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Non-thrombotic ischemic cerebrovascular events related to the use of tyrosine kinase inhibitors in patients with cancer: high-resolution magnetic resonance imaging findings 与癌症患者使用酪氨酸激酶抑制剂相关的非血栓性缺血性脑血管事件:高分辨率磁共振成像结果
IF 0.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-01-01 DOI: 10.23838/pfm.2021.00072
J. Sim, J. Park, O. Bang
The targeted cancer therapies that have been introduced in recent years are directed against cancer-specific molecules and signaling pathways, and thus, they have limited nonspecific toxicities. However, major vascular events, including stroke, are common in patients receiving tyrosine kinase inhibitors (TKIs). Inhibition of vascular endothelial growth factor receptor by some TKIs probably explains such events. Moreover, venous and arterial thromboses, atherosclerosis, and bleeding have been reported. Ischemic lesions can also occur due to impaired angiogenesis or endothelial dysfunction. However, the exact mechanisms of arterial stroke in patients with cancer receiving TKIs are unknown. Here, we have report two cases of non-thrombotic ischemic cerebrovascular events related to TKIs and described the high-resolution magnetic resonance imaging findings.
近年来引入的靶向癌症治疗是针对癌症特异性分子和信号通路的,因此它们具有有限的非特异性毒性。然而,主要血管事件,包括中风,在接受酪氨酸激酶抑制剂(TKIs)的患者中很常见。一些TKIs对血管内皮生长因子受体的抑制可能解释了这些事件。此外,静脉和动脉血栓形成、动脉粥样硬化和出血也有报道。缺血性病变也可能由于血管生成受损或内皮功能障碍而发生。然而,接受tki治疗的癌症患者动脉卒中的确切机制尚不清楚。在这里,我们报告了两例与TKIs相关的非血栓性缺血性脑血管事件,并描述了高分辨率磁共振成像结果。
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引用次数: 1
Predictive value of chest computed tomography for axillary lymph node metastasis in patients with breast cancer 胸部计算机断层扫描对乳腺癌腋窝淋巴结转移的预测价值
IF 0.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-01-01 DOI: 10.23838/pfm.2021.00079
C. Kim, M. Chung, S. Chong
Purpose: This study aimed to evaluate the predictive value of preoperative chest computed tomography (CT) for axillary lymph node (ALN) metastasis in patients with breast cancer. Methods: CT features of ALNs were retrospectively reviewed in 212 patients with breast cancer who underwent preoperative chest CT examination and ALN dissection. Primary tumor size and CT characteristics of ALNs (cortical thickness, cortical shape, the presence or absence of contrast enhancement of ALNs, and the presence or absence of perinodal infiltration) were recorded and analyzed. A nomogram was developed to visualize the associations between the predictors and each ALN status endpoint. Results: Of 212 patients, 95 (44.8%) had ALN metastasis. Primary tumor size and CT characteristics of ALNs were identified as predictors of ALN metastasis. The nomogram comprising primary tumor size and cortical shape was a good validation model for predicting ALN metastasis. The sensitivity, specificity, and accuracy of the nomogram for predicting ALN metastasis were 88.4%, 79.5%, and 83.5%, respectively. Conclusion: Using preoperative chest CT scans, a nomogram combining the cortical shape of ALNs with the primary tumor size showed good performance in predicting ALN metastasis.
