• Title/Summary/Keyword: multimodal treatment

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Surgical treatment of velopharyngeal insufficiency

  • Nam, Seung Min
    • Archives of Craniofacial Surgery
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    • v.19 no.3
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    • pp.163-167
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    • 2018
  • Velopharyngeal insufficiency (VPI) is a common complication after primary palatoplasty. Although the several surgical treatments of VPI have been introduced, there is no consensus guide to select the optimal surgical treatment for VPI patients. The selection of surgical treatment for VPI depends on a multimodal patient evaluation, such as perceptual speech evaluation, nasometery and nasoendoscopy. We can provide more adequate treatment for VPI through the deeper understanding of anatomy and physiology in VPI.

Multimodal Treatment Strategies in Esophagogastric Junction Cancer: a Western Perspective

  • Goetze, Thorsten Oliver;Al-Batran, Salah-Eddin;Berlth, Felix;Hoelscher, Arnulf Heinrich
    • Journal of Gastric Cancer
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    • v.19 no.2
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    • pp.148-156
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    • 2019
  • Esophagogastric junction (EGJ) cancer is a solid tumor entity with rapidly increasing incidence in the Western countries. Given the high proportion of advanced cancers in the West, treatment strategies routinely employed include surgery and chemotherapy perioperatively, and chemoradiation in neoadjuvant settings. Neoadjuvant chemoradiation and perioperative chemotherapy are mostly performed in esophageal cancer that extends to the EGJ and gastric as well as EGJ cancers, respectively. Recent trials have tried to combine both strategies in a perioperative context, which might have beneficial outcomes, especially in patients with EGJ cancer. However, it is difficult to recruit patients for trials, exclusively for EGJ cancers; therefore, the results have to be carefully reviewed before establishing a standard protocol. Trastuzumab was the first drug for targeted therapy that was positively evaluated for this tumor entity, and there are several ongoing trials investigating more targeted drugs in order to customize effective therapies based on tissue characteristics. The current study reviews the multimodal treatment concept for EGJ cancers in the West and summarizes the latest reports.

Molecular imaging application of iron oxide nanoradiomaterial

  • Ran Ji Yoo;Ji Yong Park;Tae Hyeon Choi;Jin Sil Kim;Yun-Sang Lee
    • Journal of Radiopharmaceuticals and Molecular Probes
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    • v.7 no.2
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    • pp.133-140
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    • 2021
  • Various iron oxide nanoparticle-based radiomaterials(IO-NRM) can be used for multimodal imaging of magnetic resonance imaging and molecular imaging, can be easily sized, can be easily functionalized, and have biocompatibility, making them a very good platform for molecular imaging. Based on the previously revealed molecular imaging technology of iron oxide nanoparticles, this paper introduces the in vivo distribution and use in various diseases through iron oxide nanoparticles-based radiolabeled compounds for diagnosis and treatment of iron oxide nanoparticles-based molecular imaging platforms. We would like to look forward to its potential as a radiopharmaceutical.

Multimodal Treatment of Pleuropulmonary Blastoma -Two case report- (흉막폐아세포종(Pleuropulmonary Blastoma) -치험 2예 보고-)

  • 박준석;한정호;구홍회;김진국
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.614-618
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    • 2003
  • Pleuropulmonary blastoma (PPB) is a rare intrathoracic neoplasm, found solely in childhood. The usual symptoms are dyspnea, chest discomfort, recurrent respiratory infections, fever, dry cough, and chest pain. The progress of PPB is usually aggressive and its progress is generally poor. Lymphatic spread to the hilar and mediastinal nodes can occur Distant metastasis is found in brain, bones, and intra-abdominal organs. Surgical resection is the treatment of choice. When the disease Is too extensive for surgical resection, neoadjuvant chemotherapy can be used. We report 2 cases of pleuropulrnonary blastoma in children successfully treated with multimodal therapy.

