Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “recurrence timing”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources
PubMed1997

[Surgical treatment of extrahepatic bile duct carcinoma].

OBJECTIVE: To evaluate the experience in the diagnosis and surgical treatment of the extrahepatic bile duct carcinomas. METHODS: 242 patients with extrahepatic bile duct carcinoma over the past 20 years was retrospectively studied. RESULTS: The origin points were carcinomas of the upper bile duct in 168, of the middle bile duct in 18, and of the lower bile duct in 56 patients. The preoperative diagnostic rates for the location and the nature of the lesion were respectively raised to 97.2% and 94.5% by combination of ultrasonography and CT. The curative resection rates for the tumors in the upper, middle, and lower bile duct over the recent five years reached to 50.0%, 50.0% and 71.4%. respectively. Follow-up of patients with curative resection showed a one year recurrent rate of 73.9% and a three year recurrent rate of 100.0% with a mean recurrent time of 9.6 months in patients with local metastasis, in contrast to 13.3%, 71.4% and 17.5 months in those without metastasis. Metastasis was mainly responsible for the recurrence. Liver or multiple organ failure, intra-abdominal infection and gastrointestinal hemorrhage were the common and serious complications. CONCLUSION: The case number of the bile duct carcinoma presented a remarkable increment tendency. Ultrasonography and CT were satisfactory enough for diagnosis. To reduce the recurrent rate, resection of the tumor together with the lymph, nervous, fatty and connective tissues in the hepatic hilus, even the right celiac ganglia, should be considered the necessary procedure. Monitoring and protecting the main organs to prevent the multiple organ failure, controlling the gastrointestinal hemorrhage and the intra-abdominal infection are important to decreasing the mortality.

Adult↗
PubMed2000

A comparison of suture repair with mesh repair for incisional hernia.

BACKGROUND: Incisional hernia is an important complication of abdominal surgery. Procedures for the repair of these hernias with sutures and with mesh have been reported, but there is no consensus about which type of procedure is best. METHODS: Between March 1992 and February 1998, we performed a multicenter trial in which we randomly assigned to suture repair or mesh repair 200 patients who were scheduled to undergo repair of a primary hernia or a first recurrence of hernia at the site of a vertical midline incision of the abdomen of less than 6 cm in length or width. The patients were followed up by physical examination at 1, 6, 12, 18, 24, and 36 months. Recurrence rates and potential risk factors for recurrent incisional hernia were analyzed with the use of life-table methods. RESULTS: Among the 154 patients with primary hernias and the 27 patients with first-time recurrent hernias who were eligible for the study, 56 had recurrences during the follow-up period. The three-year cumulative rates of recurrence among patients who had suture repair and those who had mesh repair were 43 percent and 24 percent, respectively, with repair of a primary hernia (P=0.02; difference, 19 percentage points; 95 percent confidence interval, 3 to 35 percentage points). The recurrence rates were 58 percent and 20 percent with repair of a first recurrence of hernia (P=0.10; difference, 38 percentage points; 95 percent confidence interval, -1 to 78 percentage points). The risk factors for recurrence were suture repair, infection, prostatism (in men), and previous surgery for abdominal aortic aneurysm. The size of the hernia did not affect the rate of recurrence. CONCLUSIONS: Among patients with midline abdominal incisional hernias, mesh repair is superior to suture repair with regard to the recurrence of hernia, regardless of the size of the hernia.

Adult↗
PubMed2005

A simulation-based approach to forecasting the next great San Francisco earthquake.

In 1906 the great San Francisco earthquake and fire destroyed much of the city. As we approach the 100-year anniversary of that event, a critical concern is the hazard posed by another such earthquake. In this article, we examine the assumptions presently used to compute the probability of occurrence of these earthquakes. We also present the results of a numerical simulation of interacting faults on the San Andreas system. Called Virtual California, this simulation can be used to compute the times, locations, and magnitudes of simulated earthquakes on the San Andreas fault in the vicinity of San Francisco. Of particular importance are results for the statistical distribution of recurrence times between great earthquakes, results that are difficult or impossible to obtain from a purely field-based approach.

Disasters↗
PubMed1996

On the Hopfield Neural Networks and Mean Field Theory.

In this paper, we analyse mathematically the relationship between the mean field theory network (MFT) model and the continuous-time Hopfield neural network by the use of the theory of dynamical systems. This MFT model, which is obtained by applying the mean field approximation to the Boltzmann machine, is a discrete-time recurrent neural network. We prove that the set of asymptotically stable fixed points of the asynchronous MFT model coincides with the set of asymptotically stable equilibria of the continuous-time Hopfield neural network. Therefore, it is shown that the asynchronous MFT model is equivalent to the Hopfield neural network on the nature of the fixed points (or equilibria). Copyright 1996 Elsevier Science Ltd.

