treatment of T4 rectal cancer. Although, this operation still presents considerable mortality and high morbidity. AIM: To report on a series of 15 patients with a T4 rectal cancer at a general hospital and describe the outcomes (morbidity, mortality and long-term survival) following pelvic exenteration. METHODS: Complete follow-up data were available on 15 patients who underwent pelvic exenteration for T4 rectal cancer between 1998 and 2006. These subjects comprised seven men and eight women with a mean age of 65 years. All of them presented serious incapacitating complaints. The surgical procedures included: infraelevator exenteration (n = 6), supraelevator exenteration (n = 4), posterior exenteration (n = 3) and, posterior exenteration plus partial cystectomy and ureterectomy (n = 2). RESULTS: The mean duration of surgery was 403 minutes (280-485). The mean blood loss was 1620 mL (300-4.800). The postoperative mortality was 6,66% (n = 1). The overall rate morbidity was 53,3% (n = 8). The pathological examination showed that all resections were R0. Lymph node involvement was present in four patients (26,66 %), and all of them died due to tumor recurrence. The overall 5-year survival rate was 35,7%. CONCLUSION: In spite of its aggressive nature and high morbidity, pelvic exenteration seems justified in rectal carcinoma when the disease extends to the urinary or genital tract. This procedure may offer long-term disease control.
A series of five cases of right-colon adenocarcinoma that invaded the proximal duodenum is presen... more A series of five cases of right-colon adenocarcinoma that invaded the proximal duodenum is presented. All patients underwent successful en-bloc pancreatoduodenectomy plus right hemicolectomy by General Surgery Service of the Teaching Hospital of the ABC Medical School, Santo André, SP, Brazil. The study was conducted between 2000 and 2007. There were two major complications but no mortality. Three patients did not present any recurrence over the course of 15 to 54 months of follow-up. Multivisceral resection with en-bloc pancreatoduodenectomy should be considered for patients who are fit for major surgery but do not present distant dissemination. Long-term survival may be attained.
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