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1.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-782488

RESUMO

BACKGROUND: The chronic obstructive pulmonary disease (COPD) assessment test (CAT) is a validated, eight-item questionnaire used to quantify the health status of patients. The aim of this study was to evaluate the usefulness of the CAT questionnaire as a tool to assess the response to treatment in acute exacerbations of COPD in an outpatient setting.METHODS: A multicenter, phase 3 randomized controlled trial was conducted previously to examine the efficacy and safety of oral zabofloxacin for the treatment of COPD exacerbations. In the present post hoc analysis of the original study, patients with COPD exacerbation were categorized as responders or non-responders according to the respiratory symptoms persisting on day 10 (visit 3) of treatment. The CAT questionnaire was completed daily by patients at home from the initial visit to the second visit on day 5. Subsequently, the questionnaire was completed in the presence of a physician on days 10 (visit 3) and 36 (visit 4). Multivariate regression analysis was performed to determine the association between CAT scores and the therapeutic response.RESULTS: The CAT scores decreased more rapidly in responders compared to non-responders during the first 5 days (23.3–20.4 vs. 23.5–22). Among responders, patients with higher severity of illness also revealed higher CAT scores on the first day of an exacerbation (mild, 19.8; moderate, 21.4; severe, 23.8; very severe, 28.6). Multivariate analysis revealed that a change in the CAT score during the first 3 days influenced the therapeutic response. A significant decrease in scores in the domains of sputum production, chest tightness, and activities of daily living was seen among responders.CONCLUSION: Early improvement in CAT scores may be associated with a more favorable response to the treatment of COPD exacerbations.TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01658020TRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0000532


Assuntos
Atividades Cotidianas , Animais , Gatos , Humanos , Serviços de Informação , Análise Multivariada , Pacientes Ambulatoriais , Doença Pulmonar Obstrutiva Crônica , Escarro , Tórax
2.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-810962

RESUMO

BACKGROUND: Although the association of hyperuricemia with an increased risk of mortality has been demonstrated in the context of acute exacerbation of chronic obstructive pulmonary disease (COPD), the long-term outcomes of hyperuricemia have not been studied in the case of stable COPD.METHODS: We retrospectively analyzed baseline data of 240 men with stable COPD enrolled in the Korea Obstructive Lung Disease cohort. We evaluated associations between serum uric acid levels and clinical parameters, risk factors for all-cause mortality, and acute exacerbation of COPD.RESULTS: The mean age of subjects was 66.4 ± 7.7 years, and the median follow-up time was 5.9 years. We identified no significant difference in terms of lung function or laboratory findings between patients with hyperuricemia and those without. Serum uric acid level was negatively associated with systemic inflammation indicated by neutrophil–lymphocyte ratio (r = −0.211, P = 0.001). Univariate Cox regression analysis revealed hyperuricemia to not be associated with an increased risk of all-cause mortality in men with stable COPD (hazard ratio [HR], 0.580; 95% confidence interval [CI], 0.250–1.370; P = 0.213). In the multivariate Cox regression model, hyperuricemia was not an independent predictor of acute exacerbation (HR, 1.383; 95% CI, 0.977–1.959; P = 0.068).CONCLUSION: Among men with stable COPD, hyperuricemia is not an independent predictor of all-cause mortality or future acute exacerbation of COPD. These results differ from those of previous studies on patients with acute exacerbation of COPD.


Assuntos
Estudos de Coortes , Seguimentos , Humanos , Hiperuricemia , Inflamação , Coreia (Geográfico) , Pulmão , Pneumopatias Obstrutivas , Masculino , Mortalidade , Doença Pulmonar Obstrutiva Crônica , Estudos Retrospectivos , Fatores de Risco , Ácido Úrico
3.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-786599

