scholarly journals Feasibility of transrectal and transperineal fiducial marker placement for prostate cancer before proton therapy

2020 ◽  
Author(s):  
Kengo Ohta ◽  
Hiroyuki Ogino ◽  
Hiromitsu Iwata ◽  
Shingo Hashimoto ◽  
Yukiko Hattori ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Proton Therapy ◽  
Clinical Success ◽  
Clinical Success Rate ◽  
Fiducial Marker ◽  
Success Rates ◽  
Migration Rates ◽  
Pain Scores ◽  
Number Of Patients ◽  
Lower Pain

Abstract Background To compare the feasibility of transrectal and transperineal fiducial marker placement for prostate cancer before proton therapy. Materials and Methods From 2013 to 2015, the first 40 prostate cancer patients that were scheduled for proton therapy underwent transrectal fiducial marker placement, and the next 40 patients underwent transperineal fiducial marker placement (the first series). Technical and clinical success and pain scores were evaluated. In the second series (n = 280), the transrectal or transperineal approach was selected depending on the presence/absence of comorbidities, such as blood coagulation abnormalities. Seven patients refused to undergo the procedure. Thus, the total number of patients across both series was 353 (262 and 91 underwent the transrectal and transperineal approach, respectively). Technical and clinical success, complications, marker migration and the distance between the two markers were evaluated. Results In the first series, the technical and clinical success rates were 100% in both groups. The transrectal group exhibited lower pain scores than the transperineal group. The overall technical success rates of the transrectal and transperineal groups were 100% (262/262) and 99% (90/91), respectively (P > 0.05). The overall clinical success rate was 100% in both groups, and there were no major complications in either group. The migration rates of the two groups did not differ significantly. The mean distance between the two markers was 25.6 ± 7.1 mm (mean ± standard deviation) in the transrectal group and 31.9 ± 5.2 mm in the transperineal group (P < 0.05). Conclusion Both the transrectal and transperineal fiducial marker placement methods are feasible and safe.

Lower Respiratory Tract Infections Treated with Bacampicillin: A Dose Comparison

1977 ◽  
Vol 5 (5) ◽  
pp. 313-321 ◽  
Author(s):  
J Sjövall
Keyword(s):  
Success Rate ◽  
Chronic Bronchitis ◽  
Clinical Success ◽  
Clinical Success Rate ◽  
Success Rates ◽  
Dose Comparison ◽  
Number Of Patients ◽  
Acute Exacerbations ◽  
Tract Infections

In an open multicentre study of bacampicillin (Penglobe®), a new orally well absorbed prodrug of ampicillin, 516 patients with acute exacerbations of chronic bronchitis or pneumonia were treated by a group of Belgian pneumologists or internists. Bacampicillin was given in a dosage regimen of 400 mg or 800 mg three times daily. In patients with acute exacerbations of chronic bronchitis the clinical success rate was high, over 95% in both groups. A n improvement in the sputum purulence score was seen in 93% of the patients with an initially purulent sputum and 69% had a normal mucoid sputum at follow-up. The clinical success rate in patients with pneumonia was also similar in both dosage groups with success rates over 96%. The total number of patients with adverse reactions was not more than 5·4%, of which the majority were considered mild or moderate. Each type of side-effect occurred in a frequency of 1·2% or less. There were no differences between the two dosage regimens as regards the frequency of side-effects which indicates a remarkably good tolerance of bacampicillin also with the higher dosage.

Endoscopic Treatment of Arachnoid Cysts

Neurosurgery ◽  
2010 ◽  
Vol 67 (3) ◽  
pp. 824-836 ◽  
Author(s):  
Joachim M.K. Oertel ◽  
Wolfgang Wagner ◽  
Yvonne Mondorf ◽  
Joerg Baldauf ◽  
Henry W.S. Schroeder ◽  
...  
Keyword(s):  
Arachnoid Cyst ◽  
Clinical Success ◽  
Clinical Success Rate ◽  
Endoscopic Technique ◽  
Arachnoid Cysts ◽  
Success Rates ◽  
Endoscopic Procedures ◽  
Endoscopic Techniques ◽  
Presenting Symptoms ◽  
Long Term Follow Up

