• Title/Summary/Keyword: Radiographic progression

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Abiraterone for Treatment of Metastatic Castration-resistant Prostate Cancer: a Systematic Review and Meta-analysis

  • Zhou, Zhi-Rui;Liu, Shi-Xin;Zhang, Tian-Song;Xia, Jun;Li, Bo
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.3
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    • pp.1313-1320
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    • 2014
  • Introduction: Although most prostate cancers initially respond to castration with luteinizing hormonereleasing analogues or bilateral orchiectomy, progression eventually occurs. Based on the exciting results of several randomized controlled trials (RCTs), it seems that patients with metastatic castration-resistant prostate cancer (mCRPC) might benefit more from treatment withabiraterone. Therefore we conducted a systematic review to evaluate the efficacy and toxicity of abiraterone in the treatment of mCRPC. Methods: Literature was searched from Embase, PubMed, Web of Science, and Cochrane Library up to July, 2013. Quality of the study was evaluated according to the Cochrane's risk of bias of randomized controlled trial (RCT) tool, then the Grading of Recommendations Assessment, Development and Evaluation (GRADE) System was used to rate the level of evidence. Stata 12.0 was used for statistical analysis. Summary data from RCTs comparing abiraterone plus prednisone versus placebo plus prednisone for mCRPC were meta-analyzed. Pooled hazard ratios (HRs) for overall survival (OS), radiographic progression-free survival (RPFS) and time to PSA progression (TTPP); Pooled risk ratios (RR) for PSA response rate, objective response rate and adverse event were calculated. Results: Ten trials were included in the systematic review; Data of 2,283 patients (1,343 abiraterone; 940 placebo) from two phase 3 trials: COU-AA-301 and COU-AA-302 were meta-analyzed. Compared with placebo, abiraterone significantly prolonged OS (HR, 0.74; 95% confidence interval [CI], 0.66 to 0.84), RPFS (HR, 0.59; 95% CI, 0.48 to 0.74) and time to PSA progression (HR, 0.55; 95% CI, 0.43 to 0.70); it also significantly increased PSA response rate (RR, 3.63; 95% CI, 1.72 to 7.65) and objective response rate (RR, 3.05; 95% CI, 1.51 to 6.15). This meta-analysis suggested that the adverse events caused by abiraterone are acceptable and can be controlled. Conclutios: Abiraterone significantly prolonged OS, RPFS and time to progression patients with mCRPC, regardless of prior chemotherapy or whether chemotherapy-na$\ddot{i}$ve, and no unexpected toxicity was evident. Abiraterone can serve as a new standard therapy for mCRPC.

A new classification of periodontal and peri-implant disease (치주질환 및 임플란트 주위 질환의 새 분류)

  • Shin, Hyun-Seung
    • The Journal of the Korean dental association
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    • v.57 no.12
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    • pp.758-767
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    • 2019
  • The classification of periodontal disease in 1999 has been widely used for determining a diagnosis, establishing a treatment plan, and evaluating the prognosis of the patient with periodontal disease. However, scientific evidence from many studies indicates the need for a new classification system for periodontal and peri-implant disease. Summary at 2017 world workshop as follows: 1) Periodontal health and peri-implant health was defined; 2) Chronic periodontitis and aggressive periodontitis were unified as periodontitis; 3) Periodontitis was further classified by staging and grading to reflect disease severity and management complexity, rate of disease progression, respectively; 4) Periodontal disease as manifestation of systemic disease is based on the International Statistical Classification of Diseases and Related Health Problems-10 (ICD-10) code; 5) Periodontal biotype and biologic width was replaced to periodontal phenotype and supracrestal tissue attachment, respectively; 6) The excessive occlusal force was replaced by a traumatic occlusal force; 7) ≥3 mm of radiographic bone loss, ≥6 mm of pocket probing depth and bleeding on probing indicates peri-implantitis in the absence of radiograph at final prosthesis delivery.

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Chronic Mitral Valvular Insufficiency in Dogs (개에서의 만성 승모판 부전증)

  • 최호정;장동우;서민호;정주현;정우조;원성준;장진화;이기창;이희천
    • Journal of Veterinary Clinics
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    • v.18 no.3
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    • pp.273-278
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    • 2001
  • Chronic mitral valvular insufficiency (CMVI) is the most common heart disease in dogs. The prevalence of CMVI is age-dependent. CMVI is usually affected to small to medium size breeds. It is more prevalent in males than females. The characteristic lesions of CMVI are caused by an acquired chronic structural degeneration of the mitral valve defined as endocardiosis or myxomatous degeneration. The main clinical signs are cough, respiratory distress, weakness and pleural effusion and ascites by secondary right-sided heart failure. The most prominent clinical finding is a systolic heart murmur. The thoracic radiography and echocardiography are useful methods in diagnosis of CMVI. Thoracic radiographic findings are left atrial enlargement, left main stem bronchial compression and pulmonary edema. Echocardiography is confirmed to increased left atrial and ventricular dimension, mitral regurgitation, mitral valve thickening and abnormal movement. Thoracic radiography and echocardiography are used to obtain a definite diagnosis of CMVI, and then to study the progression of the condition.