Journal Article↗
PubMed2000

Morbidity and risk factors of diarrheal diseases among under-five children in rural Upper Egypt.

Diarrhea is a leading cause of mortality and morbidity in developing countries. In Egypt, researchers have traditionally been targeting diarrhea-related mortality. This study is an attempt to portray the morbidity and risk factors of diarrhea among children under 5 years old (under-fives) in rural Upper Egypt. The incidence of diarrhea in the 6 months before the study was determined among 1025 under-fives in six sentinel sites by interviewing mothers or caretakers. The association between diarrhea and a set of risk variables was examined using a multivariate logistic regression model. Variables that appeared to have a significant predictive power were then included in a forward wald stepwise logit analysis model to estimate statistical functions which best predict the diarrheal morbidity. The incidence rate of diarrhea was found to be 3.6 episodes per child semiannually and the point prevalence was 19.5 per cent. The average duration of current episodes was 4.8 +/- 3.7 days; 33.6 per cent of children had had diarrhea more than three times (recurrent diarrhea). Four variables were found to have a significant association with recurrent diarrhea. The logit coefficients and their significance levels indicated that, in order of contribution to risk prediction, the variables ranked as follows: household meat consumption, mother's age at the time of birth of the child, child's age, and father's illiteracy. A total of 74.8 per cent of overall children were correctly predicted by these risk factors, a figure which indicates the goodness of fit of the model. It is concluded that the diarrheal morbidity is still unacceptably high in rural Upper Egypt. More interventions are needed to control for specific risk factors.

Age Distribution↗
PubMed2005

Salvage treatment with high-dose-rate brachytherapy for isolated vaginal endometrial cancer recurrence.

OBJECTIVE: To evaluate the outcome of patients with recurrent vaginal endometrial cancer treated with high-dose-rate brachytherapy (HDRB) and external beam radiation therapy (EBRT). MATERIALS AND METHODS: The records of all patients diagnosed with endometrial cancer who had presented an isolated vaginal recurrence in our institution between January 1, 1997 and December 30, 2003 were reviewed. Twenty-two patients were identified; 18 (82%) received both EBRT and HDRB, and 4 (18%) received HDRB only. The median EBRT dose prescribed was 45 Gy (range: 44-50.4), and median HDRB was 26 Gy (range: 8-48). Recurrence-free intervals as well as disease-specific survival rates were noted. Complications were assessed in terms of early and late Radiation Therapy Oncology Group toxicity (grade 3 or worse) of the gastrointestinal tract, genitourinary tract and vagina. RESULTS: Median age at recurrence for the 22 patients was 72 years (range: 54-86). Median recurrence time was 20 months (range: 4-135). A complete response was achieved in 100% of patients. After a median follow-up of 32 months (range: 11-78), no patient had locoregional recurrence; 1 developed distant metastasis and died from the disease. Five-year local control, disease-free survival and disease-specific survival were 100%, 96% and 96%, respectively. Four patients (18%) presented grades 3-4 gastrointestinal toxicity, and 11 (50%), grade 3 vaginal toxicity. CONCLUSION: Recurrent vaginal endometrial cancer is amenable to salvage therapy with HDRB and EBRT.

Aged↗
PubMed1990

Upper GI bleeding in an urban hospital. Etiology, recurrence, and prognosis.

Acute upper gastrointestinal bleeding (UGIB) continues to be a common cause of hospital admission and morbidity and mortality. This study reviews 469 patients admitted to a surgical service of an urban hospital. There were 562 total admissions because 53 patients were readmitted 93 times (recurrence rate, 20%). The most common causes of bleeding, all endoscopically diagnosed, included acute gastric mucosal lesion (AGML) (135 patients, 24%), esophageal varices (EV) (121 patients, 22%), gastric ulcer (108 patients, 19%), duodenal ulcer (78 patients, 14%), Mallory-Weiss tear (61 patients, 11%), and esophagitis (15 patients, 3%). Nonoperative therapy was sufficient in 504 cases (89.5%). Endoscopic treatment was used in 144 cases. Operations were performed in 58 cases (10.5%), including 29% of ulcers. Emergency operations to control hemorrhage were required in only 2.5% of all cases. The rate of major surgical complications was 11% and the mortality rate was 5.2%. There were 58 deaths (12.6%), with 36 deaths directly attributable to UGIB. Factors correlating with death include shock at admission (systolic blood pressure less than 80), transfusion requirement of more than five units, and presence of EV (all p less than 0.001). Most cases of UGIB can be treated without operation, including endoscopic treatment, when diagnostic endoscopy establishes the source. Subsequent operation in selected patients can be done with low morbidity and mortality rates.

