OBJECTIVE: To evaluate whether data acquired from perfusion computed tomography (PCT) parameters can aid in the prediction of treatment outcome after palliative chemotherapy in patients with unresectable advanced gastric cancer (AGC). MATERIALS AND METHODS: Twenty-one patients with unresectable AGCs, who underwent both PCT and palliative chemotherapy, were prospectively included. Treatment response was assessed according to Response Evaluation Criteria in Solid Tumors version 1.1 (i.e., patients who achieved complete or partial response were classified as responders). The relationship between tumor response and PCT parameters was evaluated using the Mann-Whitney test and receiver operating characteristic analysis. One-year survival was estimated using the Kaplan-Meier method. RESULTS: After chemotherapy, six patients exhibited partial response and were allocated to the responder group while the remaining 15 patients were allocated to the non-responder group. Permeability surface (PS) value was shown to be significantly different between the responder and non-responder groups (51.0 mL/100 g/min vs. 23.4 mL/100 g/min, respectively; p = 0.002), whereas other PCT parameters did not demonstrate a significant difference. The area under the curve for prediction in responders was 0.911 (p = 0.004) for PS value, with a sensitivity of 100% (6/6) and specificity of 80% (12/15) at a cut-off value of 29.7 mL/100 g/min. One-year survival in nine patients with PS value > 29.7 mL/100 g/min was 66.7%, which was significantly higher than that in the 12 patients (33.3%) with PS value ≤ 29.7 mL/100 g/min (p = 0.019). CONCLUSION: Perfusion parameter data acquired from PCT demonstrated predictive value for treatment outcome after palliative chemotherapy, reflected by the significantly higher PS value in the responder group compared with the non-responder group.
Drug Therapy ; Humans ; Methods ; Perfusion ; Permeability ; Prospective Studies ; Response Evaluation Criteria in Solid Tumors ; ROC Curve ; Sensitivity and Specificity ; Stomach ; Stomach Neoplasms ; Treatment Outcome

BACKGROUND/AIMS: Advances in endoscopic submucosal dissection (ESD) techniques have led to the development of expanded criteria for endoscopic resection of early gastric cancer (EGC). The aim of this study was to evaluate the short- and long-term outcomes for ESD using indication criteria. METHODS: A total of 1,105 patients underwent ESD for EGC at six medical centers. The patients were classified into the following two groups based on the lesion size, presence of ulceration and pathological review: an absolute criteria group (n=517) and an expanded criteria group (n=588). RESULTS: The curative resection rates (91.1% vs 91.3%, p=0.896) were similar in the absolute criteria group and the expanded criteria group. The en bloc resection rates (93.4% and 92.3%, respectively; p=0.488) and complete resection rates (98.3% and 97.4%, respectively; p=0.357) did not differ between the groups. The cumulative disease-free survival rates and the overall survival rates were similar between the groups (p=0.778 and p=0.654, respectively). Independent factors for the curative resection of EGC included tumor location (upper vs middle and lower, 2.632 [1.128-6.144] vs 3.497 [1.560-7.842], respectively) and en bloc resection rate 12.576 [7.442-21.250]. CONCLUSIONS: The expanded criteria for ESD in cases of EGC is comparable with the widely accepted pre-existing criteria.
Adult ; Aged ; Aged, 80 and over ; Disease-Free Survival ; Dissection/*methods ; Female ; Gastric Mucosa/*surgery ; Gastroscopy/*methods ; Humans ; Male ; Middle Aged ; *Response Evaluation Criteria in Solid Tumors ; Stomach Neoplasms/pathology/*surgery ; Survival Rate ; Treatment Outcome

