• Title/Summary/Keyword: Cedars

Search Result 25, Processing Time 0.028 seconds

Endoscopic Suturing for the Prevention and Treatment of Complications Associated with Endoscopic Mucosal Resection of Large Duodenal Adenomas

  • Jaeil Chung;Kelly Wang;Alexander Podboy;Srinivas Gaddam;Simon K. Lo
    • Clinical Endoscopy
    • /
    • v.55 no.1
    • /
    • pp.95-100
    • /
    • 2022
  • Background/Aims: Endoscopic mucosal resection (EMR) is the primary treatment for duodenal adenomas; however, it is associated with a high risk of perforation and bleeding, especially with larger lesions. The goal of this study was to demonstrate the feasibility and safety of endoscopic suturing (ES) for the closure of mucosal defects after duodenal EMR. Methods: Consecutive adult patients who underwent ES of large mucosal defects after EMR of large (>2 cm) duodenal adenomas were retrospectively enrolled. The OverStitch ES system was employed for closing mucosal defects after EMR. Clinical outcomes and complications, including delayed bleeding and perforation, were documented. Results: During the study period, ES of mucosal defects was performed in seven patients in eight sessions (six for prophylaxis and two for the treatment of perforation). All ES sessions were technically successful. No early or delayed post-EMR bleeding was recorded. In addition, no clinically obvious duodenal stricture or recurrence was encountered on endoscopic follow-up evaluation, and no patients required subsequent surgical intervention. Conclusions: ES for the prevention and treatment of duodenal perforation after EMR is technically feasible, safe, and effective. ES should be considered an option for preventing or treating perforations associated with EMR of large duodenal adenomas.

Application of Quantitative Assessment of Coronary Atherosclerosis by Coronary Computed Tomographic Angiography

  • Su Nam Lee;Andrew Lin;Damini Dey;Daniel S. Berman;Donghee Han
    • Korean Journal of Radiology
    • /
    • v.25 no.6
    • /
    • pp.518-539
    • /
    • 2024
  • Coronary computed tomography angiography (CCTA) has emerged as a pivotal tool for diagnosing and risk-stratifying patients with suspected coronary artery disease (CAD). Recent advancements in image analysis and artificial intelligence (AI) techniques have enabled the comprehensive quantitative analysis of coronary atherosclerosis. Fully quantitative assessments of coronary stenosis and lumen attenuation have improved the accuracy of assessing stenosis severity and predicting hemodynamically significant lesions. In addition to stenosis evaluation, quantitative plaque analysis plays a crucial role in predicting and monitoring CAD progression. Studies have demonstrated that the quantitative assessment of plaque subtypes based on CT attenuation provides a nuanced understanding of plaque characteristics and their association with cardiovascular events. Quantitative analysis of serial CCTA scans offers a unique perspective on the impact of medical therapies on plaque modification. However, challenges such as time-intensive analyses and variability in software platforms still need to be addressed for broader clinical implementation. The paradigm of CCTA has shifted towards comprehensive quantitative plaque analysis facilitated by technological advancements. As these methods continue to evolve, their integration into routine clinical practice has the potential to enhance risk assessment and guide individualized patient management. This article reviews the evolving landscape of quantitative plaque analysis in CCTA and explores its applications and limitations.

A Study on Preservation Metadata Elements for Digital Information Resources (디지털 정보자원을 위한 보존 메타데이터 요소 설정 연구)

  • Hong Jae-Hyun
    • Journal of Korean Library and Information Science Society
    • /
    • v.35 no.3
    • /
    • pp.175-204
    • /
    • 2004
  • Digital information resource requires detailed metadata to ensure its long-term preservation and accessibility for future generations. This paper illuminated the characteristics of digital information resources, the concept of digital preservation and the necessity of metadata for long-term preservation of digital information resources. And this paper examined the 16 elements of RLG metadata for preserving digital information and the Reference Model for an Open Archival Information System(OATS) to support the interoperability of digital archiving. And then this study investigated concretely element sets of the preservation metadata for digital information resources in the Cedars and OCLC/RLG embodied within the OAIS framework. As result of the study, the paper suggested basic plan required to provide preservation metadata elements to preserve digital information resources in Korea.

