• 제목/요약/키워드: Success rates

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림프종 환자의 비외상성 유미흉에서 폐림프종의 피부경유 직접천자를 통한 색전술 (Direct Percutaneous Needle Puncture and Intrapulmonary Lymphatic Embolization for Treatment of Chylothorax in a Patient with Lymphoma)

  • 황보리;권훈;전창호;김창원
    • 대한영상의학회지
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    • 제81권5호
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    • pp.1222-1226
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    • 2020
  • 림프종은 비외상성 유미흉의 원인 중 높은 빈도를 차지한다. 문헌에 따르면 비외상성 유미흉에 대해서 흉관 색전술을 시행할 경우 외상성 유미흉의 경우에 비해 치료성적이 낮은 것으로 알려져 있다. 이 논문에서는 비외상성 유미흉이 있던 림프종 환자에서 흉관 색전술을 시행하고, 추가적으로 피부경유 종양 직접 천자 색전술을 시행하여 좋은 결과를 얻었기에 이에 대한 증례를 보고하고자 한다. 본 증례는 77세 남자 환자로 림프종에 동반된 유미흉을 치료하기 위해 흉관 색전술을 시행 받았고 그 후 유미흉의 양이 줄어들었으나 지속되는 흉막삼출을 호소하였다. 이에 피부경유로 폐를 침범한 림프종을 직접 천자하여 이차 색전술을 시행하였고, 이후 흉막삼출이 호전되어 성공적으로 흉관을 제거하였다. 이 시술은 림프종과 동반된 유미흉이 있는 경우에 시행할 수 있는 새로운 치료 선택지라 할 수 있다.

Commensal Microbiota and Cancer Immunotherapy: Harnessing Commensal Bacteria for Cancer Therapy

  • Jihong Bae; Kwangcheon Park;You-Me Kim
    • IMMUNE NETWORK
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    • 제22권1호
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    • pp.3.1-3.21
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    • 2022
  • Cancer is one of the leading causes of death worldwide and the number of cancer patients is expected to continuously increase in the future. Traditional cancer therapies focus on inhibiting cancer growth while largely ignoring the contribution of the immune system in eliminating cancer cells. Recently, better understanding of immunological mechanisms pertaining to cancer progress has led to development of several immunotherapies, which revolutionized cancer treatment. Nonetheless, only a small proportion of cancer patients respond to immunotherapy and maintain a durable response. Among multiple factors contributing to the variability of immunotherapy response rates, commensal microbiota inhabiting patients have been identified as one of the most critical factors determining the success of immunotherapy. The functional diversity of microbiota differentially affects the host immune system and controls the efficacy of immunotherapy in individual cancer patients. Moreover, clinical studies have demonstrated that changing the gut microbiota composition by fecal microbiota transplantation in patients who failed a previous immunotherapy converts them to responders of the same therapy. Consequently, both academic and industrial researchers are putting extensive efforts to identify and develop specific bacteria or bacteria mixtures for cancer immunotherapy. In this review, we will summarize the immunological roles of commensal microbiota in cancer treatment and give specific examples of bacteria that show anticancer effect when administered as a monotherapy or as an adjuvant agent for immunotherapy. We will also list ongoing clinical trials testing the anticancer effect of commensal bacteria.

A Newly Designed Nitinol Stent: Early Clinical Experience in the Treatment of Iliac Artery Stenoses and Occlusions

