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Katherine M. Krajewski,Marta Braschi-Amirfarzan,Pamela J. DiPiro,Jyothi P. Jagannathan,Atul B. Shinagare 대한영상의학회 2017 Korean Journal of Radiology Vol.18 No.1
Oncology is a rapidly evolving field with a shift toward personalized cancer treatment. The use of therapies targeted to the molecular features of individual tumors and the tumor microenvironment has become much more common. In this review, anti-angiogenic and other molecular targeted therapies are discussed, with a focus on typical and atypical response patterns and imaging manifestations of drug toxicities.
Granulomatosis With Polyangiitis in Otolaryngologist Practice: A Review of Current Knowledge
Joanna Wojciechowska,Wojciech Krajewski,Piotr Krajewski,Tomasz Kręcicki 대한이비인후과학회 2016 Clinical and Experimental Otorhinolaryngology Vol.9 No.1
Granulomatosis with polyangiitis (GPA) is an idiopathic vasculitis of medium and small arteries, characterized by necrotizing granulomatous inflammation. GPA typically affects upper and lower respiratory tract with coexisting glomerulonephritis. This disease is generally characterized by antineutrophil cytoplasm antibodies (ANCA), nevertheless, there are rare cases with negative ANCA. GPA affects people at any age, with predominance of the sixth and seventh decade of life. In 80%–95% of the patients the first symptoms of GPA are otorhinolaryngological manifestations of head and neck including nose/sinuses, ears, eyes, larynx/trachea, oral cavity, and salivary glands. Diagnosis of GPA is based on Criteria of the American College of Rheumatology. In clinical practice diagnosis, the presence of distinctive ANCA antibodies and biopsy of affected organ are crucial. GPA must be differentiated from neoplastic, infectious or inflammatory ulcerative lesions of the head and neck. The standard treatment procedure is divided into two essential phases, induction and maintenance. The induction phase is based on combination of systemic corticosteroid and immunosuppressant therapy, whereas the maintenance phase comprises corticosteroids and azathioprine/methotrexate supplementation. Surgical treatment ought to be considered for patients who are not responding to pharmacotherapy.
On the Asymptotic Accuracy of Reduced–Order Models
Daniele Casagrande,Wiesław Krajewski,Umberto Viaro 제어·로봇·시스템학회 2017 International Journal of Control, Automation, and Vol.15 No.5
Popular model reduction methods can easily be adapted to retain the asymptotic response to inputs withrational transform. To this purpose, the forced response of the high-order system is decomposed into a transientand a steady-state component. Then, the reduced-order model is obtained by combining the unaltered steady-statecomponent with an approximation of the transient component. Examples show that forcing the reduced-order modelto retain the steady-state component does not compromise the transient accuracy.
Kim, Kyung Won,Shinagare, Atul B.,Krajewski, Katherine M.,Pyo, Junhee,Tirumani, Sree Harsha,Jagannathan, Jyothi P.,Ramaiya, Nikhil H. The Korean Society of Radiology 2015 KOREAN JOURNAL OF RADIOLOGY Vol.16 No.2
<P><B>Objective</B></P><P>We aimed to describe radiologic signs and time-course of imatinib-associated fluid retention (FR) in patients with gastrointestinal stromal tumor (GIST), and its implications for management.</P><P><B>Materials and Methods</B></P><P>In this Institutional Review Board-approved, retrospective study of 403 patients with GIST treated with imatinib, 15 patients with imaging findings of FR were identified by screening radiology reports, followed by manual confirmation. Subcutaneous edema, ascites, pleural effusion, and pericardial effusion were graded on a four-point scale on CT scans; total score was the sum of these four scores.</P><P><B>Results</B></P><P>The most common radiologic sign of FR was subcutaneous edema (15/15, 100%), followed by ascites (12/15, 80%), pleural effusion (11/15, 73%), and pericardial effusion (6/15, 40%) at the time of maximum FR. Two distinct types of FR were observed: 1) acute/progressive FR, characterized by acute aggravation of FR and rapid improvement after management, 2) intermittent/steady FR, characterized by occasional or persistent mild FR. Acute/progressive FR always occurred early after drug initiation/dose escalation (median 1.9 month, range 0.3-4.0 months), while intermittent/steady FR occurred at any time. Compared to intermittent/steady FR, acute/progressive FR was severe (median score, 5 vs. 2.5, <I>p</I> = 0.002), and often required drug-cessation/dose-reduction.</P><P><B>Conclusion</B></P><P>Two distinct types (acute/progressive and intermittent/steady FR) of imatinib-associated FR are observed and each type requires different management.</P>
Pamela J. DiPiro,Katherine M. Krajewski,Angela A. Giardino,Marta Braschi-Amirfarzan,Nikhil H. Ramaiya 대한영상의학회 2017 Korean Journal of Radiology Vol.18 No.1
The purpose of the article is to describe the various radiology consultation models in the Era of Precision Medicine. Since the inception of our specialty, radiologists have served as consultants to physicians of various disciplines. A variety of radiology consultation services have been described in the literature, including clinical decision support, patient-centric, subspecialty interpretation, and/or some combination of these. In oncology care in particular, case complexity often merits open dialogue with clinical providers. To explore the utility and impact of radiology consultation services in the academic setting, this article will further describe existing consultation models and the circumstances that precipitated their development. The hybrid model successful at our tertiary cancer center is discussed. In addition, the contributions of a consultant radiologist in breast cancer care are reviewed as the archetype of radiology consultation services provided to oncology practitioners.
김경원,Atul B. Shinagare,Katherine M. Krajewski,Junhee Pyo,Sree Harsha Tirumani,Jyothi P. Jagannathan,Nikhil H. Ramaiya 대한영상의학회 2015 Korean Journal of Radiology Vol.16 No.2
We aimed to describe radiologic signs and time-course of imatinib-associated fluid retention (FR) in patients with gastrointestinal stromal tumor (GIST), and its implications for management. In this Institutional Review Board-approved, retrospective study of 403 patients with GIST treated with imatinib, 15 patients with imaging findings of FR were identified by screening radiology reports, followed by manual confirmation. Subcutaneous edema, ascites, pleural effusion, and pericardial effusion were graded on a four-point scale on CT scans; total score was the sum of these four scores. The most common radiologic sign of FR was subcutaneous edema (15/15, 100%), followed by ascites (12/15, 80%), pleural effusion (11/15, 73%), and pericardial effusion (6/15, 40%) at the time of maximum FR. Two distinct types of FR were observed: 1) acute/progressive FR, characterized by acute aggravation of FR and rapid improvement aftermanagement, 2) intermittent/steady FR, characterized by occasional or persistent mild FR. Acute/progressive FR always occurred early after drug initiation/dose escalation (median 1.9 month, range 0.3–4.0 months), while intermittent/steady FR occurred at any time. Compared to intermittent/steady FR, acute/progressive FR was severe (median score, 5 vs. 2.5, p = 0.002), and often required drug-cessation/dose-reduction. Two distinct types (acute/progressive and intermittent/steady FR) of imatinib-associated FR are observed and each type requires different management.