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MAXILLOFACIAL INFECTIONS MASQUERADING AS MALIGNANT TUMOR ; CASE REPORTS (악성종양과 감별이 어려웠던 악안면 영역의 감염질환에 대한 치험례)

  • Seo, Jae-Hoon;Yeo, Hwan-Ho;Kim, Young-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.3
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    • pp.302-308
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    • 1995
  • It is very difficult to differentiate the malignant tumor from the maxillofacial infections that have unclear cause, severe indurated swelling, pain and nonresponsiveness to antibioitic treatment and incision and drainage. Incisional biopsy, CT, and MRI examination may not distinguish between infection and a malignant tumors. And then, the clinicians can make a mistake that they perform a unnecessary radical surgery because of inaccurate diagnosis. We present three case reports of maxillofacial infectious disease with diagnosis process, treatment and differential diagnosis. The infectious disease were not resolved with antibiotic and surgical drainage. The progression of clinical sign and radiographic, indings of these disease were masqueraded as malignant tumors.

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Clinical investigation of bisphosphonate-related osteonecrosis of the jaws in patients with malignant tumors

  • Kim, Sei-Kyoung;Kwon, Tae-Geon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.3
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    • pp.152-159
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    • 2012
  • Objectives: This study evaluated bisphosphonate-related osteonecrosis of the jaws (BRONJ) in patients diagnosed with malignant bone tumors. Demographic findings, laboratory, and radiographic analyses were performed to characterize disease severity and progression. Materials and Methods: Patients who had been diagnosed with BRONJ (2005-2010) at the authors' hospital according to the American Association of Oral and Maxillofacial Surgeons were investigated. Twenty-one patients (12 with multiple myelomas, 7 with breast cancer, and 2 with prostate cancer) who had been treated with bisphosphonates (BPs) for malignant bone tumors were included. Radiographic evaluations with a panorama, computed tomography, whole body bone scan, and laboratory findings were evaluated for erythrocyte sedimentation rate (ESR), c-reactive proteins (CRPs), and c-terminal cross-linked telopeptides (CTXs). Results: The average age of the patients was 64.3 (range 51-80), and they were treated with BPs for an average of $35{\pm}19$ months before BRONJ was diagnosed. Types of BPs were zolendronic acid (81%, intravenous [IV]), pamidronate (4.8%, IV), zoledronic acid+pamidronate (4.8%, IV), alendronate (4.8%, per os [PO]), and ibadronate (4.75%, PO). Extraction (67%) and persistent irritation of dentures (20%) were the most common triggering factors. BRONJ in the mandible was reported in 62% of the cases, in the maxilla 24%, and both 14%. BRONJ occurred more frequently in patients with multiple myelomas (n=12, 57.1%). Most of the patients revealed an advanced BRONJ stage; Stage I (n=2, 9%), Stage II (n=13, 62%), and Stage III (n=6, 29%). Conclusion: The differences of the ESR, CRP, and CTX values between the BRONJ-recurring and non-recurring patients after the treatment were not evident. Later stage BRONJ patients showed lower CTX levels. A drug holiday after the diagnosis of BRONJ did not remarkably influence the surgical outcomes. However, the limited number of patients in the study should be considered.

Postoperative Valgus Deformity and Progression of Ostheoarthritis in Non-Displaced Femoral Neck Fractures

  • Hyungtae Kim;Ji Su Kim;Yerl Bo Sung
    • Hip & pelvis
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    • v.35 no.4
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    • pp.259-267
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    • 2023
  • Purpose: Nondisplaced femoral neck fractures have traditionally been treated with in situ fixation. However, poor surgical and clinical outcomes have been reported for fractures with valgus deformity >15°, and the reduction of valgus impaction has recently been emphasized. In addition, early degenerative osteoarthritis can be caused by cam-type femoroacetabular impingement after healing of femoral neck fractures. This study was designed with the objective of confirming the difference in progression of radiographic osteoarthritis according to the severity of the valgus deformity. Materials and Methods: Patients who underwent internal fixation using multiple cannulateld screws for management of nondisplaced femoral neck fractures were divided into two groups: high valgus group (postoperative valgus angle ≥15°) and low valgus group (postoperative valgus angle <15°). Evaluation of demographic data and changes in the joint space width from the immediate postoperative period to the latest follow-up was performed. Results: A significant decrease in joint space width in both hip joints was observed in the high valgus group when compared with the low valgus group, including cases with an initial valgus angle less than 15° and those corrected to less than 15° of valgus by reduction. No complications requiring surgical treatment were observed in either group; however, two cases of avascular necrosis, one in each group, which developed in the low valgus group after reduction of the fracture, were followed for observation. Conclusion: Performing in situ fixation in cases involving a valgus deformity ≥15° in non-displaced femoral neck fractures may cause accelerated narrowing of the hip joint space.

