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Additional Value of Integrated 18F-FDG PET/MRI for Evaluating Biliary Tract Cancer: Comparison with Contrast-Enhanced CT

  • Jeongin Yoo;Jeong Min Lee;Jeong Hee Yoon;Ijin Joo;Dong Ho Lee
    • Korean Journal of Radiology
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    • v.22 no.5
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    • pp.714-724
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    • 2021
  • Objective: To evaluate the value of 18F-fluorodeoxyglucose PET/MRI added to contrast-enhanced CT (CECT) in initial staging, assessment of resectability, and postoperative follow-up of biliary tract cancer. Materials and Methods: This retrospective study included 100 patients (initial workup [n = 65] and postoperative follow-up [n = 35]) who had undergone PET/MRI and CECT for bile duct or gallbladder lesions between January 2013 and March 2020. Two radiologists independently reviewed the CECT imaging set and CECT plus PET/MRI set to determine the likelihood of malignancy, local and overall resectability, and distant metastasis in the initial workup group, and local recurrence and distant metastasis in the follow-up group. Diagnostic performances of the two imaging sets were compared using clinical-surgical-pathologic findings as standards of reference. Results: The diagnostic performance of CECT significantly improved after the addition of PET/MRI for liver metastasis (area under the receiver operating characteristic curve [Az]: 0.77 vs. 0.91 [p = 0.027] for reviewer 1; 0.76 vs. 0.92 [p = 0.021] for reviewer 2), lymph node metastasis (0.73 vs. 0.92 [p = 0.004]; 0.81 vs. 0.92 [p = 0.023]), and overall resectability (0.79 vs. 0.92 [p = 0.007]; 0.82 vs. 0.94 [p = 0.021]) in the initial workup group. In the follow-up group, the diagnostic performance of CECT plus PET/MRI was significantly higher than that of CECT imaging for local recurrence (0.81 vs. 1.00 [p = 0.029]; 0.82 vs. 0.94 [p = 0.045]). Conclusion: PET/MRI may add value to CECT in patients with biliary tract cancer both in the initial workup for staging and determination of overall resectability and in follow-up for local recurrence.

Risk indicators associated with peri-implant diseases: a retrospective cross-sectional study of Colombian patients with 1 to 18 years of follow-up

  • Ana Maria Ortiz-Echeverri;Carolina Gallego-Gonzalez;Maria Catalina Castano-Granada;Sergio Ivan Tobon-Arroyave
    • Journal of Periodontal and Implant Science
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    • v.54 no.3
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    • pp.161-176
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    • 2024
  • Purpose: Peri-implant mucositis (PIM) and peri-implantitis (PI) are multicausal conditions with several risk factors contributing to their pathogenesis. In this study, we retrospectively investigated risk variables potentially associated with these peri-implant diseases (PIDs) over a follow-up period of 1 to 18 years. Methods: The study sample consisted of 379 implants placed in 155 patients. Single-visit clinical and radiographic evaluations were employed to determine the presence or absence of PIDs. Parameters related to the patient, site, surgery, implant, and prosthetic restoration were documented. The relationships between risk variables and the occurrence of PIDs were individually examined and adjusted for confounders using multivariate binary logistic regression models. Results: The prevalence rates of PIM and PI were 28.4% and 36.8% at the patient level and 33.5% and 24.5% at the implant level, respectively. Poor oral hygiene, active gingivitis/periodontitis, preoperative alveolar ridge deficiency, early or delayed implant placement, implant length of 11.0 mm or less, and poor restoration quality were strong and independent risk indicators for both PIDs. Furthermore, a follow-up period of more than 5 years and a loading time of more than 4 years were important indicators for PI. Simultaneously, age and smoking status acted as modifiers of the effect of mesiodistal (MD) and buccolingual (BL) widths of restoration on PI. Conclusions: In this study population, oral hygiene, periodontal status, preoperative alveolar ridge status, implant placement protocol, implant length, and the quality of coronal restoration appear to be robust risk indicators for both PIM and PI. Additionally, the length of follow-up and functional loading time are robust indicators of PI. Furthermore, the potential modifying relationships of age and smoking status with the MD and BL widths of restoration may be crucial for the development of PI.

Application of HPV DNA Testing in Follow-up after Loop Electrosurgical Excision Procedures in Northern Thailand

