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        Comparison of Transjugular Intrahepatic Portosystemic Shunt with Covered Stent and Balloon-Occluded Retrograde Transvenous Obliteration in Managing Isolated Gastric Varices

        김성권,Kristen A. Lee,Steven Sauk,Kevin Korenblat 대한영상의학회 2017 Korean Journal of Radiology Vol.18 No.2

        Objective: Although a transjugular intrahepatic portosystemic shunt (TIPS) is commonly placed to manage isolated gastric varices, balloon-occluded retrograde transvenous obliteration (BRTO) has also been used. We compare the long-term outcomes from these procedures based on our institutional experience. Materials and Methods: We conducted a retrospective review of patients with isolated gastric varices who underwent either TIPS with a covered stent or BRTO between January 2000 and July 2013. We identified 52 consecutive patients, 27 who had received TIPS with a covered stent and 25 who had received BRTO. We compared procedural complications, re-bleeding rates, and clinical outcomes between the two groups. Results: There were no significant differences in procedural complications between patients who underwent TIPS (7%) and those who underwent BRTO (12%) (p = 0.57). There were also no statistically significant differences in re-bleeding rates from gastric varices between the two groups (TIPS, 7% [2/27]; BRTO, 8% [2/25]; p = 0.94) or in developing new ascites following either procedure (TIPS, 4%; BRTO, 4%; p = 0.96); significantly more patients who underwent TIPS developed hepatic encephalopathy (22%) than did those who underwent BRTO (0%, p = 0.01). There was no statistically significant difference in mean survival between the two groups (TIPS, 30 months; BRTO, 24 months; p = 0.16); median survival for the patients who received TIPS was 16.6 months, and for those who underwent BRTO, it was 26.6 months. Conclusion: BRTO is an effective method of treating isolated gastric varices with similar outcomes and complication rates to those of TIPS with a covered stent but with a lower rate of hepatic encephalopathy.

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        Decomposing achievement gaps among OECD countries

        Liang Zhang,Kristen A. Lee 서울대학교 교육연구소 2011 Asia Pacific Education Review Vol.12 No.3

        In this study, we use decomposition methods on PISA 2006 data to compare student academic performance across OECD countries. We first establish an empirical model to explain the variation in academic performance across individuals, and then use the Oaxaca-Blinder decomposition method to decompose the achievement gap between each of the OECD countries and the OECD average. Results indicate that the explained portion of the achievement gap varies across countries. In some countries, our empirical models are able to account for almost all the achievement gap, while unexplained country-specific effects still dominate in other countries. Finally, we use two Asian countries, Japan and Korea, to demonstrate how to identify major factors that have contributed to the observed achievement gap across countries.

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