BACKGROUND/AIMS: Advances in endoscopic submucosal dissection (ESD) techniques have led to the development of expanded criteria for endoscopic resection of early gastric cancer (EGC). The aim of this study was to evaluate the short- and long-term outcomes for ESD using indication criteria. METHODS: A total of 1,105 patients underwent ESD for EGC at six medical centers. The patients were classified into the following two groups based on the lesion size, presence of ulceration and pathological review: an absolute criteria group (n=517) and an expanded criteria group (n=588). RESULTS: The curative resection rates (91.1% vs 91.3%, p=0.896) were similar in the absolute criteria group and the expanded criteria group. The en bloc resection rates (93.4% and 92.3%, respectively; p=0.488) and complete resection rates (98.3% and 97.4%, respectively; p=0.357) did not differ between the groups. The cumulative disease-free survival rates and the overall survival rates were similar between the groups (p=0.778 and p=0.654, respectively). Independent factors for the curative resection of EGC included tumor location (upper vs middle and lower, 2.632 [1.128-6.144] vs 3.497 [1.560-7.842], respectively) and en bloc resection rate 12.576 [7.442-21.250]. CONCLUSIONS: The expanded criteria for ESD in cases of EGC is comparable with the widely accepted pre-existing criteria.
Adult ; Aged ; Aged, 80 and over ; Disease-Free Survival ; Dissection/*methods ; Female ; Gastric Mucosa/*surgery ; Gastroscopy/*methods ; Humans ; Male ; Middle Aged ; *Response Evaluation Criteria in Solid Tumors ; Stomach Neoplasms/pathology/*surgery ; Survival Rate ; Treatment Outcome

Myxomas are the most common type of primary cardiac tumour with 86% occurring in the left atrium. Right atrial myxomas is far less common. Patients usually present with progressive dyspnoea, fever, weight loss, right-sided heart failure, or pulmonary embolisation. We report the case of a 55-year-old man who presented with progressive dyspnoea and signs of right heart failure secondary to a large right atrial myxoma, which was diagnosed with a bedside transthoracic echocardiogram. This was successfully removed surgically.
Atrial Myxoma ; Dyspnea ; Heart Failure ; Treatment Outcome

Radionuclide therapies have been applied in the diverse fields of medicine, and it has been demonstrated the usefulness of it, especially in the field of oncology. Accurate dosimetric assessment is imperative during radionuclide therapy, in order to optimize the treatment efficacy for target sites and to minimize the radiation exposure for normal organ. Recent advancement in imaging technology permits the precise determination of the absorbed dose non-invasively. This imaging based dosimetry can be routinely applicable to the bedside in the near future.
Treatment Outcome

OBJECTIVE: This study described childhood interstitial lung disease profiles at the Philippine Children‘s Medical Center (2013-2022). MATERIALS AND METHODS: A retrospective chart review at PCMC analyzed pediatric interstitial lung disease cases (Jan 2013-Dec 2022). Included were patients aged 0-18 with childhood interstitial lung disease. Excluded were those with specific conditions. Data included clinical course, tests, therapeutic management, and short-term outcomes based on a previous study. RESULTS: Twenty-three patients were included in this study. Most (52.17%) were diagnosed between 2013-2017, and were within the ages of 0-2 years. Majority of patients had normal nutritional status (52.17%). Common clinical presentation on admission included breathing difficulties, with chest retractions, crackles, and hypoxemia. Few had a family history of chronic lung disease. Comorbidities included pulmonary hypertension (30.43%) and pulmonary tuberculosis (21.74%). Chest radiography revealed infiltrates in all cases, and HRCT scans showed ground glass opacities in 82.61%. Prednisone was the primary treatment (86.96%). Lung biopsy results (43.48%) were mostly unclassified or nondiagnostic, with lymphoid interstitial pneumonia as the predominant diagnosis (20%). Improvement of signs and symptoms was seen in 39.13% of cases, whereas death occurred in 21.74%. Furthermore, the outcome remained undetermined in as much as 34.78% of cases due to inadequate follow-up. CONCLUSION This retrospective study emphasizes chILD's prevalence in infants under 2 years, with male predominance. Nutritional variations underscore the need for supplementation. Various common signs include crackles, retractions, and hypoxemia, with breathing difficulty as a frequent symptom. The diagnostic process involves imaging and ancillary tests, advocating a systematic approach with noninvasive methods like CXR and HRCT, reserving lung biopsy for inconclusive cases. Corticosteroids, whether used alone or in combination, prove beneficial in managing chILD by suppressing inflammation.
Treatment Outcome

OBJECTIVEConducting a meta-analysis to evaluate the efficacy of artificial liver support system (ALSS) in the treatment of hepatic failure in China.

METHODSClinical trials comparing ALSS vs. routine medical treatment of hepatic failure in China were identified from computer-based literature. The pooled odds ratio and 95% confidence interval (CI) of prognostic indicators, such as survival rate and clinical improvement rate at discharge, were used to measure the magnitude of the efficacy.