  • Khunamornpong, Surapan;Settakorn, Jongkolnee;Sukpan, Kornkanok;Kietpeerakool, Chumnan;Tantipalakorn, Charuwan;Suprasert, Prapaporn;Siriaunkgul, Sumalee
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.6093-6097
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    • 2015
  • Background: HPV DNA testing has been recently introduced as an adjunct test to cytology in the follow-up of patients after treatment for cervical lesions using the loop electrosurgical excision procedure (LEEP). The aim of this study was to evaluate the role of HPV testing in the detection of persistent or recurrent disease after LEEP in patients with cervical epithelial lesions in northern Thailand. Materials and Methods: Patients who underwent LEEP as a treatment for histological low-grade (LSIL) or high-grade squamous intraepithelial lesion (HSIL) or worse at Chiang Mai University Hospital between June 2010 and May 2012 were included. Follow-ups were scheduled at 6-month intervals and continued for 2 years using co-testing (liquid-based cytology and Hybrid Capture 2 [HC2]) at 6 months and 24 months and liquid-based cytology alone at 12 and 18 months. Results: Of 98 patients included, the histological diagnoses for LEEP included LSIL in 16 patients, and HSIL or worse in 82 patients. The LEEP margin status was negative in 84 patients (85.7%). At follow-up, 10 patients (10.2%) had persistent/recurrent lesions; 4 among LSIL patients (25.0%) and 6 in the group with HSIL or worse (7.3%). Only 2 of 82 patients (2.4%) with HSIL or worse diagnoses had histological HSIL in the persistent/recurrent lesions. Using histologically confirmed LSIL as the threshold for the detection of persistent/recurrent disease, cytology had a higher sensitivity than HC2 (90.0% versus 70.0%). At the 6-month follow-up appointment, combined cytology and HC2 (co-testing) had a higher sensitivity in predicting persistent/recurrent disease (80.0%) compared with that of cytology alone (70.0%) and HC2 (50.0%). Conclusions: After LEEP with a negative surgical margin, the rate of persistent/recurrent lesions is low. The addition of HPV testing at the 6-month visit to the usual cytology schedule may be an effective approach in the follow-up after LEEP.

Comparative Analysis of the Results between the Early Period and the Midterm Period of a Single Surgeon's Experience in the Treatment of Hallux Valgus Using Scarf Osteotomy (단일 수술자에 의한 초기와 중기에 시행한 무지외반증에 대한 Scarf 절골술의 결과 비교)

  • Lee, Yeong-Hyeon;Nam, Il-Hyun;Lee, Tae-Hun;Ahn, Gil-Yeong;Lee, Yong-Sik;Hwang, Sung-Hyun;Lee, Kyung-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.4
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    • pp.135-141
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    • 2020
  • Purpose: This study evaluated the results of two groups-the early group and midterm group-comparatively in the treatment of hallux valgus using a scarf osteotomy. Materials and Methods: From January 2005 to December 2009 (Group 1) and from January 2010 to December 2013 (Group 2), this study compared hallux valgus cases treated by a scarf osteotomy by a single surgeon with at least a five-year follow-up. Results: The average ages of Group 1 and Group 2 were 50.5 and 51.7 years old, respectively. The average follow-up of Groups 1 and 2 were 7.4 and 6.2 years, respectively. Groups 1 and 2 had 86 cases (53 patients) and 93 cases (64 patients) with at least a five-year follow-up, respectively. The average hallux valgus angle (HVA) and 1-2 intermetatarsal angle (IMA) of Group 1 were improved from 31.3° and 13.9° preoperatively to 11.3° and 6.8° at the final follow-up, respectively (p<0.001). The average HVA and 1-2 IMA of Group 2 were improved from 31.7° and 13.4° preoperatively to 8.9° and 6.6° at the final follow-up, respectively (p<0.001). The mean American Orthopaedic Foot and Ankle Society (AOFAS) score of both groups increased from 48.5 and 45.0 points preoperatively to 73.7 and 82.4 points at the final follow-up, respectively. The numbers of patient-assessed subjective satisfaction of Groups 1 and 2 at the final follow-ups were as follows: excellent, 27 and 36 (31.4%, 38.7%); good, 34 and 49 (39.5%, 52.7%); fair, 13 and 5 (15.1%, 5.4%); poor, 12 and 3 (13.9%, 3.2%); respectively. Neither troughing nor stress fractures occurred in both groups. Conclusion: Scarf osteotomy for treating hallux valgus is an excellent surgical method with a relatively low incidence of complications. The results in Group 2 were better than those in Group 1, showing that more surgical experience and evolution of the techniques provided better results.

The Spontaneous Regression of Lumbar Disc Herniation: 3 Cases Report (요추간판 탈출의 자연적 축소(3례 증례보고))

  • Kwon, Won-An;Kim, Han-Soo
    • The Journal of Korean Physical Therapy
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    • v.20 no.3
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    • pp.69-74
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    • 2008
  • Purpose: The majority of patients with radiculopathy caused by a herniated nucleus pulposus (HNP) heal spontaneously without surgery. The aim of this report is to describe the spontaneous regression of lumbar disc herniation and the results of clinical follow-up. Methods: Three patients with radiating low back pain presented with an extruded intervertebral disc on magnetic resonance imaging (MRI). We performed follow-up with conservative treatment (epidural injection, medication, physical therapy, exercise) and clinical assessments on the 6th, 10th and 22nd months. Results: The extruded intervertebral disc almost complete regressed, and correlated with clinical improvement and follow-up MRI. Conclusion: Conservative treatment can be an effective approach for a herniated lumbar discs if no neurological deficits are present.

