• Title/Summary/Keyword: Long-Term Follow-Up

Search Result 1,446, Processing Time 0.022 seconds

The Extended Indications of Endoscopic Submucosal Dissection (ESD) for Early Gastric Cancer Are Thus Not Entirely Safe

  • Lee, Ju-Hee;Kim, Hyung-Ho
    • Journal of Gastric Cancer
    • /
    • v.10 no.3
    • /
    • pp.87-90
    • /
    • 2010
  • Early gastric cancer (EGC) is defined as tumor invasion confined to the mucosa or submucosa, regardless of the presence of regional lymph node metastasis. Lymph node metastasis is the most powerful and important prognostic factor for gastric cancer. Based on the risk of lymph node metastasis in EGC obtained from a large number of surgical cases in Japan, it was suggested that the criteria for endoscopic mucosal resection (EMR) and endoscopic submucosal resection (ESD) as local treatment for EGC might be extended. However, extending the indications for EMR and ESD remains controversial because the long-term outcomes of these procedures have not been fully documented, and there is a risk for lymph node metastasis. Furthermore, current diagnostic imaging techniques are unsatisfactory for accurately predicting metastasis to lymph nodes. Moreover, the long-term results of standard radical gastrectomy including minimally invasive procedures for stage IA have been increasing and have reached 99 to 100%. To determine the true efficacy of endoscopic resection of EGC, we need more evidence of long-term follow-up, standardization of techniques, and pathological interpretation.

Long-Term Follow-Up Ultrasonographic Findings of Intrathyroidal Thymus in Children

  • Yun-Woo Chang;Hee Min Kang;Eun Ji Lee
    • Korean Journal of Radiology
    • /
    • v.21 no.11
    • /
    • pp.1248-1255
    • /
    • 2020
  • Objective: To analyze long-term follow-up sonographic findings of intrathyroidal thymus in children. Materials and Methods: Among 1259 patients with congenital hypothyroidism under 15 years of age who underwent thyroid ultrasonography (US), 41 patients were diagnosed with an intrathyroidal thymus based on US criteria, i.e., hypoechoic solid lesion with punctate and linear echogenicity. In 26 patients aged one to 14 years old, the last follow-up US was performed after 6 to 132 months and compared with the initial US. The lesion was considered to decrease in size if there was a change of more than 2 mm in any dimension. The margin change was divided into well-defined and indistinct, blurred. When the echogenicity changed to a hyperechoic from a characteristic thymic echogenicity pattern, the pattern was considered a hyperechogenic. The changes in size were compared with the changes in shape, margin, and echogenicity pattern. The changes in size, shape, margin, and echogenicity were analyzed the association with the age of last follow-up. Statistical analysis was conducted using the chi-squared test and logistic regression. Results: Fifteen (57.7%) cases were stable in size, and 11 (42.3%) decreased in size, including one that disappeared. Ten (38.5%) cases changed to indistinct margins from initially well-defined margins including one case of initially indistinct margin. Six (23.1%) changed to hyperechogenic, from initially characteristic thymic echogenicity patterns. When follow-up change was compared, decreases in size were significantly associated with lesion changes to indistinct margins (p = 0.004). The age at last follow-up was significantly associated with change to hyperechogenicity (odd ratio, 2.141; 95% confidence interval, 1.144-4.010, p = 0.017). Conclusion: On follow-up US, an intrathyroidal thymus may be decreased in size, with indistinct margins, or show changes to a hyperechoic mass. Decreases in size may be associated with changing to indistinct margins, and changes to hyperechogenicity may be associated with increasing age.

A Review on the Follow-up Study of the Refractive Surgeries (굴절교정수술에 대한 follow-up Study Review)

  • Jung Se-yeon;Kim Yoon-bum
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
    • /
    • v.17 no.2
    • /
    • pp.170-176
    • /
    • 2004
  • Refractive surgeries for myopia are rapidly spreading in our daily lives. In this study Korean and foreign follow-up studies, mainly focused on long-term outcomes of LASIK and LASEK, were analyzed. Examining the evidence of the efficacy, accuracy, stability, complications and patient satisfaction will help refine our approach to refractive surgeries.