  • Chang Jin Yoon;Jin Wook Chung;Jae Hyung Park;Soon Hyung Hong;Soon Young Song;Hyung Gehn Lim;Yoon Sin Lee
    • Korean Journal of Radiology
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    • 제2권3호
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    • pp.145-150
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    • 2001
  • Objective: To investigate the effectiveness of the newly designed Niti-S stent in the management of iliac arterial stenoses and occlusions. Materials and Methods: Stenoses (n=25) or occlusions (n=5) in the iliac arteries of 25 patients (30 limbs) were treated. The site of the lesions was the common (n=15) or external (n=11) iliac artery, or both (n=4). Eight limbs were treated for diffuse disease, six for highly eccentric lesion, five for occlusive lesion, and 11 for failed angioplasty. Results: In all patients, technical success was achieved without major complications. One death, not procedure-related, occurred within 30 days. Ankle-brachial indexes improved from 0.63 0.30 to 0.99 0.21, and ischemic symptoms showed improvement in 22 patients (88%). Fontaine classifications before stenting, namely IIa(n=3), IIb(n=16), III(n=2), and IV(n=4) improved to I(n=17), IIa(n=5), and IV(n=3). Follow-up over a 27 (mean, 19.8 8)-month period showed that cumulative patency rates were 95.8% at 1 year and 86.2% at 2 and 3 years. No significant decrease in the mean ankle-brachial index was observed. Conclusion: The Niti-S stent appears to be a safe and effective device for the treatment of iliac stenoses and occlusions. These preliminary results require confirmation with a larger series.

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A Hybrid Multi-Level Feature Selection Framework for prediction of Chronic Disease

  • G.S. Raghavendra;Shanthi Mahesh;M.V.P. Chandrasekhara Rao
    • International Journal of Computer Science & Network Security
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    • 제23권12호
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    • pp.101-106
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    • 2023
  • Chronic illnesses are among the most common serious problems affecting human health. Early diagnosis of chronic diseases can assist to avoid or mitigate their consequences, potentially decreasing mortality rates. Using machine learning algorithms to identify risk factors is an exciting strategy. The issue with existing feature selection approaches is that each method provides a distinct set of properties that affect model correctness, and present methods cannot perform well on huge multidimensional datasets. We would like to introduce a novel model that contains a feature selection approach that selects optimal characteristics from big multidimensional data sets to provide reliable predictions of chronic illnesses without sacrificing data uniqueness.[1] To ensure the success of our proposed model, we employed balanced classes by employing hybrid balanced class sampling methods on the original dataset, as well as methods for data pre-processing and data transformation, to provide credible data for the training model. We ran and assessed our model on datasets with binary and multivalued classifications. We have used multiple datasets (Parkinson, arrythmia, breast cancer, kidney, diabetes). Suitable features are selected by using the Hybrid feature model consists of Lassocv, decision tree, random forest, gradient boosting,Adaboost, stochastic gradient descent and done voting of attributes which are common output from these methods.Accuracy of original dataset before applying framework is recorded and evaluated against reduced data set of attributes accuracy. The results are shown separately to provide comparisons. Based on the result analysis, we can conclude that our proposed model produced the highest accuracy on multi valued class datasets than on binary class attributes.[1]

일학습병행 재직자학위연계 교육과정 참여학생의 학습성과와 대학측 대응 노력 간의 연관성 고찰 (An Examination of the Relationship between Learning Outcomes of Employees Participating in Work-Study Integrated Degree Programs and University Efforts in Response)

  • 최성연
    • 공학교육연구
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    • 제27권1호
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    • pp.3-12
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    • 2024
  • The degree-linked programs for employees, operated by joint training centers in specialized universities that have implemented work-study integrated programs, are educational programs that require an annual government budget of around 80 billion KRW. However, the 70+ universities running these programs face issues such as a decline in academic achievement and an increase in dropout rates among students. In this paper, I conducted multiple regression analysis based on observed and measured information to examine whether the participating students in these programs are achieving an appropriate level of academic performance and to identify the factors that universities need to invest in to achieve that level. To do this, I hypothesized a causal relationship between the university's input factors and students' academic achievement, and used the SPSS program to analyze the statistical data, confirming the validity of the hypothesis. The collected data for the study were obtained through a survey developed using a Likert 4-point scale, which quantified the distribution of grades among students enrolled in IT-related departments offering the degree-linked programs for employees and the emotional contact efforts made by the universities to motivate them for academic success. Particularly, through the results of multiple regression analysis, it was confirmed that these input factors, unlike those for students in general education programs, require more personalized and frequent interactions.