RESUMO

PURPOSE: This study evaluated color stability of Dentca 3D-printed denture teeth, in comparison to color stabilities of four conventional types of denture teeth, upon being immersed in various colorants.MATERIALS AND METHODS: Four types of conventional prefabricated denture teeth (Surpass, GC, Artic 6, Heraeus Kulzer, Premium 6, Heraeus Kulzer, Preference, Candulor), 3D-printed denture teeth (Dentca); and Z250 (Filtek Z250, 3M ESPE) were prepared for testing. The samples were immersed in erythrosine 3%, coffee, cola, and distilled water (DW) at 37℃. Color change (ΔE) was measured by spectrophotometer before immersion and at 7, 14, and 21 days after immersion. One-way analysis of variance was performed along with Tukey's honestly significant difference multiple comparisons test (P<.05).RESULTS: No great difference was observed between the color change of Dentca denture teeth and that of conventional denture teeth in most cases (P>.05). The color change of Dentca denture teeth immersed in erythrosine 3% was greater than that of Surpass (ΔE = 0.67 ± 0.25) after 1 week; Artic 6 (ΔE = 1.44 ± 0.38) and Premium 6 (ΔE = 1.69 ± 0.35) after 2 weeks; and Surpass (ΔE = 1.79 ± 0.49), Artic 6 (ΔE = 2.07 ± 0.21), Premium 6 (ΔE = 2.03 ± 0.75), and Preference (ΔE = 2.01 ± 0.75) after 3 weeks (P<.05).CONCLUSION: A color change was observed in Dentca denture teeth when immersed in some colorants; however, the maximum value of ΔE for Dentca denture teeth was within the clinically acceptable range.


Assuntos
Café , Cola , Dentaduras , Eritrosina , Imersão , Impressão Tridimensional , Dente , Água
4.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-760276

RESUMO

Hepatocellular carcinoma (HCC) can be noninvasively diagnosed on the basis of its characteristic imaging findings of arterial phase enhancement and portal/delayed “washout” on computed tomography (CT) and magnetic resonance imaging (MRI) in cirrhotic patients. However, different specific diagnostic criteria have been proposed by several countries and major academic societies. In 2018, major guideline updates were proposed by the Association for the Study of Liver Diseases, European Association for the Study of the Liver (EASL), Korean Liver Cancer Association and National Cancer Center (KLCA-NCC) of Korea. In addition to dynamic CT and MRI using extracellular contrast media, these new guidelines now include magnetic resonance imaging (MRI) using hepatobiliary contrast media as the first-line diagnostic test, while the KLCA-NCC and EASL guidelines also include contrast-enhanced ultrasound (CEUS) as the second-line diagnostic test. Therefore, hepatobiliary MR contrast media and CEUS will be increasingly used for the noninvasive diagnosis and staging of HCC. In this review, we discuss the emerging role of hepatobiliary phase MRI and CEUS for the diagnosis of HCC and also review the changes in the HCC diagnostic criteria in major guidelines, including the KLCA-NCC practice guidelines version 2018. In addition, we aimed to pay particular attention to some remaining issues in the noninvasive diagnosis of HCC.


Assuntos
Carcinoma Hepatocelular , Meios de Contraste , Diagnóstico , Testes Diagnósticos de Rotina , Humanos , Coreia (Geográfico) , Fígado , Hepatopatias , Neoplasias Hepáticas , Imagem por Ressonância Magnética , Ultrassonografia
5.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-742452

RESUMO

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrosing interstitial pneumonia, which presents with a progressive worsening dyspnea, and thus a poor outcome. The members of the Korean Academy of Tuberculosis and Respiratory Diseases as well as the participating members of the Korea Interstitial Lung Disease Study Group drafted this clinical practice guideline for IPF management. This guideline includes a wide range of topics, including the epidemiology, pathogenesis, risk factors, clinical features, diagnosis, treatment, prognosis, and acute exacerbation of IPF in Korea. Additionally, we suggested the PICO for the use of pirfenidone and nintendanib and for lung transplantation for the treatment of patients with IPF through a systemic literature review using experts' help in conducting a meta-analysis. We recommend this guideline to physicians, other health care professionals, and government personnel in Korea, to facilitate the treatment of patients with IPF.