Abstract BACKGROUND Surgical treatment of arachnoid cysts remains under debate. Although many authors favor endoscopic techniques, others attribute a higher recurrence rate to the endoscope. OBJECTIVE The authors report their experience with endoscopic procedures for arachnoid cyst. METHODS All pure endoscopic procedures for arachnoid cysts performed by the authors were analyzed. Particular reference was given to surgical complications and patient outcome in relation to cyst location and endoscopic technique. RESULTS Sixty-six endoscopic procedures were performed in 61 patients (mean age, 28 years; range, 23 days to 74 years; 35 males, 26 females). The main presenting symptoms were cephalgia (61%), hemisymptoms (18%), and macrocephalus (18%). Cyst location was temporobasal (34%), suprasellar (21%), at the cisterna quadrigemina (18%), paraxial supratentorial (16%), and various (10%). Thirty cystocisternostomies, 14 ventriculocystostomies, 12 cystoventriculostomies, and 10 ventriculocystocisternostomies were performed. The overall clinical success rate was 90%. The endoscopic technique was abandoned in 4 cases (7%). Postoperative complications were found in 16%; there was only one permanent deficit (2%). Five recurrences (8%) occurred up to 7 years after the first procedure. Of the various locations, the temporobasal cysts were the most difficult to treat with lowest clinical success (81%), highest recurrence (19%), and highest complication rate (24%). Of the various endoscopic techniques, ventriculocystostomy and ventriculocystocisternostomy reached the highest success rates with 100%. CONCLUSIONS Endoscopic techniques provide very good results in arachnoid cyst treatment. The most frequent cyst location is the most difficult to treat. A long-term follow-up is recommended since recurrences can occur many years after the procedure.

scholarly journals Salvage therapy using self-expandable metal stents for recalcitrant anastomotic strictures after living-donor liver transplantation

2017 ◽  
Vol 10 (3) ◽  
pp. 297-309 ◽  
Author(s):  
Sung Ill Jang ◽  
Se Yong Sung ◽  
Hyunsung Park ◽  
Kwang-Hun Lee ◽  
Seung-Moon Joo ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Clinical Success ◽  
Anastomotic Stricture ◽  
Clinical Success Rate ◽  
Metal Stents ◽  
Success Rates ◽  
Donor Liver Transplantation ◽  
Percutaneous Procedure ◽  
Anastomotic Strictures ◽  
The Mean

Background: Recently, there has been an increase in clinical success rates using nonsurgical methods to resolve anastomotic biliary strictures (ABSs) that develop after liver transplantation (LT). However, some strictures are particularly refractory and cannot be completely resolved by an endoscopic or percutaneous procedure. Consequently, the aim of this study was to examine the feasibility and efficacy of using a newly designed fully covered self-expandable metal stent (FCSEMS) to resolve refractory ABS. Methods: A total of 35 patients with an ABS that developed after LT, but could not be resolved by an endoscopic or percutaneous procedure, were included in this study. FCSEMSs were positioned endoscopically and removed after 2–3 months. After stent removal, the patients were followed to assess complications, including re-stenosis. Results: The mean period from LT to stricture was 13.7 months, and the mean duration of the stricture was 31.8 months. The type and mean number of procedures previously attempted were endoscopic retrograde cholangiopancreatography (ERCP) (9.1 ± 5.1) in 19 patients and percutaneous transhepatic biliary drainage (9.2 ± 4.8) in 16 patients. All patients had successful FCSEMS insertions and removals; the mean stent indwelling time was 3.2 months. The mean follow-up period was 18.7 months (range: 6.4–37.8 months). Stricture recurrence was observed in 6 of 29 patients (recurrence rate: 20.7%). The anastomotic stricture resolved with the FCSEMS insertion in 29 of 35 patients (clinical success rate: 82.9%). Conclusions: The newly designed FCSEMS is a potentially feasible and effective treatment for anastomotic strictures that develop after LT but are not amenable to treatment by conventional procedures.

scholarly journals Robotic-assisted total knee arthroplasty demonstrates decreased postoperative pain and opioid usage compared to conventional total knee arthroplasty