Multimodal MRI analysis model based on deep neural network for glioma grading classification (신경교종 등급 분류를 위한 심층신경망 기반 멀티모달 MRI 영상 분석 모델)

  • Kim, Jonghun;Park, Hyunjin
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2022.05a
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    • pp.425-427
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    • 2022
  • The grade of glioma is important information related to survival and thus is important to classify the grade of glioma before treatment to evaluate tumor progression and treatment planning. Glioma grading is mostly divided into high-grade glioma (HGG) and low-grade glioma (LGG). In this study, image preprocessing techniques are applied to analyze magnetic resonance imaging (MRI) using the deep neural network model. Classification performance of the deep neural network model is evaluated. The highest-performance EfficientNet-B6 model shows results of accuracy 0.9046, sensitivity 0.9570, specificity 0.7976, AUC 0.8702, and F1-Score 0.8152 in 5-fold cross-validation.

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Surgical treatment of perianal fistula in Crohn's disease (크론병에서 복잡성 항문주위 샛길의 수술적 치료)

  • Kim, Sohyun
    • Journal of Yeungnam Medical Science
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    • v.34 no.2
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    • pp.169-173
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    • 2017
  • Perianal Crohn's disease is a major problem that impair quality of life. This article reviews the current surgical treatment of Crohn's perianal fistula. Fistulotomy and loose seton are commonly used surgical methods for treatment of perianal Crohn's disease. Mucosal advancement flap and fibrin glue are used in this treatment, despite a lake of controlled trials. Fecal diversion is disturbingly high in complicated complex perianal fistula in Crohn's disease. Ligation of intersphincteric fistula and autologous or allogenic stem cells are new surgical procedures for treatment of Crohn's disease that need further studies. Treatment success might be improved by multimodal treatment and new surgical and medical treatment options.

Major Lessons from the MTA in Treatment of Attention-Deficit Hyperactivity Disorder (주의력결핍 과잉행동장애 치료에서 MTA의 주요 교훈)

  • Hwang, Jun-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.21 no.1
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    • pp.3-10
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    • 2010
  • Objectives : The current review aimed to describe the major findings of the NIMH Collaborative Multisite Multimodal Treatment Study of Children with Attention-Deficit Hyperactivity Disorder (MTA) with regard to the treatment of children with attention-deficit hyperactivity disorder (ADHD). Methods : We performed a general review of the literature regarding the efficacy of the MTA's proposed treatments. Results : There is a large and still increasing body of evidence regarding the MTA's treatment outcomes. We present and discuss details of the findings at each follow-up point. Conclusion : Currently, findings regarding the MTA's treatments suggest children with combined-type ADHD exhibit significant impairment in adolescence, despite their initial symptom improvement. Further studies, using innovative treatment approaches and targeting specific areas of adolescent impairment, are needed in order to enhance ADHD treatment outcomes.

Implications of Liver-Directed Therapy for Postoperative Hepatic Metastasis from Esophageal Cancer

  • Urabe, Masayuki;Yagi, Koichi;Shiomi, Shinichiro;Toriumi, Tetsuro;Okumura, Yasuhiro;Setoa, Yasuyuki
    • Journal of Chest Surgery
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    • v.55 no.5
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    • pp.397-404
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    • 2022
  • Background: Distant recurrence of esophageal cancer (EC), even after radical resection, is common, and the most frequent site of EC metastasis is the liver. However, a multidisciplinary treatment strategy for postoperative liver metastasis (LM) from EC has yet to be established; in particular, the role of liver-directed therapy (LDT) remains uncertain. We investigated the clinicopathological features and outcomes of patients undergoing post-esophagectomy LM with versus without LDT to explore its therapeutic implications. Methods: Among 624 consecutive patients undergoing R0/R1 esophagectomy for EC, 30 were identified in whom LM had developed as the initial recurrence. Their characteristics were retrospectively reviewed. Results: Six of the 30 subjects underwent LDT for metachronous LM. Five of those 6 also received systemic chemotherapy. A comparison between the 6 LDT and 24 non-LDT cases revealed no significant differences in major clinicopathological and operative factors, except for concurrent metastasis to extrahepatic organs (1/6 vs. 15/24, p=0.044). Twenty-nine of the 30 patients died during the study period, whereas 1 who had received multimodal treatment with LDT remained alive more than 200 months after multiple LM had been detected. Kaplan-Meier analysis for survival after LM demonstrated significantly prolonged survival in LDT cases compared to non-LDT cases treated with systemic chemotherapy alone (p=0.014). Even when the analysis was limited to patients without extrahepatic metastasis, this significant prognostic advantage of LDT was maintained (p=0.047). Conclusion: Multimodal treatment combined with LDT might be beneficial for patients with metachronous LM from EC and should therefore be considered a potential treatment option.