目的:探讨术前胸部计算机断层扫描(CT)对乳腺癌腋窝淋巴结(ALN)转移的预测价值。方法:回顾性分析212例乳腺癌患者术前行胸部CT检查及ALN剥离的CT表现。记录并分析原发肿瘤大小及ALNs的CT特征(皮质厚度、皮质形态、有无ALNs对比增强、有无淋巴结周围浸润)。开发了一个nomogram来可视化预测因子和每个ALN状态端点之间的关联。结果:212例患者中有95例(44.8%)发生ALN转移。原发肿瘤大小和CT特征被确定为ALN转移的预测因素。包括原发肿瘤大小和皮质形状的nomogram是预测ALN转移的一个很好的验证模型。nomogram预测ALN转移的敏感性、特异性和准确性分别为88.4%、79.5%和83.5%。结论:术前胸部CT扫描,结合ALN皮质形态和原发肿瘤大小的nomogram预测ALN转移的效果较好。
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引用次数: 0
Surgical approach for the treatment of thymic carcinoma: 201 cases from a multi-institutional study 手术入路治疗胸腺癌:201例多机构研究
IF 0.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2020-12-18 DOI: 10.23838/pfm.2020.00163
Y. Jeon, Y. Choi, J. Cho, H. Kim, G. Lee, D. K. Kim, C. Kang, Y. T. Kim, Chang Young Lee, J. Lee
Purpose: This study aimed to compare the outcomes of surgical approach (video-assisted thoracoscopic surgery [VATS] vs. sternotomy vs. thoracotomy) for the treatment of thymic carcinoma Methods: We retrospectively reviewed 201 patients with pathologically proven thymic carcinoma who underwent surgical resection at four Korean institutions. Results: From 2007 to 2013, 158 sternotomy, 33 VATS and 10 thoracotomy were conducted for thymic carcinoma. Open group underwent more preoperative biopsy (41.8% and 50% vs. 15.2%, P=0.012) and neoadjuvant treatment (22.2% and 30% vs. 0%, P=0.008) than VATS group. In preoperative imaging, tumor size of VATS group was smaller than sternotomy group (3.8±1.1 cm vs. 5.8±2 cm, P<0.05) and 91% of the VATS group was clinical tumor-node-metastasis (TNM) stage I. The lengths of chest tube and mechanical ventilation duration, postoperative hospital day and intensive care unit stay were shorter in VATS group than open group (P<0.001). The incidence of postoperative complications of VATS group was lower than sternotomy group (P=0.014). The 5-year overall survival of the sternotomy, VATS and thoracotomy group were 100%, 100% and 87.5%±11.7%, respectively (P=0.107). The 5-year recurrence-free survival rate was not significantly different between the groups (55.4%±4.5%, 67.9%±12.1%, and 87.5%±11.7%; P=0.131) Conclusion: The VATS approach of surgical treatment for thymic carcinoma can be selectively employed in small (<5 cm) and TNM stage I tumor without compromise of oncologic outcome.
目的:本研究旨在比较胸廓癌的手术方法(电视胸腔镜手术与胸骨切开术与开胸术)的疗效。方法:我们回顾性回顾了在四家韩国机构接受手术切除的201例经病理证实的胸廓癌患者。结果:2007年至2013年,胸廓癌共行胸骨切开术158例,胸腔镜手术33例,开胸手术10例。与VATS组相比,开放组接受了更多的术前活检(41.8%和50%对15.2%,P=0.012)和新辅助治疗(22.2%和30%对0%,P=0.008)。在术前影像学检查中,VATS组的肿瘤大小小于胸骨切开术组(3.8±1.1cm vs.5.8±2cm,P<0.05),91%的VATS组为临床肿瘤淋巴结转移(TNM)I期,VATS组的术后住院天数和重症监护室住院时间均短于开放组(P<0.001)。VATS组术后并发症发生率低于胸骨切开术组(P=0.014)。胸骨切开术、VATS和开胸术组的5年总生存率分别为100%、100%和87.5%±11.7%,两组5年无复发生存率无显著差异(55.4%±4.5%,67.9%±12.1%,87.5%±11.7%;P=0.131)。
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引用次数: 0
Recent dyslipidemia guidelines for patients with diabetes mellitus 近期糖尿病患者血脂异常指南
IF 0.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2020-09-09 DOI: 10.23838/pfm.2020.00100
E. Rhee
Treatment of diabetic dyslipidemia is important for the prevention of cardiovascular diseases in patients with diabetes. Although glucose control is the main target in patients with diabetes mellitus (DM) to prevent diabetic complications, multifactorial interventions are absolutely important to reduce the risk of cardiovascular diseases. Recent joint guidelines from the European Society of Cardiology and European Society for the Study of Diabetes have recommended lower low-density lipoprotein cholesterol (LDL-C) targets for patients with DM and included DM duration in the stratification of risk groups for cardiovascular disease prevention, emphasizing higher cardiovascular risk in patients with DM. In addition, the American Heart Association/American College of Cardiology guidelines were revised so that the LDL-C cutoff appeared in the guidelines for high risk groups and for changes in treatment options. The Korean Diabetes Association also released new treatment guidelines for patients with DM and adopted recent changes from other guidelines with respect to dyslipidemia control. In this review, I examined recent updates in the guidelines for dyslipidemia treatment for patients with DM.