  • PDF

Left Ventricular Ejection Fraction Determined by Gated Tl-201 Perfusion SPECT and Quantitative Software (게이트 Tl-201 관류 SPECT와 Cedars 소프트웨어를 이용하여 측정한 좌심실 구혈률)

  • Hyun, In-Young;Kim, Sung-Eun;Seo, Jeong-Kee;Hong, Eui-Soo;Kwan, Jun;Park, Keum-Soo;Lee, Woo-Hyung
    • The Korean Journal of Nuclear Medicine
    • /
    • v.34 no.3
    • /
    • pp.222-227
    • /
    • 2000
  • Purpose: We compared estimates of ejection fraction (EF) determined by gated Tl-201 perfusion SPECT (g-Tl-SPECT) with those by gated blood pool (GBP) scan. Materials and Methods: Eighteen subjects underwent g-Tl-SPECT and GBP scan. After reconstruction of g-Tl-SPECT, we measured EF with Cedars software. The comparison of the EF with g-Tl-SPECT and GBP scan was assessed by correlation analysis and Bland Altman plot. Results: The estimates of EF were significantly different (p<0.05) with g-Tl-SPECT ($40%{\pm}14%$) and GBP scan ($43%{\pm}14%$). There was an excellent correlation of EF between g-Tl-SPECT and GBP scan (r=0.94, p<0.001). The mean difference of EF between GBP scan and g-Tl-SPECT was +3.2% Ninety-five percent limits of agreement were ${\pm}9.8%$. EF between g-Tl-SPECT and GBP scan were in poor agreement. Conclusion: The estimates of EF by g-Tl-SPECT was well correlated with those by GBP scan. However, EF of g-Tl-SPECT doesn't agree with EF of GBP scan. EF of g-Tl-SPECT can't be used interchangeably with EF of GBP scan.

  • PDF

DNA Microarray Analysis of Immediate Response to EGF Treatment in Rat Schwannoma Cells

  • OH, Min-Kyu;Scoles, Daniel R.;Pulst, Stefan-M.
    • Biotechnology and Bioprocess Engineering:BBE
    • /
    • v.10 no.5
    • /
    • pp.444-450
    • /
    • 2005
  • Epidermal growth factor (EGF) activates many intracellular effector molecules, which subsequently influence the expression levels of many genes involved in cell growth, apoptosis and signal transduction, etc. In this study, the early response of gene expressions due to EGF treatment was monitored using oligonucleotide DNA microarrays in rat schwannoma cell lines. An immunoblotting experiment showed the successful activation of EGF receptors and an effector protein, STAT5, due to EGF treatment. The microarray study showed that 35 genes were significantly induced and 2 were repressed within 60 min after the treatment. The list of induced genes included early growth response 1, suppressor of cytokine signaling 3, c-fos, interferon regulatory factor 1 and early growth response 2, etc. According to the microarray data, six of these were induced by more than 10-fold, and showed at least two different induction patterns, indicating complicated regulatory mechanisms in the EGF signal transduction.

Three-Dimensional Video Microscopy: Potential for Improved Ergonomics without Increased Operative Time?