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Antegrade Recanalization of Parent Artery after Internal Trapping of Ruptured Vertebral Artery Dissecting Aneurysm

  • Ihn, Yon-Kwon;Sung, Jae-Hoon;Byun, Je-Hoon
    • Journal of Korean Neurosurgical Society
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    • v.51 no.5
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    • pp.301-304
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    • 2012
  • We report a patient with a ruptured vertebral artery (VA) dissecting aneurysm that was treated by internal trapping of the aneurysm and parent artery using detachable coils with subsequent antegrade recanalization of occluded vertebral artery during the follow-up period. A 38-year-old man was admitted with a ruptured right VA dissecting aneurysm just distal to origin of right posterior inferior cerebellar artery. The dissected segment of the VA was occluded by coil embolization. The 14 months follow-up angiography showed that dissected aneurysm was completely occluded, but the parent artery was recanalized in an antegrade fashion. Based on this unique case, the authors suggest that careful angiographic follow-up of dissecting aneurysm is required, even in patients successfully treated with endovascular occlusion of the affected artery and aneurysm.

Optimal Level and Follow-up Management as Success Factors from BACHE Company's Knowledge Management Experiences (눈높이와 후속관리로 성공한 지식경영: BACHE 사례)

  • Yang, Choonhee
    • Knowledge Management Research
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    • v.7 no.1
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    • pp.81-96
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    • 2006
  • The purpose of this study is to survey what strategy BACHE, a bathtub manufacturing company, chooses to implement knowledge management. Generally speaking, the success factors of this case company is follow-up management. The first factor is to use linguistic metaphors for employees to understand difficult knowledge management terms easily. The second one is that CEO tries to set and lead pro-knowledge management corporate culture. The third one is based on the CKO's competence to read business circumstances and apply the theory of knowledge management to the workplace. The fourth one has something to do with a way of knowledge creation, for example, a suggestion system and QC circle. The fifth one depends upon CKO's mission to share knowledge invented from his own company's with the rivals and large companies which order bathtubs so that overall bathtub industry can upgrade knowledge management.

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An Empirical Study on the ISO 9000 Follow-up Management Practices of Korean Small Enterprises (ISO 인증 중소기업의 사후관리에 관한 실증적 연구)

  • Lee Jae-Kwan
    • Journal of Korean Society for Quality Management
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    • v.32 no.4
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    • pp.78-91
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    • 2004
  • The ISO 9000 Follow-up Management Practices (FMP) as an integrated area including training, QM systems, management commitment, customer focus, communication and related issues are examined. A sample of 191 small and medium-sized firms data from mail survey is analyzed by the SPSSWIN. A model of FMP including three factors (Systems, Training, and Customer Focus) is introduced. In this paper, a focus is laid on the comparison between ISO 9000:1994 vs. ISO 9000:2000 or 05 9000 certificates and between groups classified by the time length after certification, and on regression relationships between FMP level and business performance. The result shows that the difference of FMP level is significant between two versions and between groups. Quality level and system satisfaction are influenced significantly by the three factors.

THE CLINICAL STUDY OF IMPLANTATION OF TOOTHASH COMBINED WITH PLASTER OF PARIS;LONG-TERM FOLLOW UP STUDY (치아회분과 석고 혼합매식물 이식에 관한 임상적 연구;장기간 추적 연구)

  • Kim, Su-Gwan;Yeo, Hwan-Ho;Kim, Young-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.771-777
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    • 1996
  • This study was undertaken to access the effect of toothash combined with plaster of Paris in the filling of jaw defect and the substitution as new bone during the follow up period. We used the toothash and plaster after the cyst enucleation, the apicoectomy, the extraction of supenumerary tooth with ratio of 2 : 1 by weigh. 15 consecutive patients were evaluated retrospectively. Complications were swelling, perforation, infection and treated without problems using incision & drainage, aspiration, antibiotic treatment, 2ndary buccal flap. The follow-up period ranged from 28 to 35 months. Based on radiographic and clinical observation, it may be concluded that toothash and dental plaster of Paris($CaSo_4\;{\cdot}\;1/2H_2O$) are useful for bone substitute.

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Surgical Management of Metastatic Lung cancer (전이성 폐암의 외과적 고찰)

  • Kim, Gil-Dong;Jeong, Gyeong-Yeong
    • Journal of Chest Surgery
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    • v.27 no.4
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    • pp.281-286
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    • 1994
  • From 1973 through June 1993, 25 patients underwent pulmonary resection for pulmonary metastases from carcinoma or sarcoma at our institution. There were 11 carcinomas and 14 sarcomas. 24 patients[96% complete] could follow-up and the median follow-up time was 20 months with a range of 4 months to 271 months and total follow-up period was 1105 months-patients. In our patients, actuarial 5-year survival rate was 49%, mean survival time was 66.6$\pm$12.6 months and median survival time was 84 months. Patients with sarcoma, more than 24 months of the tumor-free interval, postoperative adjuvant therapy had a better survival than did those with carcinoma, less than 24 months of the tumor-free interval, no postoperative adjuvant therapy. But there were no statistical differences between two groups[P>0.05]. This results recommend more aggressive surgical treatment for pulmonary metastases.

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