Assuntos
Assistência à Saúde , Diagnóstico , Gerenciamento Clínico , Dispneia , Epidemiologia , Humanos , Fibrose Pulmonar Idiopática , Coreia (Geográfico) , Doenças Pulmonares Intersticiais , Transplante de Pulmão , Prognóstico , Fatores de Risco , Tuberculose
6.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-782457

RESUMO

BACKGROUND: Pulmonary functions are interpreted using predicted values from reference equations that vary with ethnicity, gender, age, height, and weight. The universally used Choi's reference equations are not validated for Korean populations, and the purpose of this study was to validate them and develop new reference equations.METHODS: Subjects with normal spirometry and chest radiographs, no co-morbidities, and non-smokers, from the Korean National Health and National Examination Survey (KNHANES)-VI were enrolled (n = 117). Intraclass correlation coefficient (ICC) was assessed for reliability of reference equations. New reference equations were developed using linear regression analysis. Differences between observed and predicted values were assessed to compare the reference equations from Choi's, Global Lung Function Initiative 2012, KNHANES-IV, and newly developed equations.RESULTS: The ICC of Choi's reference equations was 0.854 (P < 0.001). The new reference equations for men were: forced vital capacity (FVC) (L) = − 4.38775 − 0.01184 × age + 0.05547 × height, forced expiratory volume – 1 second (FEV₁) (L) = − 2.40147 − 0.02134 × age + 0.04103 × height; and for women: FVC (L) = − 3.09063 + 0.003904 × age + 0.038694 × height; FEV₁ (L) = − 1.32933 − 0.00872 × age + 0.02762 × height. The differences between the predicted and observed means were largest in Choi's equations, but lowest in the new equations with highest goodness of fit.CONCLUSION: Because Choi's reference equations presented larger differences from the observed values, despite reliability, and the new reference equations showed better goodness of fit, we suggest the latter for Korean populations.


Assuntos
Feminino , Volume Expiratório Forçado , Humanos , Modelos Lineares , Pulmão , Masculino , Radiografia Torácica , Espirometria , Capacidade Vital
7.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-787195

RESUMO

BACKGROUND/AIMS: The etiology of colon diverticulosis is related to a range of genetic, biological, and environmental factors, but the risk factors for asymptomatic diverticulosis of the colon are unclear. This study examined the risk factors for asymptomatic colon diverticulosis.METHODS: This retrospective study included examinees who underwent a colonoscopy for screening at the health check-up center of SAM Hospital between January 2016 and December 2016. The examinees with colon diverticulosis found by colonoscopy were compared with those without diverticulosis. The comparison factors were age, gender, alcohol consumption, smoking status, medical history, lipid profile, body mass index, visceral fat area, waist-hip ratio, and severity of a fatty liver.RESULTS: This study included 937 examinees and the overall prevalence of diverticulosis was 8.1% (76/937). Fatty liver was found in 69.7% (53/76) in cases of colon diverticulosis and 50.3% (433/861) in the control group (p=0.001). The average waist-hip ratio was 0.92±0.051 in colon diverticulosis and 0.90±0.052 in the control group (p=0.052). Multivariate analysis revealed the waist-hip ratio (OR=1.035, 95% CI 1.000–1.070, p=0.043), moderate fatty liver (OR=2.238, 95% CI 1.026–4.882, p=0.043), and severe fatty liver (OR=5.519, 95% CI 1.236–21.803, p=0.025) to be associated with an increased risk of asymptomatic colon diverticulosis.CONCLUSIONS: The waist-hip ratio, moderate fatty liver, and severe fatty liver are risk factors for asymptomatic colon diverticulosis. Central obesity, which can be estimated by the waist-hip ratio, and fatty liver might affect the pathogenesis of asymptomatic colon diverticulosis.


Assuntos
Consumo de Bebidas Alcoólicas , Índice de Massa Corporal , Colo , Colonoscopia , Divertículo , Fígado Gorduroso , Gordura Intra-Abdominal , Programas de Rastreamento , Análise Multivariada , Obesidade Abdominal , Prevalência , Estudos Retrospectivos , Fatores de Risco , Fumaça , Fumar , Relação Cintura-Quadril
8.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-763403

RESUMO

The goal of this review is to present the similarities and differences among the latest guidelines for noninvasive diagnosis of hepatocellular carcinoma (HCC) of American Association for the Study of Liver Disease (AASLD), European Association for the Study of the Liver (EASL), Liver Imaging Reporting and Data System (LI-RADS), Asian Pacific Association for the Study of the Liver (APASL), and Korean Liver Cancer Association-National Cancer Center (KLCA-NCC) of Korea. In 2018, major guideline updates have been proposed by the AASLD, EASL and KLCA-NCC; AASLD newly incorporated LI-RADS into their HCC diagnostic algorithm. The AASLD and EASL guidelines now include magnetic resonance imaging (MRI) using hepatobiliary contrast media as a first-line diagnostic test in addition to dynamic computed tomography and MRI using extracellular contrast media and the KLCA-NCC and EASL guidelines also include contrast-enhanced ultrasound as a second-line diagnostic test. We will comprehensively review the HCC surveillance and diagnostic algorithms and compare and highlight key features for each guideline. We also address limitations of current systems for the noninvasive diagnosis of HCC.


