http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
Marcus A. Florez(Marcus A. Florez ),Brian De(Brian De ),Bhavana V. Chapman(Bhavana V. Chapman ),Anussara Prayongrat(Anussara Prayongrat ),Jonathan G. Thomas(Jonathan G. Thomas ),Thomas H. Beckham(Thom 대한방사선종양학회 2023 Radiation Oncology Journal Vol.41 No.1
Purpose: There has been limited work assessing the use of re-irradiation (re-RT) for local failure following stereotactic spinal radiosurgery (SSRS). We reviewed our institutional experience of conventionally-fractionated external beam radiation (cEBRT) for salvage therapy following SSRS local failure. Materials and Methods: We performed a retrospective review of 54 patients that underwent salvage conventional re-RT at previously SSRS-treated sites. Local control following re-RT was defined as the absence of progression at the treated site as determined by magnetic resonance imaging. Results: Competing risk analysis for local failure was performed using a Fine-Gray model. The median follow-up time was 25 months and median overall survival (OS) was 16 months (95% confidence interval [CI], 10.8–24.9 months) following cEBRT re-RT. Multivariable Cox proportional-hazards analysis revealed Karnofsky performance score prior to re-RT (hazard ratio [HR] = 0.95; 95% CI, 0.93– 0.98; p = 0.003) and time to local failure (HR = 0.97; 95% CI, 0.94–1.00; p = 0.04) were associated with longer OS, while male sex (HR = 3.92; 95% CI, 1.64–9.33; p = 0.002) was associated with shorter OS. Local control at 12 months was 81% (95% CI, 69.3–94.0). Competing risk multivariable regression revealed radioresistant tumors (subhazard ratio [subHR] = 0.36; 95% CI, 0.15–0.90; p = 0.028) and epidural disease (subHR = 0.31; 95% CI, 0.12–0.78; p =0.013) were associated with increased risk of local failure. At 12 months, 91% of patients maintained ambulatory function. Conclusion: Our data suggest that cEBRT following SSRS local failure can be used safely and effectively. Further investigation is needed into optimal patient selection for cEBRT in the retreatment setting.
William A Florez,Ezequiel Garcia-Ballestas,Gabriel Alexander Quiñones-Ossa,Tariq Janjua,Subhas Konar,Amit Agrawal,Luis Rafael Moscote-Salazar 대한신경중재치료의학회 2021 Neurointervention Vol.16 No.3
Flow diverters have become a critical instrument for complex aneurysms treatment. However, limited data are currently available regarding short and long-term outcomes for the Silk flow diverter. The objective of the study is to determine neurological prognosis and mortality rates for the Silk flow diversion device used in intracranial aneurysms. A systematic review with meta-analysis was performed using databases. The following descriptors were used for the search: “SILK”, “Flow Diverter”, “Mortality”, and “Prognosis”. The following data were extracted: mortality, good functional outcome, Glasgow outcome scale, complete or near-complete occlusion rates, rate of retreatment, and complications (thromboembolic and hemorrhagic complications). A total of 14 studies were selected. Among the 14 studies, 13 were retrospective observational cohort studies and 1 was a prospective observational cohort study. The mortality rate was 2.84%. The clinical good outcomes rate was 93.3%. The poor outcome rate was 6.6%. The overall thromboembolic complication rate was 6.06% (95% confidence interval [CI] 0.00–6.37, P=0.12, I2=3.13%). The total hemorrhagic complication rate was 1.62% (95% CI 0.00–5.34, P=0.28, I2=1.56%). The complete aneurysm occlusion rate was 80.4% (95% CI 8.65–9.38, P<0.0001, I2=9.09%). The Silk diverter device has a good safety and efficacy profile for treating intracranial aneurysms with high complete occlusion rates.
Sebastián Contreras-Fernández,Lennin Florez-Leiva,María Camila Bernal-Sánchez,Wilberto Pacheco-Paternina,Shalenys Bedoya-Valestt,Lorenzo Portillo-Cogollo 한국해양과학기술원 2022 Ocean science journal Vol.57 No.4
Estuaries are highly diverse ecosystems that occur at the interface between land and sea and thus possess a high degree of environmental variation over short spatial and temporal scales. The Gulf of Urabá (1800 km 2; mean depth ~ 40 m) is a semiclosed estuarine area located in the southwestern part of the Caribbean Sea (South America). This large coastal–estuarine ecosystem operates as a biogeochemical reactor due to it featuring examples of high nutrient concentrations on the surface (NO 3- = 1619 μM; NO 2- = 0.505 μM; NH 4+ = 2.938 μM; PO 4 3- = 7.603 μM), high Chl α (max = 30.17; min = 0.02; mean = 9 mg m−3), as well as blooms of toxic algae, mostly Pseudo-nitzschia pseudodelicatissima. An outbreak of Tripos fusus causes bioluminescence and about 20 events of hypoxia (< 2–4 mg O 2 L−1) within a time series of 10 years. Despite this, information regarding the biological and biogeochemical oceanography (chlorophyll α, biomass, planktonic composition, nutrient cycling, mass balance of elements, and interannual variability) remains non-existent. Therefore, elucidating an ecosystem’s thresholds for various features is necessary for managing marine ecosystems, and especially for climate change projections. We here present a review of the functioning of this estuary, evaluating and reviewing each aspect of oceanographic variability.