2020 ◽  
Vol 1 (2) ◽  
pp. 8-12 ◽  
Author(s):  
Samrath J. Bhimani ◽  
Rohat Bhimani ◽  
Austin Smith ◽  
Christian Eccles ◽  
Langan Smith ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Opioid Use ◽  
Robotic Assisted ◽  
Pain Scores ◽  
Number Of Patients ◽  
Lower Pain ◽  
Clinical Benefits ◽  
Total Knee ◽  
Pain At Rest

Aims Robotic-assisted total knee arthroplasty (RA-TKA) has been introduced to provide accurate bone cuts and help achieve the target knee alignment, along with symmetric gap balancing. The purpose of this study was to determine if any early clinical benefits could be realized following TKA using robotic-assisted technology. Methods In all, 140 consecutive patients undergoing RA-TKA and 127 consecutive patients undergoing conventional TKA with minimum six-week follow-up were reviewed. Differences in visual analogue scores (VAS) for pain at rest and with activity, postoperative opiate usage, and length of stay (LOS) between the RA-TKA and conventional TKA groups were compared. Results Patients undergoing RA-TKA had lower average VAS pain scores at rest (p = 0.001) and with activity (p = 0.03) at two weeks following the index procedure. At the six-week interval, the RA-TKA group had lower VAS pain scores with rest (p = 0.03) and with activity (p = 0.02), and required 3.2 mg less morphine equivalents per day relative to the conventional group (p < 0.001). At six weeks, a significantly greater number of patients in the RA-TKA group were free of opioid use compared to the conventional TKA group; 70.7% vs 57.0% (p = 0.02). Patients in the RA-TKA group had a shorter LOS; 1.9 days versus 2.3 days (p < 0.001), and also had a greater percentage of patient discharged on postoperative day one; 41.3% vs 20.5% (p < 0.001). Conclusion Patients undergoing RA-TKA had lower pain levels at both rest and with activity, required less opioid medication, and had a shorter LOS.

Formocresol versus Calcium Hydroxide Direct Pulp Capping of Human Primary Molars: Two Year Follow-Up

2010 ◽  
Vol 34 (4) ◽  
pp. 317-321 ◽  
Author(s):  
Naser Asl Aminabadi ◽  
Ramin Mostofi Zadeh Farahani ◽  
Sina Ghertasi Oskouei
Keyword(s):  
Calcium Hydroxide ◽  
Root Resorption ◽  
Clinical Success ◽  
Clinical Success Rate ◽  
Radiographic Evaluation ◽  
Primary Molars ◽  
Spontaneous Pain ◽  
Success Rates ◽  
Direct Pulp Capping ◽  
Pulp Capping

Objectives: Clinical and radiographic evaluation of the premedicated direct pulp capping using formocresol(PDC) versus conventional direct pulp capping using calcium hydroxide (CDC) in human carious primary molars. Study design: A total of 120 vital primary molars with pinpoint exposure during caries removal in 84 patients aged 4-5 years were selected. In the PDC group (n = 60), 20% Buckley's formocresol solution, and in the CDC group (n = 60), calcium hydroxide powder were applied to the exposure sites followed by placement of zinc oxide-eugenol base. Teeth were restored with preformed stainless steel crowns. Clinical and radiographic evaluations of the treatment outcomes were performed at regular intervals of 6 and 12 months, respectively, for two years post-operatively. Results: The prevalence of spontaneous pain,sensitivity on percussion, and fistula were significantly higher in the CDC group compared to the PDC group (P &lt; 0.05). The number of teeth exhibiting periapical/furcal radiolucency or external/internal root resorption was also higher in the CDC group (P &lt; 0.05). The clinical success rate of the PDC was 90% compared to the 61.7% of the CDC (P &lt; 0.05). The radiographic success rates of the PDC and CDC groups were 85% and 53.3%, respectively (P &lt; 0.05). Conclusion: It seems formocresol premedicated direct pulp capping could safely be used as a substitute for conventional direct pulp capping.

scholarly journals Evaluation of the clinical efficiency of rotary and manual files for root canal instrumentation in primary teeth pulpectomies: A comparative randomized clinical trial