Rotatable sphincterotome as a rescue device for endoscopic retrograde cholangiopancreatography cannulation: a single-center experience

  • Takeshi Okamoto;Takashi Sasaki;Tsuyoshi Takeda;Takafumi Mie;Chinatsu Mori;Takaaki Furukawa;Yuto Yamada;Akiyoshi Kasuga;Masato Matsuyama;Masato Ozaka;Naoki Sasahira
    • Clinical Endoscopy
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    • 제57권1호
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    • pp.96-104
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    • 2024
  • Background/Aims: Selective bile duct or pancreatic duct cannulation remains a significant initial hurdle in endoscopic retrograde cholangiopancreatography (ERCP) despite advances in endoscopy and accessories. This study evaluated our experience with a rotatable sphincterotome in cases of difficult cannulation. Methods: We retrospectively reviewed ERCP cases using TRUEtome, a rotatable sphincterotome, as a rescue device for cannulation at a cancer institute in Japan from October 2014 to December 2021. Results: TRUEtome was used in 88 patients. Duodenoscopes were used for 51 patients, while single-balloon enteroscopes (SBE) were used for 37 patients. TRUEtome was used for biliary and pancreatic duct cannulation (84.1%), intrahepatic bile duct selection (12.5%), and strictures of the afferent limb (3.4%). Cannulation success rates were similar in the duodenoscope and SBE groups (86.3% vs. 75.7%, p=0.213). TRUEtome was more commonly used in cases with steep cannulation angles in the duodenoscope group and in cases requiring cannulation in different directions in the SBE group. There were no significant differences in adverse events between the two groups. Conclusions: The cannulation sphincterotome was useful for difficult cannulations in both unaltered and surgically altered anatomies. It may be an option to consider before high-risk procedures such as precut and endoscopic ultrasound-guided rendezvous techniques.

Endoscopic ultrasound-directed transgastric endoscopic retrograde cholangiopancreatography for patients with Roux-en-Y gastric bypass anatomy: technical overview

  • Hirokazu Honda;Jeffrey D. Mosko;Ryosuke Kobayashi;Andras Fecso;Bong Sik Kim;Schoeman Scott;Gary R. May
    • Clinical Endoscopy
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    • 제55권6호
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    • pp.736-741
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    • 2022
  • Endoscopic retrograde cholangiopancreatography (ERCP) in patients with Roux-en-Y gastric bypass anatomy is a well-documented challenge. Traditionally, this problem has been overcome with adjunctive techniques, such as device-assisted ERCP, including double-balloon or single-balloon enteroscopy and laparoscopy-assisted transgastric ERCP. Endoscopic ultrasound-directed transgastric ERCP (EDGE) is a novel technique that enables access to the ampulla using a duodenoscope without surgical intervention and has shown high clinical and technical success rates in recent studies. However, this approach is technically demanding, necessitating a thorough understanding of the gastrointestinal anatomy as well as high operator experience. In this review, we provide a technical overview of EDGE in parallel with our personal experience at our center and propose a simple algorithm to select patients for its appropriate application. In conjunction, the outcomes of EDGE compared with those of device-assisted and laparoscopy-assisted transgastric ERCP will be discussed.

Systematic review of self-assembling peptides as topical agents for treatment and prevention of gastrointestinal bleeding

  • Andrei Voiosu;Monica State;Victor Dragan;Sergiu Vaduva;Paul Balanescu;Radu Bogdan Mateescu;Theodor Voiosu
    • Clinical Endoscopy
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    • 제57권4호
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    • pp.454-465
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    • 2024
  • Background/Aims: Gastrointestinal bleeding is a significant and potentially lethal event. We aimed to review the efficiency and safety of self-assembling peptides for the treatment and prevention of gastrointestinal tract bleeding. Methods: We conducted a systematic search for studies describing the endoscopic use of self-assembling peptides for treatment or prevention of bleeding in the gastrointestinal tract in a parallel, independent fashion. The primary outcomes were rates of successful initial hemostasis, delayed bleeding, and rebleeding. The secondary outcomes were adverse events and ease and volume of gel used. Results: Seventeen studies were analyzed. Overall success rate of self-assembling peptides in gastrointestinal bleeding was 87.7% (38%-100%), regardless of etiology or associated treatments. Rebleeding rate ranged from 0% to 16.2%, with a mean of 4.7%, and overall delayed bleeding rate was 5% (range, 0%-15.9%). Only three adverse events were reported in a pooled number of 815 patients. The volume of gel used varied (0.43 to 3.7 mL) according to indication and type of bleeding. Conclusions: The limited available data on the use of self-assembling peptides in gastrointestinal endoscopy suggest a high efficiency and good safety profile.