糖尿病血脂异常的治疗对于预防糖尿病患者的心血管疾病非常重要。尽管血糖控制是糖尿病(DM)患者预防糖尿病并发症的主要目标,但多因素干预对于降低心血管疾病的风险绝对重要。欧洲心脏病学会和欧洲糖尿病研究学会最近的联合指南建议糖尿病患者达到较低的低密度脂蛋白胆固醇(LDL-C)目标,并将糖尿病持续时间纳入心血管疾病预防的风险组分层,强调糖尿病患者的心血管风险较高。此外,修订了美国心脏协会/美国心脏病学会指南,使LDL-C临界值出现在高危人群和治疗方案变化的指南中。韩国糖尿病协会还发布了针对糖尿病患者的新治疗指南,并在控制血脂异常方面采用了与其他指南相比的最新变化。在这篇综述中,我研究了糖尿病患者血脂异常治疗指南的最新进展。
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引用次数: 2
Value of systematic biopsy added to target biopsy for detecting significant cancer in men with Prostate Imaging and Reporting and Data System 5 在前列腺成像和报告及数据系统5中,在靶活检中添加系统活检对检测男性显著癌症的价值
IF 0.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2020-08-27 DOI: 10.23838/pfm.2020.00015
T. An, B. K. Park
Purpose: To assess the value of systematic biopsy added to target biopsy for detecting significant cancer in men with Prostate Imaging and Reporting and Data System 5 (PIRADS 5). Methods: Between March 2014 and November 2018, 186 men had a PI-RADS 5 categorized as an index lesion on magnetic resonance imaging prior to transrectal ultrasound (TRUS)-guided biopsy. Of these patients, 135 (group I) underwent target biopsy alone because of good depiction. The remaining 51 (group II) underwent target and systematic biopsies because of poor depiction. Significant cancer detection rates (CDRs) were compared between the groups. Which type of biopsies contributed to detecting significant cancer was evaluated in the group II. Results: Significant CDRs of the target biopsy were 67.4% (91/135) in the group I and 47.1% (24/51) in the group II (P=0.0173). However, when systematic biopsy was added to target biopsy, the significant CDR of the group II increased to 52.9% (27/51) (P=0.0900). Of the 27 significant cancers missed by target biopsy in the group II, three were detected by systematic biopsy alone. Moreover, systematic biopsy detected higher Gleason scores in two cases than target biopsy. Conclusion: Systematic biopsy contributes to detecting additional significant cancers in men with PI-RADS 5 partially visible on TRUS.
目的:通过前列腺成像和报告与数据系统5(PIRADS 5),评估系统活检与靶活检相结合在检测男性显著癌症中的价值。方法:在2014年3月至2018年11月期间,186名男性在经直肠超声(TRUS)引导的活检前,在磁共振成像中将PI-RADS 5归类为指数病变。在这些患者中,135例(I组)由于描述良好而单独进行了靶活检。其余51例(II组)因描述不清而接受了靶向和系统活检。比较两组之间显著的癌症检出率(CDR)。第二组评估了哪种类型的活组织检查有助于发现显著的癌症。结果:靶活检的显著CDR在I组为67.4%(91/135),在II组为47.1%(24/51)(P=0.0173)。然而,当靶活检中加入系统活检时,II组的显著CDR增加到52.9%(27/51)(P=0.0900)。在II组靶活检遗漏的27种显著癌症中,有3种仅通过系统活检检测到。此外,系统活检在两个病例中检测到比目标活检更高的Gleason评分。结论:系统活检有助于检测TRUS上部分可见的PI-RADS 5男性的其他重要癌症。
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引用次数: 3
Computed tomography and magnetic resonance imaging assessment of aortic valve stenosis: an update 主动脉瓣狭窄的计算机断层扫描和磁共振成像评估:最新进展
IF 0.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2020-08-24 DOI: 10.23838/pfm.2020.00093
Y. Choe, S. Kim, Sung-Ji Park
Computed tomography (CT) and magnetic resonance imaging (MRI) are being increasingly utilized for the evaluation of cardiac valves. Although echocardiography is the first-line imaging modality in the evaluation of aortic stenosis (AS), CT and MRI can be adopted as adjunct imaging modalities for assessing the severity of AS. First, CT has established its role in the evaluation of co-existing coronary artery disease in AS patients, while stress MRI can be employed to exclude myocardial perfusion abnormalities. For the preand post-procedural evaluation of transcatheter aortic valve implantation or replacement, CT plays a very important role in determining the size of prosthetic valves and evaluating post-procedural complications. CT also helps assess the prosthetic valve sizes with 3-dimensional printing. Late gadolinium enhancement, T1 mapping, and feature tracking of left ventricular myocardium enable assessment of left ventricular function and myocardial fibrosis in patients with AS. Four-dimensional flow analysis gives new insights on flow patterns, kinetic energy, and wall shear stress in the ascending aorta in AS patients. In summary, CT and MRI are playing increasingly important roles in the evaluation of aortic valve disease.