Assuntos
Grupo com Ancestrais do Continente Asiático , Carcinoma Hepatocelular , Meios de Contraste , Diagnóstico , Testes Diagnósticos de Rotina , Humanos , Sistemas de Informação , Coreia (Geográfico) , Fígado , Hepatopatias , Neoplasias Hepáticas , Imagem por Ressonância Magnética , Ultrassonografia
9.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-761547

RESUMO

BACKGROUND/AIMS: The etiology of colon diverticulosis is related to a range of genetic, biological, and environmental factors, but the risk factors for asymptomatic diverticulosis of the colon are unclear. This study examined the risk factors for asymptomatic colon diverticulosis. METHODS: This retrospective study included examinees who underwent a colonoscopy for screening at the health check-up center of SAM Hospital between January 2016 and December 2016. The examinees with colon diverticulosis found by colonoscopy were compared with those without diverticulosis. The comparison factors were age, gender, alcohol consumption, smoking status, medical history, lipid profile, body mass index, visceral fat area, waist-hip ratio, and severity of a fatty liver. RESULTS: This study included 937 examinees and the overall prevalence of diverticulosis was 8.1% (76/937). Fatty liver was found in 69.7% (53/76) in cases of colon diverticulosis and 50.3% (433/861) in the control group (p=0.001). The average waist-hip ratio was 0.92±0.051 in colon diverticulosis and 0.90±0.052 in the control group (p=0.052). Multivariate analysis revealed the waist-hip ratio (OR=1.035, 95% CI 1.000–1.070, p=0.043), moderate fatty liver (OR=2.238, 95% CI 1.026–4.882, p=0.043), and severe fatty liver (OR=5.519, 95% CI 1.236–21.803, p=0.025) to be associated with an increased risk of asymptomatic colon diverticulosis. CONCLUSIONS: The waist-hip ratio, moderate fatty liver, and severe fatty liver are risk factors for asymptomatic colon diverticulosis. Central obesity, which can be estimated by the waist-hip ratio, and fatty liver might affect the pathogenesis of asymptomatic colon diverticulosis.


Assuntos
Consumo de Bebidas Alcoólicas , Índice de Massa Corporal , Colo , Colonoscopia , Divertículo , Fígado Gorduroso , Gordura Intra-Abdominal , Programas de Rastreamento , Análise Multivariada , Obesidade Abdominal , Prevalência , Estudos Retrospectivos , Fatores de Risco , Fumaça , Fumar , Relação Cintura-Quadril
10.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-761455

RESUMO

A conventional approach for the treatment of long-span edentulous areas is the use of removable dentures. However, placing implants in these areas results in superior functional outcomes by increasing the stability, support, and resistance of the prostheses and improving the masticatory efficiency. Treatment modalities utilizing implants can be further classified into either removable or fixed-type prostheses. Several factors such as the amount of alveolar bone resorption, inter-arch relationship, patient preferences, and socioeconomic status should be considered when determining the appropriate treatment approach. Monolithic zirconia has been considered a suitable material for implant-supported fixed dental prosthesis, because of the drastic improvement in its mechanical properties. It exhibits fewer incidences of fracture and chipping of the prostheses, and has greater bulk of material than metal-ceramic crowns and zirconia-veneered ceramics. Moreover, highly translucent monolithic zirconia is also available in the market, and its application is gradually increasing for anterior tooth rehabilitation. The present report describes a patient who underwent full-mouth rehabilitation with fixed dental prostheses (eight upper and three lower implant placements). All teeth, except bilateral mandibular canines and left mandibular first and second premolars, were extracted after the diagnosis of generalized chronic moderate-to-advanced periodontitis of the remaining teeth. The patient reported satisfactory esthetic and functional outcomes during the one-year follow-up visit.


