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Background: Gastrectomy remains the curative option in gastric cancer. However, the growing concern that preoperative waiting jeopardizes survival has not been fully addressed. The present population‐based cohort study aimed to clarify the impact of preoperative waiting time (PreWT). Methods: We included patients with clinical Stage II–III gastric cancer who received curative surgery from 2008 to 2017 of Taiwan Cancer Registry. PreWT was defined as the time from endoscopic diagnosis to surgery. The prognostic impact on overall survival (OS) was evaluated with Cox and restricted cubic spline regressions. Results: A total of 3059 patients with a median age of 68 years were evaluated. The median PreWT was 16 days (interquartile range, 11–24 days), and patients with a shorter PreWT were younger, had a more advanced disease and received adjuvant therapies. Despite a shorter OS occurring with prolonged PreWT (median OS by PreWT [days]: 7–13, 2.7 years; 14–20, 3.1 years; 21–27, 3.0 years; 28–34, 4.7 years; 35–31, 3.7 years; 42–48, 3.4 years; 49–118, 2.8 years; p = 0.029), the differences were not significant after adjustment. The Cox and restricted cubic spline regressions showed that prolonged PreWT was not a significant prognostic factor for OS (p = 0.719). Conclusions: The population‐based study suggests that a PreWT of 49–118 days does not independently correlate with a poor prognosis in Stage II–III gastric cancer. The study provides rationale for a window period for preoperative therapies and patient optimization. The population‐based study suggests that preoperative waiting within an acceptable range dose not impact the survival in Stage II–III gastric or gastroesophageal junction cancer. [ABSTRACT FROM AUTHOR]

Levobupivacaine has been developed as a safer alternative to bupivacaine because of its reduced systemic toxicity. However, the effect of directly delivering levobupivacaine into tracheal smooth muscle has not been adequately explored. We performed this study to determine the in vitro effects of levobupivacaine on isolated rat tracheal smooth muscle. A portion of rat trachea 5 mm in length was mounted in 30 ml of Krebs solution in a muscle bath at 37 °C. The following effects of levobupivacaine were assessed: (1) the effect on tracheal smooth muscle resting tension (n = 6), (2) the effect on contraction caused by 10.sup.-6 M methacholine (n = 6) and (3) the effect on electrically induced tracheal smooth muscle contractions (n = 6). Levobupivacaine caused dose-dependent relaxation in the trachealis muscle precontracted with 10.sup.-6 M methacholine. Contraction inhibition was statistically significant when 10.sup.-5 and 10.sup.-4 M levobupivacaine were applied, compared with the contraction inhibition that occurred in the control groups (p < 0.01). A high dose of levobupivacaine also decreased the spike contraction induced by electrical field stimulation. This study indicated that high concentrations of levobupivacaine might antagonize the cholinergic receptors and inhibit parasympathetic function of the trachea., Author(s): Hung-Chi Chang[sup.1] [sup.2] , Shin-Yan Chen[sup.1] , Yu-Feng Huang[sup.1] , Feng-Lin Liu[sup.1] , Yih-Giun Cherng[sup.1] [sup.3] , Hsing-Won Wang[sup.4] [sup.5] Author Affiliations: (1) Department of Anesthesiology, Shuang Ho Hospital, [...]

The Just-In-Time (JIT) philosophy has received a great deal of attention. Several actions such as improving quality, reducing setup cost and shortening lead time have been recognized as effective ways to achieve the underlying goal of JIT. This paper considers the partial backorders, lot size reorder point inventory system with an imperfect production process. The objective is to simultaneously optimize the lot size, reorder point, process quality, setup cost and lead time, constrained on a service level. We assume the explicit distributional form of lead time demand is unknown but the mean and standard deviation are given. The minimax distribution free approach is utilized to solve the problem and a numerical example is provided to illustrate the results. .

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ejor.2004.06.029 Byline: Hung-Chi Chang (a), Liang-Yuh Ouyang (b), Kun-Shan Wu (c), Chia-Huei Ho (d) Keywords: Inventory; Integrated model; Lead time reduction; Ordering cost reduction Abstract: This study deals with the lead time and ordering cost reduction problem in the single-vendor single-buyer integrated inventory model. We consider that buyer lead time can be shortened at an extra crashing cost which depends on the lead time length to be reduced and the ordering lot size. Additionally, buyer ordering cost can be reduced through further investment. Two models are presented in this study. The first model assumes that the ordering cost reduction has no relation to lead time crashing. The second model assumes that the lead time and ordering cost reduction are interacted. An iterative procedure is developed to find the optimal solution and numerical examples are presented to illustrate the results of the proposed models. Author Affiliation: (a) Department of Logistics Engineering and Management, National Taichung Institute of Technology, Taichung, Taiwan (b) Department of Management Sciences and Decision Making, Tamkang University, Tamsui, Taipei, 25137 Taiwan (c) Department of Business Administration, Tamkang University, Tamsui, Taipei, Taiwan (d) Graduate Institute of Management Sciences, Tamkang University, Tamsui, Taipei, Taiwan Article History: Received 28 May 2003; Accepted 16 June 2004

Solution for lead time and ordering cost problem of buyer in a single-vendor single buyer integrated inventory model is evaluated.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ejor.2004.04.044 Byline: Hung-Chi Chang (a), Jing-Shing Yao (b), Liang-Yuh Ouyang (c) Keywords: Inventory; Lead time; Fuzzy random variable; Fuzzy total cost Abstract: This article considers the mixture inventory model involving variable lead time with backorders and lost sales. We first fuzzify the random lead-time demand to be a fuzzy random variable and obtain the total cost in the fuzzy sense. Then, we further fuzzify the total demand to be the triangular fuzzy number and derive the fuzzy total cost. By the centroid method of defuzzification, we derive the estimate of total cost in the fuzzy sense. Also, we find the optimal solution for order quantity and lead time in the fuzzy sense such that the total cost has a minimum value. A numerical example is provided to illustrate the results of proposed model. Author Affiliation: (a) Department of Logistics Engineering and Management, National Taichung Institute of Technology, Taichung 404, Taiwan (b) Department of Mathematics, National Taiwan University, Taipei 251, Taiwan (c) Department of Management Sciences, Tamkang University, Taipei 106, Taiwan Article History: Received 11 September 2002; Accepted 1 April 2004