  • PDF

The Physical Environment and Behavioral·Psychological Health and Quality of Life for the Elderly People with Dementia - A Follow-up Study of Empirical Research, conducted on the Context of Long-term Care Facilities for the Elderly People with Dementia, to Identify Healing Environmental Factors and to Expand the Understanding of Related Clinical Outcomes (물리적 환경과 치매거주노인의 행동·심리적 건강과 삶의 질 - 노인요양시설 치유환경 디자인 요소 도출과 연계된 중재적 의료성과의 이해확장을 위한 후속연구)

  • Choi, Young-Seon
    • Journal of The Korea Institute of Healthcare Architecture
    • /
    • v.29 no.4
    • /
    • pp.7-20
    • /
    • 2023
  • Purpose: The main purpose of this paper is to assess a body of research evidence that articulates the impact of physical and environmental factors on behavioral·psychological health and quality of life for the elderly people with dementia who reside in long-term care facilities. This follow-up study of the previous literature review aims to further identify physical and environmental factors, that improve health and quality of life for the elderly people with dementia, published in recent five years and to expand the understanding of clinical outcomes as mechanism that mediate the effect of physical environmental factors on improving behavioral·psychological health and quality of life for the elderly people with dementia. Methods: Comprehensive literature review has been conducted to identify empirical studies that link the design of dementia care facilities to health- and quality of care(QOL)-related outcomes and this follow-up review scrutinized peer-reviewed articles published in recent five years (from January 2018 to December 2022), filling the gap between the previous literature review and the current state of research. Results: The review identified a growing body of literature that articulates environment-related factors that improve behavioral·psychological health and quality of life for the elderly people with dementia living long-term care facilities. Implications: The findings of the review can be translated to design implications and design decisions to promote psychological and behavioral health and quality of life of people with dementia in long-term care facilities.

Endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma: long-term follow-up in a Western center

  • Andreas Probst;Alanna Ebigbo;Stefan Eser;Carola Fleischmann;Tina Schaller;Bruno Markl;Stefan Schiele;Bernd Geissler;Gernot Muller;Helmut Messmann
    • Clinical Endoscopy
    • /
    • v.56 no.1
    • /
    • pp.55-64
    • /
    • 2023
  • Background/Aims: Endoscopic submucosal dissection (ESD) has been established as a treatment modality for superficial esophageal squamous cell carcinoma (ESCC). Long-term follow-up data are lacking in Western countries. The aim of this study was to analyze long-term survival in a Western center. Methods: Patients undergoing ESD for ESCC were included. The analysis was performed retrospectively using a prospectively collected database. Results: R0 resection rate was 96.7% (59/61 lesions in 58 patients). Twenty-seven patients (46.6%) fulfilled the curative resection criteria (M1/M2) (group A), 11 patients (19.0%) had M3 lesions without lymphovascular invasion (LVI) (group B), and 20 patients (34.5%) had lesions with submucosal invasion or LVI (group C). Additional treatment was recommended after non-curative resection. It was not performed in 20/31 patients (64.5%), mainly because of comorbidities (75%). Twenty-nine out of 58 (50.0%) patients died during a mean follow-up of 3.7 years. Death was related to ESCC in 17.2% (5/29) of patients. The disease-specific survival rate after curative resection was 100%. Overall survival rates after 5 years were 61.5%, 63.6% and 28.1% for groups A, B, and C, respectively. The overall survival was significantly worse after non-curative resection (p=0.038). Conclusions: Non-curative resection is frequent after ESD for ESCC in Western patients. The long-term prognosis is limited and mainly determined by comorbidity. Early diagnosis and pre-interventional assessments need to be improved.