Assuntos
Dente Pré-Molar , Reabsorção Óssea , Cerâmica , Coroas , Prótese Dentária , Dentaduras , Diagnóstico , Seguimentos , Humanos , Incidência , Mandíbula , Maxila , Preferência do Paciente , Periodontite , Próteses e Implantes , Reabilitação , Classe Social , Dente
11.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-741444

RESUMO

OBJECTIVE: To evaluate whether computed tomography (CT) reconstruction algorithms affect the CT texture features of the liver parenchyma. MATERIALS AND METHODS: This retrospective study comprised 58 patients (normal liver, n = 34; chronic liver disease [CLD], n = 24) who underwent liver CT scans using a single CT scanner. All CT images were reconstructed using filtered back projection (FBP), hybrid iterative reconstruction (IR) (iDOSE4), and model-based IR (IMR). On arterial phase (AP) and portal venous phase (PVP) CT imaging, quantitative texture analysis of the liver parenchyma using a single-slice region of interest was performed at the level of the hepatic hilum using a filtration-histogram statistic-based method with different filter values. Texture features were compared among the three reconstruction methods and between normal livers and those from CLD patients. Additionally, we evaluated the inter- and intra-observer reliability of the CT texture analysis by calculating intraclass correlation coefficients (ICCs). RESULTS: IR techniques affect various CT texture features of the liver parenchyma. In particular, model-based IR frequently showed significant differences compared to FBP or hybrid IR on both AP and PVP CT imaging. Significant variation in entropy was observed between the three reconstruction algorithms on PVP imaging (p 0.75) for CT imaging without filtration. CONCLUSION: CT texture features of the liver parenchyma evaluated using the filtration-histogram method were significantly affected by the CT reconstruction algorithm used.


Assuntos
Entropia , Filtração , Humanos , Hepatopatias , Fígado , Métodos , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
12.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-742436

RESUMO

BACKGROUND: The diffusing capacity of the lung is influenced by multiple factors such as age, sex, height, weight, ethnicity and smoking status. Although a prediction equation for the diffusing capacity of Korea was proposed in the mid-1980s, this equation is not used currently. The aim of this study was to develop a new prediction equation for the diffusing capacity for Koreans. METHODS: Using the data of the Korean National Health and Nutrition Examination Survey, a total of 140 nonsmokers with normal chest X-rays were enrolled in this study. RESULTS: Using linear regression analysis, a new predicting equation for diffusing capacity was developed. For men, the following new equations were developed: carbon monoxide diffusing capacity (DLco)=−10.4433−0.1434×age (year)+0.2482×heights (cm); DLco/alveolar volume (VA)=6.01507−0.02374×age (year)−0.00233×heights (cm). For women the prediction equations were described as followed: DLco=−12.8895−0.0532×age (year)+0.2145×heights (cm) and DLco/VA=7.69516−0.02219×age (year)−0.01377×heights (cm). All equations were internally validated by k-fold cross validation method. CONCLUSION: In this study, we developed new prediction equations for the diffusing capacity of the lungs of Koreans. A further study is needed to validate the new predicting equation for diffusing capacity.


Assuntos
Monóxido de Carbono , Difusão , Feminino , Humanos , Coreia (Geográfico) , Modelos Lineares , Pulmão , Masculino , Métodos , Inquéritos Nutricionais , Capacidade de Difusão Pulmonar , Fumaça , Fumar , Tórax
13.
Korean Journal of Medicine ; : 482-486, 2018.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-717446

RESUMO

Human toxocariasis is a common helminthozoonosis due to the infestation of toxocara canis or toxocara cati larvae, and is a common cause of blood eosinophilia in Korea. Toxocariasis has various clinical manifestations depending on the involved organ, and cardiac involvement can range from asymptomatic to fulminant myocarditis with cardiogenic shock. Treatment of toxocariasis is based on corticosteroid and anthelmintic therapies. Here, we report a case of a 57-year-old male with eosinophilic myocarditis caused by toxocariasis as diagnosed via serial echocardiography follow up.