Long-term outcomes of carotid artery stenting in patients with carotid artery stenosis: A single-center 14-year retrospective analysis

  • Beom Mo Kang;Seok Mann Yoon;Jae Sang Oh;Hyuk Jin Oh;Jae Min Ahn;Gi Yong Yun
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • 제25권2호
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    • pp.160-174
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    • 2023
  • Objective: Carotid artery stenting (CAS) is currently widely used for the treatment of carotid artery stenosis. The objective of this study was to analyze the outcomes of CAS performed in a single institution. Methods: We retrospectively analyzed 313 CAS cases from January 2007 to December 2020, including 206 (66%) symptomatic and 107 (34%) asymptomatic cases. Procedure-related morbidity and mortality were assessed. Rates of periprocedural (≤30 days after CAS) and postprocedural ipsilateral strokes (>30 days after CAS) were also assessed. Logistic regression analysis was used to identify risk factors for the periprocedural complication, in-stent restenosis (ISR), and ipsilateral stroke. Results: The success rate of CAS was 98%. Among 313 cases, 1 patient died due to hyperperfusion-related intracerebral hemorrhage (ICH). The CAS-related mortality rate was 0.31%. The overall incidence of periprocedural complications is 5.1%. A risk factor for periprocedural complication was a symptomatic carotid artery stenosis (7.3% vs. 0.9%, p=0.016). Twenty cases of ISR occurred during 63.7±42.1 months of follow-up. The overall incidence of ISR was 10.2% (20/196). A risk factors for ISR were diabetes mellitus (17.6% vs. 5.7%, p=0.008) and patients who used Open-cell stents (19.6% vs. 6.9%, p=0.010). The overall incidence of ipsilateral stroke is 5.6%. A risk factors for ipsilateral stroke was ISR (95% CI, p=0.002). Conclusions: CAS is a safe and effective procedure for carotid artery stenosis. Although the incidence of complications is low, fatal complication such as hyperperfusion-related ICH can occur. To prevent hyperperfusion-related ICH, several methods such as strict blood pressure (BP) control, intentional less widening of stenotic segment should be used. To prevent ISR or stroke occurrence, special attention should be paid to patients who have ISR or ipsilateral stroke risk factors.

Clinical Features of Molar Root-Incisor Malformation: A Retrospective Study

  • Sejin Chun;Hyuntae Kim;Ji-Soo Song;Teo Jeon Shin;Hong-Keun Hyun;Jung-Wook Kim;Ki-Taeg Jang;Young-Jae Kim
    • 대한소아치과학회지
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    • 제51권3호
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    • pp.279-289
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    • 2024
  • This study aimed to identify the clinical characteristics of molar root-incisor malformation (MRIM) and provide clinical considerations for treatments. Panoramic radiographs and electronic medical records of 64 patients with MRIM were retrospectively reviewed. Age, gender, follow-up period, medical history, complications, distribution of MRIM teeth, treatment, and prognosis were analyzed. Females were affected 1.56 times more than males, and the average age was 8.2 years. Dental complications, including periapical lesions, abscesses, and alveolar bone loss, were observed in 71.9%, and eruption disturbance of adjacent teeth was noticed in 37.5%. Most patients had medical histories in the first year of life. The most prevalent history was prematurity or low birthweight, followed by neurological conditions, surgeries, medications, and infections. All patients had MRIM on permanent first molars. The primary second molars were the second most frequently involved, followed by maxillary permanent central incisors and primary first molars. The prevalence was low on permanent lateral incisors and canines. Extraction was the most prevalent treatment done on MRIM-affected teeth, and most extraction sockets were managed by the eruption of permanent second molars. Few cases received endodontic treatment but with low success rates. Early detection of MRIM and prompt, appropriate treatment are important to avoid unnecessary discomfort from complications.