Multimodal Therapy for Patients with Acute Ischemic Stroke : Outcomes and Related Prognostic Factors

  • Jeong, Seung-Young;Park, Seung-Soo;Koh, Eun-Jeong;Eun, Jong-Pil;Choi, Ha-Young
    • Journal of Korean Neurosurgical Society
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    • v.45 no.6
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    • pp.360-368
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    • 2009
  • Objective : The objectives of this study were to analyze the recanalization rates and outcomes of multimodal therapy that consisted of sequential intravenous (IV)/intra-arterial (IA) thrombolysis, mechanical thrombolysis including mechanical clot disruption using microcatheters and microwires, balloon angioplasty, and stenting for acute ischemic stroke, and to evaluate the prognostic factors related to the outcome. Methods : Fifty patients who were admitted to the hospital within 8 hours from ischemic symptom onset were retrospectively analyzed. Initial IV thrombolysis and subsequent cerebral angiography were performed in all patients. If successful recanalization was not achieved by IV thrombolysis, additional IA thrombolysis with mechanical thrombolysis, including balloon angioplasty and stenting, were performed. The outcomes were assessed by the National Institute of Health Stroke Scale (NIHSS) change and modified Rankin scale (mRS) and prognostic factors were analyzed. Results : Successful recanalization was achieved in 42 (84%) of 50 patients, which consisted of 8 patients after IV thrombolysis, 19 patients after IA thrombolysis with mechanical clot disruption, and 15 patients after balloon angioplasty or stenting. Symptomatic hemorrhage occurred in 4 (8%) patients. Good outcomes were achieved in 76% and 70% of patients upon discharge, and 93% and 84% of patients after 3 months according to the NIHSS change and mRS. The initial clinical status, recanalization achievement, and presence of symptomatic hemorrhage were statistically related to the outcomes. Conclusion : Multimodal therapy may be an effective and safe treatment modality for acute ischemic stroke. Balloon angioplasty and stenting is effective for acute thrombolysis, and produce higher recanalization rates with better outcomes.

Multimodal Medical Image Fusion Based on Double-Layer Decomposer and Fine Structure Preservation Model (복층 분해기와 상세구조 보존모델에 기반한 다중모드 의료영상 융합)

  • Zhang, Yingmei;Lee, Hyo Jong
    • KIPS Transactions on Computer and Communication Systems
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    • v.11 no.6
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    • pp.185-192
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    • 2022
  • Multimodal medical image fusion (MMIF) fuses two images containing different structural details generated in two different modes into a comprehensive image with saturated information, which can help doctors improve the accuracy of observation and treatment of patients' diseases. Therefore, a method based on double-layer decomposer and fine structure preservation model is proposed. Firstly, a double-layer decomposer is applied to decompose the source images into the energy layers and structure layers, which can preserve details well. Secondly, The structure layer is processed by combining the structure tensor operator (STO) and max-abs. As for the energy layers, a fine structure preservation model is proposed to guide the fusion, further improving the image quality. Finally, the fused image can be achieved by performing an addition operation between the two sub-fused images formed through the fusion rules. Experiments manifest that our method has excellent performance compared with several typical fusion methods.