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.
{"title":"Surgical approach for the treatment of thymic carcinoma: 201 cases from a multi-institutional study","authors":"Y. Jeon, Y. Choi, J. Cho, H. Kim, G. Lee, D. K. Kim, C. Kang, Y. T. Kim, Chang Young Lee, J. Lee","doi":"10.23838/pfm.2020.00163","DOIUrl":"https://doi.org/10.23838/pfm.2020.00163","url":null,"abstract":"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.","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2020-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46998675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Recent dyslipidemia guidelines for patients with diabetes mellitus","authors":"E. Rhee","doi":"10.23838/pfm.2020.00100","DOIUrl":"https://doi.org/10.23838/pfm.2020.00100","url":null,"abstract":"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.","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2020-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45471413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Value of systematic biopsy added to target biopsy for detecting significant cancer in men with Prostate Imaging and Reporting and Data System 5","authors":"T. An, B. K. Park","doi":"10.23838/pfm.2020.00015","DOIUrl":"https://doi.org/10.23838/pfm.2020.00015","url":null,"abstract":"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.","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2020-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49589499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Computed tomography and magnetic resonance imaging assessment of aortic valve stenosis: an update","authors":"Y. Choe, S. Kim, Sung-Ji Park","doi":"10.23838/pfm.2020.00093","DOIUrl":"https://doi.org/10.23838/pfm.2020.00093","url":null,"abstract":"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.","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2020-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48116071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Message from the P&FM editors to our ad hoc reviewers","authors":"Oh Young Bang","doi":"10.23838/pfm.2020.00051","DOIUrl":"https://doi.org/10.23838/pfm.2020.00051","url":null,"abstract":"","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2020-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43424549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Intrafamilial variability and clinical heterogeneity in a family with PLA2G6-associated neurodegeneration","authors":"Jongkyu Park, J. Youn, J. Cho","doi":"10.23838/pfm.2019.00086","DOIUrl":"https://doi.org/10.23838/pfm.2019.00086","url":null,"abstract":"","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2019-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47813840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Robotic assisted rehabilitation therapy for enhancing gait and motor function after stroke","authors":"Y. Kim","doi":"10.23838/pfm.2019.00065","DOIUrl":"https://doi.org/10.23838/pfm.2019.00065","url":null,"abstract":"","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2019-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48686944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Precision surgery for cancer: a new surgical concept in individual tumor biology-based image-guided surgery","authors":"N. Choi, Han-Sin Jeong","doi":"10.23838/pfm.2019.00072","DOIUrl":"https://doi.org/10.23838/pfm.2019.00072","url":null,"abstract":"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.","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2019-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46372694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Proton therapy has the potential advantages of better conformal planning and higher biological effect than photon therapy (X-ray) for targeting tumor tissues. While the energy of a photon passes through the target, the energy of a proton is deposited at a certain depth, which in turn is negligible beyond this stopping point (i.e., the “Bragg peak”). In addition, the proton beam has a 10% higher biological effect in the same dose than the photon beam. Recent technological advances have led to wide use of proton therapy in clinical practice. To date, more than 170,000 patients have received proton therapy. Although clinical experience with proton therapy is increasing now, only approximately 1% of all radiation therapy recipients receive proton therapy and prospective randomized studies involving large sample populations remain very limited yet. The aim of this review is to describe the physical and biological properties of proton therapy and discusses the clinical evidence supporting proton therapy in various disease sites.
{"title":"Proton therapy: the current status of the clinical evidences","authors":"D. Oh","doi":"10.23838/pfm.2019.00058","DOIUrl":"https://doi.org/10.23838/pfm.2019.00058","url":null,"abstract":"Proton therapy has the potential advantages of better conformal planning and higher biological effect than photon therapy (X-ray) for targeting tumor tissues. While the energy of a photon passes through the target, the energy of a proton is deposited at a certain depth, which in turn is negligible beyond this stopping point (i.e., the “Bragg peak”). In addition, the proton beam has a 10% higher biological effect in the same dose than the photon beam. Recent technological advances have led to wide use of proton therapy in clinical practice. To date, more than 170,000 patients have received proton therapy. Although clinical experience with proton therapy is increasing now, only approximately 1% of all radiation therapy recipients receive proton therapy and prospective randomized studies involving large sample populations remain very limited yet. The aim of this review is to describe the physical and biological properties of proton therapy and discusses the clinical evidence supporting proton therapy in various disease sites.","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48285344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Hyeon, Sung-Ji Park, So Ree Kim, Eun Kyoung Kim, S. Kim, Sung‐A Chang, Sang-Chol Lee, K. Sung, S. Park
{"title":"Sinus of Valsalva aneurysm after blunt chest trauma with complicated perforation by infective endocarditis","authors":"C. Hyeon, Sung-Ji Park, So Ree Kim, Eun Kyoung Kim, S. Kim, Sung‐A Chang, Sang-Chol Lee, K. Sung, S. Park","doi":"10.23838/PFM.2019.00030","DOIUrl":"https://doi.org/10.23838/PFM.2019.00030","url":null,"abstract":"","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42322396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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