  • Yasmina Samaha;Edward Ray
    • Archives of Plastic Surgery
    • /
    • v.50 no.1
    • /
    • pp.125-129
    • /
    • 2023
  • Three-dimensional (3D) video exoscopes are high-magnification stereo cameras that project onto monitors mounted in the operating room, viewable from different angles. Outside of plastic surgery, exoscopes have been shown to successfully improve the ergonomics of microsurgery, though sometimes with prolonged operating times. We compare a single surgeon's early experience performing free flap procedures from 2020 to 2021 using either a binocular microscope or a 3D video exoscope. Ten procedures were performed with the standard operating microscope and 8 procedures with the 3D exoscope. The microsurgeon, having minimal prior experience using an exoscope, reported less neck discomfort following the free flap procedures performed with the exoscope compared with the binocular surgical microscope. Total average operating time was comparable between the standard surgical microscope and the 3D exoscope (13.7 vs. 13.4 hours, p = 0.34). Our early experience using a 3D exoscope in place of a standard optical microscope demonstrated that the exoscope shows promise, offering an ergonomic alternative during microvascular reconstruction without increasing overall operating times. Future studies will compare free flap ischemia time between cases performed using the exoscope and the conventional binocular microscope. Medical Subject Headings authorized following words: free tissue flaps; operating rooms; ergonomics; microsurgery.

Reproducibility of the Assessment of Myocardial Function Using Gated Tc-99m-MIBI SPECT and Quantitative Software (게이트 Tc-99m-MIBI SPECT와 Cedars 소프트웨어를 이용한 심근 기능 측정의 재현성)

  • Lee, Dong-Soo;Cheon, Gi-Jeong;Ahn, Ji-Young;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
    • /
    • v.32 no.5
    • /
    • pp.403-413
    • /
    • 1998
  • Purpose: We investigated reproducibility of the quantification of left ventricular volume and ejection fraction, and grading of myocardial wall motion and systolic thickening when we used gated myocardial SPECT and Cedars quantification software. Materials and Methods: We performed gated myocardial SPECT in 33 consecutive patients twice in the same position after Tc-99m-MIBI SPECT We used 16 frames per cycle for the gating of sequential Tc-99m-MIBI SPECT. After reconstruction, we used Cedars quantitative gated SPECT and calculated ventricular volume and ejection fraction (EF). Wall motion was graded using 5 point score. Wall thickening was graded using 4 point score. Coefficient of variation for re-examination of volume and fraction were calculated. Kappa values (k-value) for assessing reproducibility of wall motion or wall thickening were calculated. Results: Enddiastolic volumes (EDV) ranged from 58 ml to 248 ml (122 ml +/- 42 ml), endsystolic volumes (ESV) from 20 ml to 174 ml (65 ml +/- 39 ml), and EF from 20% to 65% (51% +/- 14%). Geometric mean of standard deviations of 33 patients was 5.0 ml for EDV, 3.9 ml for ESV and 1.9% for EF. Their average differences were not different from zero (p>0.05). k-value for wall motion using 2 consecutive images was 0.76 (confidence interval: 0.71-0.81). k-value was 0.87 (confidence interval: 0.83-0.90) for assessment of wall thickening. Conclusion: We concluded that quantification of functional indices, assessment of wall motion and wall thickening using gated Tc-99m-MIBI SPECT was reproducible and we could use this method for the evaluation of short-acting drug effect.

  • PDF

Differences in Incidence, Mortality and Survival of Breast Cancer by Regions and Countries in Asia and Contributing Factors

  • Kim, Yeonju;Yoo, Keun-Young;Goodman, Marc T
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.16 no.7
    • /
    • pp.2857-2870
    • /
    • 2015
  • Although the incidence of breast cancer in Asia remains lower than in North America, Western Europe, and Oceania, rates have been increasing rapidly during the past few decades, and Asian countries now account for 40% of breast cancer cases diagnosed worldwide. Breast cancer mortality has also increased among Asian women, in contrast to decreased mortality in Northern America, Western Europe, and Oceania. These increased rates are associated with higher prevalence of breast cancer risk factors (e.g., reduced parity, delayed childbirth, increased obesity) that have accompanied economic development throughout the region. However, Asian regions (western, south-central, south-eastern, and eastern) and countries differ in the types and magnitude of changes in breast cancer risk factors, and cannot be viewed as a single homogeneous group. The objective of this paper was to contrast the heterogeneous epidemiology of breast cancer by Asian regions and countries, and to suggest potential avenues for future research.