Long-Term Follow-Up Radiologic and Clinical Evaluation of Cylindrical Cage for Anterior Interbody Fusion in Degenerative Cervical Disc Disease

  • Kim, Su-Hyeong;Chun, Hyoung-Joon;Yi, Hyeon-Joong;Bak, Koang-Hum;Kim, Dong-Won;Lee, Yoon-Kyoung
    • Journal of Korean Neurosurgical Society
    • /
    • v.52 no.2
    • /
    • pp.107-113
    • /
    • 2012
  • Objective : Various procedures have been introduced for anterior interbody fusion in degenerative cervical disc disease including plate systems with autologous iliac bone, carbon cages, and cylindrical cages. However, except for plate systems, the long-term results of other methods have not been established. In the present study, we evaluated radiologic findings for cylindrical cervical cages over long-term follow up periods. Methods : During 4 year period, radiologic findings of 138 patients who underwent anterior cervical fusion with cylindrical cage were evaluated at 6, 12, 24, and 36 postoperative months using plain radiographs. We investigated subsidence, osteophyte formation (anterior and posterior margin), cage direction change, kyphotic angle, and bone fusion on each radiograph. Results : Among the 138 patients, a minimum of 36 month follow-up was achieved in 99 patients (mean follow-up : 38.61 months) with 115 levels. Mean disc height was 7.32 mm for preoperative evaluations, 9.00 for immediate postoperative evaluations, and 4.87 more than 36 months after surgery. Osteophytes were observed in 107 levels (93%) of the anterior portion and 48 levels (41%) of the posterior margin. The mean kyphotic angle was $9.87^{\circ}$ in 35 levels showing cage directional change. There were several significant findings : 1) related subsidence [T-score (p=0.039) and anterior osteophyte (p=0.009)], 2) accompanying posterior osteophyte and outcome (p=0.05). Conclusion : Cage subsidence and osteophyte formation were radiologically observed in most cases. Low T-scores may have led to subsidence and kyphosis during bone fusion although severe neurologic aggravation was not found, and therefore cylindrical cages should be used in selected cases.

Long-Term Follow-Up Result of Hydroxyurea Chemotherapy for Recurrent Meningiomas

  • Kim, Min-Su;Yu, Dong-Woo;Jung, Young-Jin;Kim, Sang Woo;Chang, Chul-Hoon;Kim, Oh-Lyong
    • Journal of Korean Neurosurgical Society
    • /
    • v.52 no.6
    • /
    • pp.517-522
    • /
    • 2012
  • Objective : Meningiomas represent 18-20% of all intracranial tumors and have a 20-50% 10-year recurrence rate, despite aggressive surgery and irradiation. Hydroxyurea, an inhibitor of ribonucleotide reductase, is known to inhibit meningioma cells by induction of apoptosis. We report the long-term follow-up result of hydroxyurea therapy in the patients with recurrent meningiomas. Methods : Thirteen patients with recurrent WHO grade I or II meningioma were treated with hydroxyurea (1000 $mg/m^2/day$ orally divided twice per day) from June 1998 to February 2012. Nine female and 4 male, ranging in age from 32 to 83 years (median age 61.7 years), were included. Follow-up assessment included physical examination, computed tomography, and magnetic resonance imaging (MRI). Standard neuro-oncological response criteria (Macdonald criteria) were used to evaluate the follow-up MRI scans. The treatment was continued until there was objective disease progression or onset of unmanageable toxicity. Results : Ten of the 13 patients (76.9%) showed stable disease after treatment, with time to progression ranging from 8 to 128 months (median 72.4 months; 6 patients still accruing time). However, there was no complete response or partial response in any patients. Three patients had progressive disease after 88, 89, 36 months, respectively. There was no severe (Grade III-IV) blood systemic disorders and no episodes of non-hematological side effects. Conclusion : This study showed that hydroxyurea is a modestly active agent against recurrent meningiomas and can induce long-term stabilization of disease in some patients. We think that hydroxyurea treatment is well tolerated and convenient, and could be considered as an alternative treatment option in patients with recurrent meningiomas prior to reoperation or radiotherapy.