EARLY CARIES DETECTION WITH DIGITAL IMAGING FIBER-OPTIC TRANS-ILLUMINATION (Digital Imaging Fiber-Optic Trans-Illumination을 이용한 초기우식의 탐지)

  • Lee, Jun-Seok;Kim, Jong-Soo;Yoo, Seung-Hoon
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.3 no.2
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    • pp.87-90
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    • 2007
  • It's important that detect early caries of deciduous and permanent teeth to prevent dental caries and prevserve teeth, especially on proximal surface of deciduous teeth. The reason is that their prominent pulp horn lead to pulp treatment easily due to rapid caries progression. There are conventional exploring, visual inspection and radiographic exam for early caries detection. But, the standard method for diagnosing dental caries is subject and cavitation may be accelerated during exploring procedure. Caries can be diagnosed up to 40% mineral loss with radiograph. $DIFOTI^{(R)}$ (Digital Imaging Fiber-Optic TransIllumination) is diagnostic imaging system for early caries detection using fiber-optic illumination. It is possible that remineralize the tooth surface without tooth preparation and conserve the tooth structure by using $DIFOTI^{(R)}$.

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Fibrous dysplasia of the maxilla in an elderly female: Case report on a 14-year quiescent phase

  • Lee, Byung-Do;Lee, Wan;Park, Yong-Chan;Kim, Myoung-Hyoun;Choi, Moon-Ki;Yoon, Jung-Hoon
    • Imaging Science in Dentistry
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    • v.46 no.4
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    • pp.259-265
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    • 2016
  • Fibrous dysplasia (FD) is an uncommon skeletal disorder in which normal bone is replaced by abnormal fibro-osseous tissue. Mainly, FD is found in children, and by adulthood it usually becomes quiescent. Our case showed FD of more than 14-year duration in the left maxilla. Our evaluation was that growth ceased in adulthood and had achieved the static stage. Because FD cases in elderly patients are rarely reported, we hereby present a monostotic FD case in a 65-year-old female. We presented sequential radiographic images and scintigraphic images of this case, and combined them with a literature review that emphasized the progression of the disease.

3-D CT Imaging of Pathological Bone Changes in a Rat Model of Adjuvant-Induced Arthritis

  • Shim, Kyung-Mi;Kim, Se-Eun;Kang, Seong-Soo
    • Journal of the Korean Society of Radiology
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    • v.2 no.4
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    • pp.41-46
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    • 2008
  • Computed tomography (CT) is a medical imaging method employing tomography. CT is a 3-Dimensional (3-D) radiographic imaging technique, which is not suited for assessment of inflammation, but can be considered a reference method for assessment of bone damage, due to its direct 3-D visualization of calcified tissue. In this study of pathological joint changes in a rat model of adjuvant-induced arthritis (AIA) and quality analysis of bone destructions were performed by 3-Dimensional computed tomography images. These data demonstrate that the destructive progression of disease in a rat AIA model can be quantified using 3-D CT image analysis, which allows assessment of arthritic disease status and efficacy of experimental therapeutic agents.

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A Reappraisal of the Necessity of a Ventriculoperitoneal Shunt After Decompressive Craniectomy in Traumatic Brain Injury

  • Yu, Seunghan;Choi, Hyuk Jin;Lee, Jung Hwan;Ha, Mahnjeong;Kim, Byung Chul
    • Journal of Trauma and Injury
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    • v.33 no.4
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    • pp.236-241
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    • 2020
  • The goal of this study was to evaluate the hypothesis that not every patient with hydrocephalus after decompressive craniectomy needs cerebrospinal fluid diversion, and that cranioplasty should be performed before considering cerebrospinal fluid diversion. Methods: Data were collected from 67 individual traumatic brain injury patients who underwent cranioplasty between January 1, 2019 and December 31, 2019. Patients' clinical and radiographic progression was reviewed retrospectively based on their medical records. Results: Twenty-two of the 67 patients (32.8%) had ventriculomegaly on computed tomography scans before cranioplasty. Furthermore, 38 patients showed progressive ventriculomegaly after cranioplasty. Of these 38 patients, only six (15.7%) showed worsening neurologic symptoms, which were improved by the tap test; these patients eventually underwent ventriculoperitoneal shunt placement. Conclusions: Cerebrospinal fluid diversion is not always required for radiologically diagnosed ventriculomegaly in traumatic brain injury patients after decompressive craniectomy. A careful clinical and neurologic evaluation should be conducted before placing a shunt.