计算机断层扫描(CT)和磁共振成像(MRI)正越来越多地用于评估心脏瓣膜。尽管超声心动图是评估主动脉狭窄(AS)的一线成像方式,但CT和MRI可作为评估AS严重程度的辅助成像方式。首先,CT已在评估AS患者合并冠状动脉疾病中发挥作用,而应力MRI可用于排除心肌灌注异常。对于经导管主动脉瓣植入或置换术的术前和术后评估,CT在确定人工瓣膜的大小和评估术后并发症方面起着非常重要的作用。CT也有助于通过三维打印来评估人工瓣膜的尺寸。晚期钆增强、T1标测和左心室心肌特征跟踪能够评估AS患者的左心室功能和心肌纤维化。四维血流分析为AS患者升主动脉的血流模式、动能和壁剪切应力提供了新的见解。总之,CT和MRI在评估主动脉瓣疾病中发挥着越来越重要的作用。
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引用次数: 2
Message from the P&FM editors to our ad hoc reviewers P&FM编辑给我们特别审稿人的消息
IF 0.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2020-03-13 DOI: 10.23838/pfm.2020.00051
Oh Young Bang
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引用次数: 0
Intrafamilial variability and clinical heterogeneity in a family with PLA2G6-associated neurodegeneration PLA2G6相关神经退行性变家族的家族内变异性和临床异质性
IF 0.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2019-09-24 DOI: 10.23838/pfm.2019.00086
Jongkyu Park, J. Youn, J. Cho
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引用次数: 3
Robotic assisted rehabilitation therapy for enhancing gait and motor function after stroke 机器人辅助康复治疗改善脑卒中后步态和运动功能
IF 0.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2019-09-24 DOI: 10.23838/pfm.2019.00065
Y. Kim
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引用次数: 10
Precision surgery for cancer: a new surgical concept in individual tumor biology-based image-guided surgery 肿瘤精准手术:基于个体肿瘤生物学的影像引导手术新理念
IF 0.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2019-09-16 DOI: 10.23838/pfm.2019.00072
N. Choi, Han-Sin Jeong
Surgery has long been a cornerstone of cancer treatment in many types of cancer. Traditionally, intraoperative assessment of the resection margin is largely dependent on visual inspection and palpation of tumors, with the aid of frozen section analysis. Although preoperative imaging can provide gross anatomical information, in situ translation of these images to the operation field is challenging. With the advancement of molecular imaging technology and its clinical application, the gap between preoperative radiologic images and surgical findings has been reduced through image-guided surgery. However, the imaging probes for intraoperative visualization of tumors are not individual tumor-specific. As conventional oncology has moved toward precision oncology with genomic and biological information specific to each tumor, image-guided surgery should also shift toward tumor biology-based image-guided surgery, so-called precision surgery for cancer. In precision cancer surgery, tumors should be analyzed molecularly and genetically to select the optimal imaging probes for individual tumors before surgical resection, beyond the use of predetermined imaging probes for certain types of cancer. This will raise the likelihood of meeting the surgical goals of cancer treatment. In summary, precision cancer surgery can be defined as individual tumor biology-based image-guided surgery.
长期以来,外科手术一直是癌症治疗许多类型癌症的基石。传统上,切除边缘的术中评估在很大程度上取决于肿瘤的视觉检查和触诊,并借助冷冻切片分析。尽管术前成像可以提供大体的解剖信息,但将这些图像原位翻译到手术领域是具有挑战性的。随着分子成像技术的进步及其临床应用,通过图像引导手术缩小了术前放射学图像与手术结果之间的差距。然而,用于术中肿瘤可视化的成像探针并不是个体肿瘤特异性的。随着传统肿瘤学向精确肿瘤学发展,每个肿瘤都有特定的基因组和生物学信息,图像引导手术也应该转向基于肿瘤生物学的图像引导手术,即所谓的癌症精确手术。在精确的癌症手术中,除了对某些类型的癌症使用预先确定的成像探针之外,还应该对肿瘤进行分子和基因分析,以在手术切除前为单个肿瘤选择最佳的成像探针。这将提高达到癌症治疗手术目标的可能性。总之,精确癌症手术可以定义为基于个体肿瘤生物学的图像引导手术。
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引用次数: 2
期刊
Precision and Future Medicine
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