2021 ◽  
pp. 21-34
Author(s):  
KL Girish Babu ◽  
◽  
Guraj Hebbar Kavyashree ◽  
Keyword(s):  
Root Canal ◽  
Clinical Success ◽  
File Systems ◽  
Clinical Success Rate ◽  
Mean Difference ◽  
Primary Molars ◽  
Success Rates ◽  
Primary Molar ◽  
The Mean

Aim: To evaluate and compare the instrumentation time, obturation time, quality of obturation, and clinical and radiological success of pulpectomized teethfollowing root canal preparation of primary molars with rotary and manual file system. Methods: A total of 150 primary molars requiring pulpectomy were selected from children aged four to seven years. These teeth were divided into three groups of 50 teeth each. In Groups 1, 2, and 3, cleaning and shaping were carried out with Kedo-S pediatric rotaryfiles, HERO Shaper rotary files, and manual NiTi K-files, respectively. Obturation was carried out with zinc oxide eugenol cement and an engine-driven Lentulo spiral. The instrumentation and obturation times were recorded. A radiographic assessment of thequality of the root filling was carried out immediately after obturation. Finally, the pulpectomized teeth were clinically and radiographically evaluated over a two-year period. Results: The mean instrumentation times for Groups 1, 2, and 3 were 14.56 ± 2.89 min, 17.93 ± 3.51 min, and 29.00 ± 2.08 min, respectively. The mean obturation times for Groups 1, 2, and 3 were 8.11 ± 1.7 min, 7.93 ± 1.3 min, and 9.64 ± 17.61 min, respectively. The mean difference in the quality of obturation was not statistically significant in primary molars instrumented with Kedo-S pediatricand HERO Shaper rotary file systems (p = 0.16). However, this mean difference was significant when compared between primary molar instrumented with rotary file systems and manual NiTi files (p = <0.001). At two years, the clinical success rate was 100% and the radiological success rates were 95.3%, 97.9%, and 89.5% in Groups 1, 2, and 3, respectively. Conclusions: The rotary file systems took significantly less instrumentation and obturation time than the manual NiTi files. There were no significant differences in obturation quality or success rates after two years.

First experience of efficacy and radiation exposure in 320-detector row CT fluoroscopy-guided interventions

2021 ◽  
pp. 20200754
Author(s):  
Shota Yamamoto ◽  
Tomohiro Matsumoto ◽  
Satoshi Suda ◽  
Kosuke Tomita ◽  
Shunsuke Kamei ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Success Rate ◽  
Dose Reduction ◽  
Clinical Success ◽  
Clinical Success Rate ◽  
Total Radiation ◽  
Success Rates ◽  
Technical Success ◽  
Total Radiation Dose ◽  
Interventional Ct

Objective: We investigated the efficacy and exposure to radiation in 320-detector row computed tomography fluoroscopy-guided (CTF-guided) interventions. Methods: We analysed 231 320-detector row CTF-guided interventions (207 patients over 2 years and 6 months) in terms of technical success rates, clinical success rates, complications, scanner settings, overall radiation doses (dose–length product, mGy*cm), patient doses of peri-interventional CT series, and interventional CT (including CTF), as a retrospective cohort study. The relationships between patient radiation dose and interventional factors were assessed using multivariate analysis. Results: Overall technical success rate was 98.7% (228/231). The technical success rates of biopsies, drainages, and aspirations were 98.7% (154/156), 98.5% (66/67), and 100% (8/8), respectively. The clinical success rate of biopsies was 93.5% (146/156). All three major complications occurred in chest biopsies. The median total radiation dose was 522.4 (393.4–819.8) mGy*cm. Of the total radiation dose, 87% was applied during the pre- and post-interventional CT series. Post-interventional CT accounted for 24.4% of the total radiation dose. Only 11.4% of the dose was applied by CTF-guided intervention. Multilinear regression demonstrated that male sex, body mass index, drainage, intervention time, and helical scan as post-interventional CT were significantly associated with higher dose. Conclusion: The 320-detector row CTF interventions achieved a high success rate. Dose reduction in post-interventional CT provides patient dose reduction without decreasing the technical success rates. Advances in knowledge: This is the first study on the relationship between various interventional outcomes and patient exposure to radiation in 320-detector row CTF-guided interventions, suggesting a new perspective on dose reduction.