RESULTSTen trials including 1030 patients were identified. The odds ratio (95% CI) of survivorship or improvement of ALSS over routine medical treatment in early, intermediate and advanced stages of hepatic failure were 3.72 (2.03-6.83), 2.79 (2.88-4.14) and 1.85 (0.96-3.56) respectively.

CONCLUSIONALSS treatment is more effective in early and intermediate stages of hepatic failure than routine medical treatment, but not in its advanced stage.

BACKGROUND: An ingrown nail is a common condition of inflammation and infection that can occur when nails are clipped too much or pressure is applied by tight shoes. In Korea, a study on the success of tube insertion after nail guttering has been reported, but studies including other treatments are lacking. OBJECTIVE: To evaluate the success rates of three treatments for ingrown nails: 1) nail splinting via a flexible tube; 2) partial nail extraction and electrocautery; or 3) partial nail extraction and phenol cauterization. METHODS: Fifty-one patients who underwent nail splinting via a flexible tube or partial nail extraction followed by either electrocautery or phenol cauterization of the nail matrix over a 6-year period at our hospital were evaluated for treatment outcome. The disease severity was classified using the Heifetz grading scale. We evaluated the success rates of the various treatments according to reduced disease severity. Treatment failure was defined as persistence or re-occurrence of disease symptoms. RESULTS: 1. Out of 51 cases of ingrown nails, 31 (60%) showed no recurrence after treatment. 2. There were conflicting results between the severity grade and success rate. 3. Treatment via partial nail extraction and either electrocautery or phenol cauterization was more effective (success rates of 63% and 60%, respectively) than nail splinting via a flexible tube (56% success rate). However, the results were not statistically significant. CONCLUSION: Selecting the proper therapeutic method is important for successful treatment of an ingrown nail.
Cautery ; Electrocoagulation ; Humans ; Inflammation ; Korea ; Nails, Ingrown* ; Phenol ; Recurrence ; Shoes ; Splints ; Treatment Failure ; Treatment Outcome

Onychomycosis is a chronic fungal nail infection which is notoriously difficult to eradicate. In spite of the selection of appropriate oral or topical antifungal medications, treatment failure or recurrences are frequent. Different therapeutic strategies must have been considered to improve the short- and long-term efficacy outcomes. These strategies are followed as: (1) correct diagnosis and classification of onychomycosis, (2) individually tailored treatment regimen, (3) maximizing method of antifungal efficacy, (4) reducing relapse and reinfection.
Antifungal Agents ; Classification ; Diagnosis ; Methods ; Onychomycosis* ; Recurrence ; Treatment Failure ; Treatment Outcome

PURPOSE: Mycophenolate mofetil (MMF) is thought to have not only low frequency of adverse side effects but also have equal efficacy to other conventional immunosuppressants (CIS). But It's hard to conclude that CIS may be replaceable with MMF. So we inquired into another aspect of MMF as 'Rescue therapy' in non-transplant renal diseases. METHODS: Twenty nine patients with non-transplant renal diseases received MMF therapy between January 2000 and April 2007. Eighteen patients who had received MMF more than 6 months were included. Sixteen of the 18 patients included were resistant to CIS and two were patients who maintained complete remission (CR) with MMF because of the adverse side effects of CIS. Treatment outcome was evaluated by dip-stick urine test. CR was defined by negative or trace, partial remission (PR) by 1 positive and treatment failure (TF) by more than 1 positive. RESULTS: Eleven of the resistant 16 patients had shown CR (69%) and maintained CR. Two of maintenance therapy with MMF had kept CR more than 12 months. The proportions of the patients who had shown decreased proteinuria in each treatment duration were 69% for 3 months (p=0.005), 81% for 6 months (p=0.001), 86% for 9 months (p=0.002) and 91% for 12 months (p=0.004), respectively. There were few adverse effects. CONCLUSION: We observed the efficacy of MMF in decreasing proteinuria and maintaining CR as 'Rescue therapy' for previously treated non-transplant renal disease patients with CIS. Large controlled clinical trials are expected for defining this effect.
Humans ; Immunosuppressive Agents ; Kidney Diseases ; Mycophenolic Acid ; Proteinuria ; Treatment Failure ; Treatment Outcome