Adolescent↗
PubMedDate not supplied

Role of angiogenesis in hepatitis and hepatocellular carcinoma.

BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) is usually a hypervascular tumor. Factor VIII-related antigens, including von Willebrand factor, are known to be expressed in HCC, which cause capillarization of the sinusoids of HCC. Capillarization of hepatic sinusoids may play a role in hepatocarcinogenesis and its metastasis. The aim of this study is to clarify the expression of Factor VIII in patients with hepatitis B or C (n = 18) and HCC (n = 16). METHODOLOGY: All specimens were sufficient for immunohistochemical study of the neo-angiogenesis with regard to clinical results. Microvessel count per square millimeter (MVC) and hot spot of microvessel per square millimeter (HSV) were measured from the histochemical study. RESULTS: In the patients with hepatitis group, the positive staining on the vessels of the portal triad was 11.1% (2/18) but in the non-neoplastic tissue of HCC patients the positive rate was 68.7% (11/16) showing a significant difference from the hepatitis group. The amount of vasculatures was easily found in the surrounding capsule of resected HCC. The MVC of the capsule was 10.17 +/- 2.78 and 13.66 +/- 5.42 for the HCC with non-direct invasion and direct invasion during operation, respectively. The HSV of capsules were 7.51 +/- 2.09 and 9.14 +/- 4.02 for the non-invasion and invasion, respectively. Therefore, in our study, it is clear that the high MVC or HSV scores were found in patients of direct invasion. However, there was no relation between hepatitis B or hepatitis C to the tumor invasiveness. The median survival times were 21.5 months for the non-invasive group and 14.5 months for the invasive group (p < 0.05). The positive rate of Factor VIII in the vessels of the portal triad were 60% and 83.3% for the non-invasive and invasive groups, respectively. However, the lower values of MVC and HSV showed a trend toward a longer recurrence time. CONCLUSIONS: It is pertinent to prove that the high score of neo-angiogenesis has a high risk of recurrence. In addition, it is wise to pay more attention to the interval of the follow-up study to detect the recurrent lesion earlier, where possible, in the patient with a high score of microvascularity.

Biopsy, Needle↗
PubMed1996

[Evaluation of radiotherapy for state I ovarian carcinoma].

To investigate the role of radiotherapy for stage I epithelial ovarian carcinoma, the results in 91 patients treated from 1970-1989 were retrospectively analysed. There were 60 patients treated by operation combined with chemotherapy, 31 patients by operation combined with chemotherapy and radiotherapy. Patients in both groups were comparable with regard to age, clinical stage, histology grade, type of operation and chemotherapeutic regimen. The 5-year actuarial survival rate was 78.3% for those receiving additional radiotherapy and 72.4% for those without additional radiotherapy. The recurrence rate was 32.2% with a median recurrence time of 34 months in the former group while 60.6% and 18.6% months for the latter. Radiotherapy did not confer survival advantage in the treatment of stage I ovarian cancer, but it could decrease recurrence rate and delay onset of recurrence.

Adenocarcinoma, Mucinous↗
PubMed1994

The role of postoperative irradiation in the treatment of oligodendroglioma.

PURPOSE: Controversy regarding the role of adjuvant radiation therapy for the treatment of oligodendroglioma continues to exist. To better define the utility of postoperative irradiation for this tumor, the experience at the University of Washington was retrospectively examined. METHODS AND MATERIALS: The histologic samples of 63 patients given the diagnosis of oligodendroglioma were reviewed by a panel of neuropathologists and 41 were classified as pure oligodendroglioma. The two treatment groups included 14 patients treated with surgery only and 27 who received surgery and postoperative radiation and were analyzed using univariate and multivariate analysis with respect to prognostic factors, freedom from relapse, and survival. RESULTS: Univariate statistical analysis of 14 clinical variables showed that a poorer prognosis was associated in patients with high cell density (p = .008), necrosis (p = .017), hemiparesis (p = .026), and papilledema (p = .091), while patients presenting with seizures had a better prognosis (p = .0096). Multivariate analysis showed necrosis (p = .001) and hemiparesis (p = .02) to be associated with decreased survival. Multivariate and univariate analysis of the treatment groups found them to be homogenous with respect to prognostic factors. Survival times were significantly longer in the group treated with postoperative irradiation (median survival time 84 vs. 47 months, p = .032). The 5 and 10 year survival rates were 83% and 46%, respectively, for the irradiated patients compared with 51% and 36% for those treated with surgery alone. Freedom from tumor recurrence times were also longer in irradiated patients (median relapse free time 79 vs. 42 months, p = .01). CONCLUSION: Based on the results of this study, we recommend continuing the practice of treating oligodendroglioma with postresection irradiation until a prospective multicenter clinical trial is conducted to thoroughly evaluate the role of postoperative irradiation in the treatment of this tumor.

