Database Security System for Applying Sophisticated Access Control via Database Firewall Server

Database security, privacy, access control, database firewall, data break masking Recently, information leakage incidents have occurred due to database security vulnerabilities. The administrators in the traditional database access control methods grant simple permissions to users for accessing database objects. Even though they tried to apply more strict permissions in recent database systems, it was difficult to properly adopt sophisticated access control policies to commercial databases due to performance degradations. This paper proposes a database security system including a database firewall server as an enhanced database access control system which can efficiently enforce sophisticated security policies to provide database with confidentiality using a data masking technique for diverse conditions such as the date, time, SQL string, and table columns to database systems

Comparison of spin-echo echo-planar imaging magnetic resonance elastography with gradient-recalled echo magnetic resonance elastography and their correlation with transient elastography

PURPOSEThis study aimed to assess the agreement between liver stiffness (LS) values obtained by the gradient-recalled echo (GRE) magnetic resonance elastography (MRE) and spin-echo echo-planar imaging (SE-EPI) MRE with those of transient elastography (TE), respectively.METHODSWe retrospectively included 48 participants who underwent liver MRE with both GRE and SE-EPI sequences in the same session and also TE within 1 year. We obtained LS values for MRE by drawing free-hand region of interest, and TE was performed using a FibroScan device. We assessed the relationship between the mean LS values obtained by each MRE sequence and TE using the correlation coefficients and Bland–Altman plots, respectively. We also compared LS values and technical failure rates of measured values from MRE between SE-EPI and GRE sequences using the paired t-test and McNemar’s test. The MRE failure was defined as the absence of pixel value with a confidence index above 95%.RESULTSThe LS values from SE-EPI and GRE sequences strongly correlated with those from TE (GRE; r = 0.73, P < .001 vs. SE-EPI; r = 0.79, P < .001). In addition, the LS values from the 2 MRE sequences showed excellent relationship (intraclass correlation coefficient, 0.94 [0.89-0.97], P < .001). The LS values from SE-EPI and GRE MRE were not significantly different (4.14 kPa vs. 3.88 kPa, P = .19). Furthermore, the technical success rate of SE-EPI MRE was superior to that of GRE (100% vs. 83.8%, P = .031).CONCLUSIONThe measured LS values obtained using TE correlated strongly with those obtained using GRE and SE-EPI MRE techniques, even though SE-EPI-MRE resulted a higher technical success rate than GRE-MRE. Therefore, we believe that TE, GRE, and SE-EPI MR elastography techniques may complement each other according to the appropriate individual situation

A Patient With Dysphagia due to an Aortic Aneurysm

Dysphagia aortica is difficulty in swallowing caused by extrinsic compression of the esophagus due to an ectatic, tortuous, or aneurysmatic atherosclerotic thoracic aorta. This condition is very uncommon, and it is usually associated with old age, women with short stature, hypertension, and kyphosis. We report herein a case involving a patient with dysphagia who had an aortic aneurysm

Rapidly Progressive Cardiac Manifestation of Behçet's Disease Involving Conduction System and Aortic Valve

Cardiac conduction system impairment is a rare clinical manifestation of Behçet's disease. We report a patient who showed 1st degree atrioventricular block at first presentation, and showed aggravated finding of 3rd degree atrioventricular block on five months later. His cardiac manifestation finally developed to acute severe aortic regurgitation on six months later from his first cardiac manifestation. We observed this rapid progression during 6 months and successfully improved symptom and disease severity of the patient with treatment targeting Behçet's disease

Successful Radiofrequency Catheter Ablation for Wolff-Parkinson-White Syndrome Within the Neck of a Coronary Sinus Diverticulum

Posteroseptal accessory pathways are often associated with coronary sinus diverticula. These diverticula contain myocardial coats which serve as a bypass tract. We report a 54-year-old woman who underwent radiofrequency (RF) catheter ablation for Wolff-Parkinson-White (WPW) syndrome. The surface electrocardiography (ECG) demonstrated pre-excitation, indicating a posteroseptal accessory pathway. A catheter ablation via a transaortic approach failed to ablate the accessory pathway. Coronary sinus venography revealed the presence of a diverticulum near the ostium. An electrogram in the neck of the diverticulum showed the coronary sinus myocardial extension potential, which was successfully ablated by delivery of RF energy

Use of doxorubicin-eluting bead transarterial chemoembolization for unresectable hepatocellular carcinoma with portal vein invasion: a prospective study