Assuntos
Ecocardiografia , Eosinofilia , Eosinófilos , Seguimentos , Humanos , Coreia (Geográfico) , Larva , Larva Migrans Visceral , Masculino , Pessoa de Meia-Idade , Miocardite , Choque Cardiogênico , Toxocara , Toxocara canis , Toxocaríase
14.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-766536

RESUMO

Acute exacerbation of chronic obstructive pulmonary disease (COPD) is defined as an acute aggravation of the patient's respiratory symptoms, particularly cough, sputum production, and dyspnea, which requires a change of medication. COPD exacerbation leads to an accelerated decline in lung function, poorer health status, and is the main cause of hospital admission and death in patients with COPD. A majority of COPD exacerbations are triggered by respiratory infection. The Management of acute exacerbation of COPD consists of systemic corticosteroids, antibiotics, and inhaled short-acting bronchodilators. Oxygen supplementation is an essential component of treatment to improve hypoxemia. Noninvasive or invasive ventilator support is necessary for COPD patients with severe exacerbation, particularly associated with hypercapnic respiratory failure. The Korean clinical practice guideline for COPD was revised in 2018 by the members of the Korean Academy of Tuberculosis and Respiratory Diseases as well as participating members of the Health Insurance Review and Assessment Service. The purpose of this review is to provide an overview of the treatment and prevention strategies recommended in the 2018 Korean Academy of Tuberculosis and Respiratory Diseases for patient with acute exacerbation of COPD.


Assuntos
Corticosteroides , Hipóxia , Antibacterianos , Broncodilatadores , Tosse , Dispneia , Humanos , Seguro Saúde , Pulmão , Oxigênio , Doença Pulmonar Obstrutiva Crônica , Insuficiência Respiratória , Escarro , Tuberculose , Ventiladores Mecânicos
15.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-714684

RESUMO

OBJECTIVE: To retrospectively assess conventional magnetic resonance imaging (MRI) features that differentiate malignant pure mesenchymal uterine tumors (MPMUT); endometrial stromal sarcoma (ESS) and leiomyosarcoma (LMS) from uterine leiomyoma with cystic degeneration (ULCD). METHODS: We retrospectively reviewed magnetic resonance (MR) images of 30 patients with ULCD, 18 with ESS, and 15 with LMS, to assess tumor location, margin, T2 signal intensity (SI), speckled appearance, and peripheral band using univariate and multivariate analyses. RESULTS: ULCD more frequently showed subserosal location (53.3%), well-defined margin (96.7%), and speckled appearance (90.0%) compared with ESS (0%, 33.3%, and 33.3%, respectively) or LMS (20.0%, 33.3%, and 60.0%, respectively). In quantitative T2 SI comparisons, the T2 SI ratio of the main solid tumor portion to gluteus maximus muscle differed significantly among the three groups, with ULCD showing a lower SI ratio (0.62) compared with ESS (2.44) and LMS (1.13). On multivariate analysis, an ill-defined margin (odds ratio [OR]=44.885; p=0.003) and high T2 SI (OR=4.396; p=0.046) were the significant MR differentiators. CONCLUSION: An ill-defined tumor margin and high T2 SI ratio of the main solid tumor-to-gluteus maximus muscle were useful MRI features in the differentiation of MPMUT from ULCD.


Assuntos
Humanos , Leiomioma , Leiomiossarcoma , Imagem por Ressonância Magnética , Análise Multivariada , Estudos Retrospectivos , Sarcoma do Estroma Endometrial
16.
Korean Journal of Radiology ; : 1099-1109, 2018.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-718939