Adolescent↗
PubMed2005

[Anti-viral therapy using lamivudine and thymosin is helpful to prevent recurrence in hepatocellular carcinoma with coexisting active hepatitis B].

OBJECTIVE: To observe the effect of postoperative anti-viral therapy using lamivudine and thymosin alpha1 on recurrence of hepatocellular carcinoma (HCC) coexisting with active hepatitis B. METHODS: From Jan. 2000 to Dec. 2002, 33 HCC patients with coexisting with active hepatitis B were randomized into two groups: Group I (n = 17) received hepatectomy only, and Group II (n = 16) received hepatectomy and postoperative therapy using lamivudine plus thymosin alpha1. The suppression of HBV-DNA, HBeAg seroconversion rate, tumor recurrence rate and median survival in the two groups were observed and compared. RESULTS: In Group II and Group I, the 1-year HBV-DNA suppression rate was 100.0% vs 6.0% (P < 0.01), HBeAg seroconversion rate was 62.5% vs 5.9% (P < 0.05), tumor recurrence rate was 81.3% vs 95.5% (P > 0.05), the recurrence time was 7.0 vs 5.0 months (P < 0.01) and median survival 10.0 vs 7.0 months (P < 0.01). CONCLUSION: Anti-viral therapy using lamivudine and thymosin alpha1 postoperatively may suppress the HBV reaction, delay the recurrence and prolong the survival for patients with HCC with coexisting active hepatitis B.

Adult↗
PubMed2002

Long-term results and quality-of-life outcomes in patients with transsphincteric fistulas after muscle-filling procedure.

PURPOSE: This study was designed to evaluate long-term results and quality-of-life outcomes after the muscle-filling procedure for posterior transsphincteric fistulas. METHODS: A questionnaire was mailed to 207 patients who had been treated by the muscle-filling procedure for posterior transsphincteric fistulas with cryptoglandular origin at the Social Health Insurance Hospital during a ten-year period. One hundred fifty-one patients who returned their questionnaires were included in this retrospective study. Information regarding fistula recurrence, time required for wound healing, postoperative incontinence, overall satisfaction with the procedure, and quality-of-life data were surveyed from the returned questionnaires. RESULTS: One hundred fifty-one patients (140 males) with a mean age of 48 (range, 17-75) years were analyzed. The mean follow-up was 70 (range, 12-131) months. Fistulas recurred in seven patients (4.6 percent). Fifty-eight patients (38 percent) healed within 3 months, and 52 (34 percent) healed within 6 months. Eighty-four patients (56 percent) reported some reduction in their sense of sphincter-tightening ability after surgery. Seventy-eight patients (52 percent) reported some degree of incontinence. One hundred thirty-three patients (88 percent) were satisfied or very satisfied with their outcomes. Of the 18 patients (12 percent) who reported unsatisfactory or very unsatisfactory results, 7 experienced recurrence. Thirty-seven patients (25 percent) indicated one or more lifestyle alterations, including social activities (11 percent), travel (12 percent), sports (5 percent), diet (4 percent), housework (1 percent), or sexual activities (1 percent), because of incontinence after surgery. Eighteen patients (12 percent) had more than one restriction in their quality-of-life parameters. CONCLUSION: The muscle-filling procedure is a viable option in the treatment of transsphincteric fistulas, with a favorable recurrence rate and an overall patient satisfaction rate above 88 percent.

Adolescent↗
PubMed2003

Delorme's procedure for rectal prolapse: clinical and physiological analysis.