Background/Aim To evaluate the applicability of transarterial chemoembolization (TACE) treatment with doxorubicin drug-eluting beads (DEBs) in advanced hepatocellular carcinoma (HCC) patients with portal vein invasion (PVI). Methods This prospective study was approved by the institutional review board and informed consent was obtained from all participants. A total of 30 HCC patients with PVI received DEB-TACE between 2015 and 2018. The following parameters were evaluated: complications during DEB-TACE, abdominal pain, fever, and laboratory outcomes, including liver function change. Overall survival (OS), time to progression (TTP), and adverse events were also analyzed and assessed. Results DEBs measuring 100–300 μm in diameter were loaded with doxorubicin (150 mg per procedure). There were no complications during DEB-TACE and no significant differences in the levels of prothrombin time, serum albumin, or total bilirubin at follow-up compared to baseline. The median TTP was 102 days (95% confidence interval [CI], 42–207 days) and the median OS was 216 days (95% CI, 160–336 days). Three patients (10%) had severe adverse reactions, including transient acute cholangitis (n=1), cerebellar infarction (n=1), and pulmonary embolism (n=1), but no treatment-related death occurred. Conclusions DEB-TACE may be a therapeutic option for advanced HCC patients with PVI

Changes in liver stiffness values assessed using transient elastography in chronic hepatitis B patients treated with tenofovir disoproxil fumarate: a prospective observational study

Background/Aims Regression of liver fibrosis during antiviral therapy in chronic hepatitis B (CHB) patients has been demonstrated, but data on the influence of long-term treatment with tenofovir disoproxil fumarate (TDF) on liver stiffness (LS) measured by transient elastography are scarce. We aimed to investigate the changes in LS values during the 144-week TDF therapy in treatment-naïve CHB patients. Methods This prospective observational study was conducted from April 2015 to July 2020 at CHA Bundang Medical Center. Laboratory tests and LS measurements were performed at baseline and repeated at weeks 12, 24, 48, 96, and 144. A significant decline in LS was defined as ≥ 30% decrease in LS value at week 96 from baseline. Results A total of 48 treatment-naïve CHB patients initiating TDF therapy were screened, and 36 patients were included in the final analysis (median age, 46 [interquartile range, 34.5–55.8] years; 19 men [52.8%]). During TDF therapy, the median LS values decreased from 13.8 kPa at baseline to 8.7 kPa, 6.5 kPa, and 6.4 kPa at weeks 48, 96, and 144, respectively (all P < 0.001). At week 96, virological and biochemical responses were achieved in 34 (94.4%) patients and 20 (76.9%) patients, respectively. Moreover, 21 of 36 (58.3%) patients showed a significant decline in LS value. A higher baseline LS value was a single independent predictor for the reduction in LS value at week 96 from baseline (P < 0.001). Conclusions During the 144-week TDF therapy, LS values declined significantly in treatment-naïve CHB patients.This study was supported by Gilead Sciences. None of the funding sources had any role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publicatio

Outcome of allogeneic hematopoietic stem cell transplantation for childhood acute lymphoblastic leukemia in second complete remission: a single institution study

PurposeThe survival rate for childhood acute lymphoblastic leukemia (ALL) has improved significantly. However, overall prognosis for the 20 to 25% of patients who relapse is poor, and allogeneic hematopoietic stem cell transplantation (HSCT) offers the best chance for cure. In this study, we identified significant prognostic variables by analyzing the outcomes of allogeneic HSCT in ALL patients in second complete remission (CR).MethodsFifty-three ALL patients (42 men, 79%) who received HSCT in second CR from August 1991 to February 2009 were included (26 sibling donor HSCTs, 49%; 42 bone marrow transplantations, 79%). Study endpoints included cumulative incidence of acute and chronic graft-versus-host disease (GVHD), relapse, 1-year transplant-related mortality (TRM), disease-free survival (DFS), and overall survival (OS).ResultsCumulative incidences of acute GVHD (grade 2 or above) and chronic GVHD were 45.3% and 28.5%, respectively. The estimated 5-year DFS and OS for the cohort was 45.2±6.8% and 48.3±7%, respectively. Only donor type, i.e., sibling versus unrelated, showed significant correlation with DFS in multivariate analysis (P=0.010). The rates of relapse and 1 year TRM were 28.9±6.4% and 26.4±6.1%, respectively, and unrelated donor HSCT (P=0.002) and HLA mismatch (P=0.022) were significantly correlated with increased TRM in univariate analysis.ConclusionIn this single institution study spanning more than 17 years, sibling donor HSCT was the only factor predicting a favorable result in multivariate analysis, possibly due to increased TRM resulting from unrelated donor HSCT