RESUMO

OBJECTIVE: In a proof of concept study, we compared no-touch radiofrequency ablation (NtRFA) in bipolar mode with conventional direct tumor puncture (DTP) in terms of local tumor control (LTC), peritoneal seeding, and tumorigenic factors, in the rabbit VX2 subcapsular hepatic tumor model. MATERIALS AND METHODS: Sixty-two rabbits with VX2 subcapsular hepatic tumors were divided into three groups according to the procedure: DTP-RFA (n = 25); NtRFA (n = 25); and control (n = 12). Each of the three groups was subdivided into two sets for pathologic analysis (n = 24) or computed tomography (CT) follow-up for 6 weeks after RFA (n = 38). Ultrasonography-guided DTP-RFA and NtRFA were performed nine days after tumor implantation. LTC was defined by either achievement of complete tumor necrosis on histopathology or absence of local tumor progression on follow-up CT and autopsy. Development of peritoneal seeding was also compared among the groups. Serum hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) were measured via ELISA (Elabscience Biotechnology Co.) after RFA for tumorigenic factor evaluation. RESULTS: Regarding LTC, there was a trend in NtRFA (80%, 20/25) toward better ablation than in DTP-RFA (56%, 14/25) (p = 0.069). Complete tumor necrosis was achieved in 54.5% of DTP-RFA (6/11) and 90.9% of NtRFA (10/11). Peritoneal seeding was significantly more common in DTP-RFA (71.4%, 10/14) than in NtRFA (21.4%, 3/14) (p = 0.021) or control (0%). Elevations of HGF, VEGF or IL-6 were not detected in any group. CONCLUSION: No-touch radiofrequency ablation led to lower rates of peritoneal seeding and showed a tendency toward better LTC than DTP-RFA.


Assuntos
Autopsia , Biotecnologia , Ablação por Cateter , Ensaio de Imunoadsorção Enzimática , Seguimentos , Fator de Crescimento de Hepatócito , Interleucina-6 , Necrose , Punções , Coelhos , Fator A de Crescimento do Endotélio Vascular
17.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-717912

RESUMO

BACKGROUND: Obstructive airway disease patients with increased variability of airflow and incompletely reversible airflow obstruction are often categorized as having asthma–chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS). ACOS is heterogeneous with two sub-phenotypes: asthma-ACOS and COPD-ACOS. The objective of this study was to determine the difference in risk of exacerbation between the two sub-phenotypes of ACOS. METHODS: A total of 223 patients exhibiting incompletely reversible airflow obstruction with increased variability (spirometrically defined ACOS) were enrolled. These patients were divided into asthma-ACOS and COPD-ACOS according to their physician's diagnosis and smoking history of 10 pack-years. Within-group comparisons were made for asthma-ACOS versus COPD-ACOS and light smokers versus heavy smokers. RESULTS: Compared to patients with COPD-ACOS, patients with asthma-ACOS experienced exacerbation more often despite their younger age, history of light smoking, and better lung function. While the light-smoking group showed better lung function, they made unscheduled outpatient clinic visits more frequently. On multivariate analysis, asthma-ACOS and poor inhaler compliance were significantly associated with more than two unscheduled clinic visits during the previous year. CONCLUSION: Spirometrically defined ACOS includes heterogeneous subgroups with different clinical features. Phenotyping of ACOS by physician's diagnosis could be significant in predicting future risk of exacerbation.


Assuntos
Assistência Ambulatorial , Instituições de Assistência Ambulatorial , Asma , Complacência (Medida de Distensibilidade) , Diagnóstico , Humanos , Pulmão , Pneumopatias Obstrutivas , Análise Multivariada , Nebulizadores e Vaporizadores , Fenótipo , Doença Pulmonar Obstrutiva Crônica , Fumaça , Fumar
18.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-716614

RESUMO

BACKGROUND/AIMS: The most widely used method for diagnosing sarcopenia is the skeletal muscle index (SMI). Several studies have suggested that psoas muscle thickness per height (PMTH) is also effective for detecting sarcopenia and predicting prognosis in patients with cirrhosis. The aim of this study was to evaluate the optimal cutoff values of PMTH for detecting sarcopenia in cirrhotic patients. METHODS: All cirrhotic patients who underwent abdominal computed tomography (CT) scan including L3 and umbilical levels for measuring SMI and transverse psoas muscle thickness, respectively, were included. Two definitions of sarcopenia were used: (1) sex-specific cutoffs of SMI (≤52.4 cm² /m² in men and ≤38.5 cm² /m² in women) for SMI-sarcopenia and (2) cutoff of PMTH ( < 16.8 mm/m) for PMTH-sarcopenia. RESULTS: Six hundred fifty-three patients were included. The average age was 53.6 ± 10.2 years, and 499 patients (76.4%) were men. PMTH correlated well with SMI in both men and women (P < 0.001). Two hundred forty-one (36.9%) patients met the criteria for SMI-sarcopenia. The best PMTH cutoff values for predicting SMI-sarcopenia were 17.3 mm/m in men and 10.4 mm/m in women, and these were defined as sex-specific cutoffs of PMTH (SsPMTH). The previously published cutoff of PMTH was defined as sex-nonspecific cutoff of PMTH (SnPMTH). Two hundred thirty (35.2%) patients were diagnosed with SsPMTH-sarcopenia, and 280 (44.4%) patients were diagnosed with SnPMTH-sarcopenia. On a multivariate Cox regression analysis, SsPMTH-sarcopenia (hazard ratio [HR], 1.944; 95% confidence interval [CI], 1.144–3.304; P=0.014) was significantly associated with mortality, while SnPMTH-sarcopenia was not (HR, 1.446; 95% CI, 0.861–2.431; P=0.164). CONCLUSIONS: PMTH was well correlated with SMI in cirrhotic patients. SsPMTH-sarcopenia was an independent predictor of mortality in these patients and more accurately predicted mortality compared to SnPMTH-sarcopenia.