scholarly journals Outcomes of EUS-guided choledochoduodenostomy as primary drainage for distal biliary obstruction with covered self-expandable metallic stents

2020 ◽  
Vol 08 (07) ◽  
pp. E861-E868
Author(s):  
Naosuke Kuraoka ◽  
Kazuo Hara ◽  
Nozomi Okuno ◽  
Takamichi Kuwahara ◽  
Nobumasa Mizuno ◽  
...  
Keyword(s):  
Success Rate ◽  
Clinical Success ◽  
Clinical Success Rate ◽  
Cancer Center ◽  
Biliary Duct ◽  
Metallic Stent ◽  
Success Rates ◽  
Stent Patency ◽  
Technical Success Rate ◽  
Drainage Technique

Abstract Background and study aims Endoscopic ultrasonography-guided choledochoduodenostomy (EUS-CDS) is an alternative therapy for percutaneous transhepatic biliary drainage. Outcomes of EUS-CDS for distal biliary tract obstruction with a covered self-expandable metallic stent (SEMS) as a primary drainage technique are unclear because there are few relevant reports. This study aimed to determine outcomes in patients undergoing EUS-CDS using SEMS as the primary drainage technique for malignant distal biliary duct obstruction. Patients and methods This retrospective study was conducted at Aichi Cancer Center Hospital, from January 2010 to July 2018, using data from our database. Results EUS-CDS was performed as a primary drainage technique for 92 patients. The technical success rate was 92.8 %, and the clinical success rate was 91.6 %. The overall incidence of adverse events was 15.7 %. The median stent patency time for the EUS-CDS was 396 days. Nineteen patients required re-intervention because of cholangitis or jaundice. Conclusion EUS-CDS as a primary drainage technique using SEMS has high technical and clinical success rates. It should be considered an effective drainage method with respect to long-term stent patency, low re-intervention rates, and absence of severe complications.

scholarly journals Comparison of facemask therapy effects using skeletal and tooth-borne anchorage:

2021 ◽  
Author(s):  
Hyeon-Jong Lee ◽  
Dong-Soon Choi ◽  
Insan Jang ◽  
Bong-Kuen Cha
Keyword(s):  
Clinical Success ◽  
Clinical Success Rate ◽  
Skeletal Anchorage ◽  
Success Rates ◽  
Class Iii ◽  
Pubertal Stage ◽  
Mandibular Plane ◽  
Lateral Cephalograms ◽  
Cephalometric Changes

ABSTRACT Objectives To investigate long-term outcomes of dentoskeletal changes induced by facemask therapy using skeletal anchorage in Class III patients and compare them to those of conventional tooth-borne anchorage. Materials and Methods This retrospective study included 20 patients who received facemask (FM) therapy with miniplates as anchorage for maxillary protraction (Miniplate/FM group, 10.6 ± 1.1 years old [mean ± SD]) and 23 patients who were treated with facemask with rapid maxillary expander (RME/FM group, 10.0 ± 1.5 years old [mean ± SD]). Dentoskeletal changes were evaluated using lateral cephalograms at pretreatment (T1), after facemask therapy (T2), and at the post-pubertal stage (T3). Cephalometric changes were compared between groups and clinical success rates at T3 were evaluated. Results SNA and A to N perpendicular to FH increased significantly more in the Miniplate/FM group than in the RME/FM group when comparing short-term effects of facemask therapy (T1–T2). ANB, Wits appraisal, Angle of convexity, mandibular plane angle, and overjet decreased significantly more in the RME/FM group than in the Miniplate/FM group after facemask therapy (T2–T3). A more favorable intermaxillary relationship was observed in the Miniplate/FM group than in the RME/FM group in long-term observations (T1–T3). Clinical success rate at T3 was 95% in the Miniplate/FM group and 85% in the RME/FM group. Conclusions Facemask therapy with skeletal anchorage showed a greater advancement of the maxilla and more favorable stability for correction of Class III malocclusion in the long-term than conventional facemask therapy with tooth-borne anchorage.

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