Assuntos
Diagnóstico , Feminino , Fibrose , Humanos , Cirrose Hepática , Fígado , Masculino , Métodos , Mortalidade , Músculo Esquelético , Prognóstico , Músculos Psoas , Sarcopenia
19.
Radiation Oncology Journal ; : 103-113, 2018.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-741943

RESUMO

PURPOSE: Anaplastic thyroid cancer (ATC) is a rare tumor with a lethal clinical course despite aggressive multimodal therapy. Intensity-modulated radiotherapy (IMRT) may achieve a good therapeutic outcome in ATC patients, and the role of IMRT should be assessed. We retrospectively reviewed outcomes for ATC treated with three-dimensional conformal radiotherapy (3D-CRT) or IMRT to determine the optimal treatment option and explore the role of radiotherapy (RT). MATERIALS AND METHODS: Between December 2000 and December 2015, 41 patients with pathologically proven ATC received RT with a sufficient dose of ≥40 Gy. Among them, 21 patients (51%) underwent surgery before RT. Twenty-eight patients received IMRT, and 13 received 3D-CRT. Overall survival (OS) and progression-free survival (PFS), patterns of failure, and toxicity were examined. RESULTS: The median follow-up time for survivors was 38.0 months. The median and 1-year OS and PFS rates were 7.2 months and 29%, 4.5 months and 15%, respectively. Surgery significantly improved the prognosis (median OS: 10.7 vs. 3.9 months, p = 0.001; median PFS: 5.9 vs. 2.5 months, p = 0.007). IMRT showed significantly better PFS and OS than 3D-CRT, even in multivariate analysis (OS: hazard ratio [HR] = 0.30, p = 0.005; PFS: HR = 0.33, p = 0.005). Significantly higher radiation dose could be delivered with IMRT than 3D-CRT (EQD210 66 vs. 60 Gy, p = 0.005). Only 2 patients had grade III dermatitis after IMRT. No other severe toxicity ≥grade III occurred. CONCLUSION: Patients with ATC showed better prognosis through multimodal treatment. Furthermore, IMRT could achieve favorable survival rates by safely delivering higher dose than 3D-CRT.


Assuntos
Terapia Combinada , Dermatite , Intervalo Livre de Doença , Seguimentos , Humanos , Análise Multivariada , Prognóstico , Radioterapia , Radioterapia Conformacional , Radioterapia de Intensidade Modulada , Estudos Retrospectivos , Taxa de Sobrevida , Sobreviventes , Carcinoma Anaplásico da Tireoide
20.
Hanyang Medical Reviews ; : 93-98, 2017.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-80742

RESUMO

Genomic medicine is to determine how an individual's DNA alteration can affect the risk of various diseases and to understand mechanisms and design targeted treatments. Here, we focus on how machine learning helps model the relationship between DNA and molecular phenotypes in a cell. Modern biology enables high throughput measurements of many cellular variables that can be handled as a training target for predictable models, such as gene expression, splicing, and protein binding to DNA or mRNA. With the increasing availability of large datasets and advanced computer skills such as deep learning, researchers have opened a new era in effective genomic medicine.


Assuntos
Biologia , Conjunto de Dados , DNA , Expressão Gênica , Genômica , Aprendizagem , Aprendizado de Máquina , Fenótipo , Ligação Proteica , RNA Mensageiro
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