PURPOSE: Clinical and physiological results of Delorme's procedure were assessed retrospectively in patients undergoing this procedure for rectal prolapse. METHODS: A consecutive series of 31 patients (7 males, 24 females; age, 14-93, mean 70 years) with full-thickness, rectal prolapse were treated by Delorme's procedure between 1994 and 2002. Median follow-up was 39 (range, 6-96) months. RESULTS: Good results were achieved in 27 patients (87 percent), prolapse recurrence was observed in 4 (13 percent), and mean recurrence time was 14 (range, 3-25) months. There were no postoperative deaths. Minor complications occurred in four patients. The median changes in preoperative and postoperative physiologic patterns in 16 patients were as follows: resting pressure from 21.0 (range, 5-48) to 23.5 (range, 12-76) cm H2O (P = 0.030), squeeze pressure from 64.0 (range, 27-248) to 108.0 (range, 32-264) cm H2O (P = 0.041), volume at first sensation from 100 (range, 70-180) to 70 (range, 40-130) ml (P = 0.002), maximum tolerated volume from 260 (range, 120-400) to 160 (range, 70-400) ml (P = 0.001). Incontinence improved in 63 percent. No patient became constipated, and 38 percent of those constipated preoperatively improved. The preoperative incontinence score improved from 11.5 (range, 1-20) to 6.0 (range, 0-20) after operation (P < 0.0001). CONCLUSION: Delorme's procedure had a low morbidity, did not lead to constipation, improved anal continence, and had a reasonably low recurrence rate. Improved anal sphincter and rectal sensation were associated with a reduced incidence of defecatory problems after Delorme's procedure.

Adolescent↗
PubMedDate not supplied

Histopathological findings in proliferative membrane from a patient with sarcoid uveitis.

BACKGROUND: Sarcoid uveitis is occasionally accompanied by proliferative changes, such as retinal neovascularization and vitreous hemorrhage. Steroid administration, retinal photocoagulation, and vitrectomy may be indicated in such proliferative cases. CASE: A 19-year-old woman presented with proliferative sarcoid uveitis accompanied by recurrent vitreous hemorrhage. OBSERVATIONS: At the initial examination, bilateral vitreous opacity, retinal exudates, mild vitreous hemorrhage, retinal vasculitis, and neovascularization of the retina and optic disc were observed. Although prednisolone was administered and panretinal photocoagulation was performed several times, recurrent vitreous hemorrhage continued. Since the vitreous hemorrhage was not absorbed, pars plana vitrectomy and lensectomy were performed. After surgery, neovascularization and intraocular inflammation decreased, and the corrected visual acuity in the right eye improved to 20/50. Histopathologic analysis of the proliferative membrane removed during surgery revealed substantial neovascularization and numerous neutrophils in the vessels. CONCLUSIONS: Based on these findings, an inflammatory reaction as well as retinal ischemia were thought to be involved in the proliferative changes in this patient.

Adult↗
PubMed2003

[Extra-abdominal desmoid tumors: 7-year outcome after surgical treatment in 12 patients].

PURPOSE OF THE STUDY: The purpose of this study was to report the clinical course and outcome in 12 patients with extra-abdominal desmoid tumors. MATERIAL AND METHODS: This retrospective series included 12 patients with extra-abdominal desmoid tumors treated between 1987 and 1996. Female gender predominated (8/12) and age ranged from 4 months to 60 years. The tumors were identified in the thoracic wall (n=2), the upper limb (n=4), and the lower limb (n=6) with a bony localization in the upper femoral metaphysis. Magnetic resonance imaging was highly contributive to the search for extension. Surgical treatment was given in all cases. All patients were living at last follow-up. RESULTS: Complete resection was achieved in three patients and incomplete resection in nine. Mean follow-up was seven years. There was one case of sarcomatous transformation and nine cases of recurrence. Mean time to recurrence was one year (range 6 months-4 years). Two tumors, in the forearm and the leg, did not recur. Secondary surgery was not attempted in four patients whose clinical situation has remained stable after recurrence. A second resection was performed for recurrence in four other patients who then remained recurrence-free to last follow-up. One tumor recurred three times after surgical resection. Functional outcome was good in nine patients. DISCUSSION: The poorly limited nature of extra-abdominal desmoid tumors makes resection a difficult task, particularly when located in the girdles or the most proximal part of the limbs. Wide first-intention surgical resection is recommended but mutilation must be avoided due to the benign nature of the tumor, its slow progression, and the possibility of regression or stability after recurrence. Nevertheless, surgical treatment of recurrent tumors is difficult and often insufficient, compromising functional outcome. Complementary treatment (radiotherapy) has been advocated for better control tumor growth.

Adolescent↗
PubMed1997

Regression analysis of interval-censored survival data with covariates using log-linear models.

We considered the regression analysis of the event time data with left-, right-, or interval-censored observations. We extended life-table techniques for censored survival data using log-linear models to incorporate interval-censored failures. The EM algorithm was used to calculate maximum likelihood estimates for the parameters. We assumed that the hazard function was a stepwise function over disjoint intervals of time; thus, the nonparametric model, the parametric exponential model, and the semiparametric Cox proportional hazard model were easily implemented as special cases. We adapted the restricted EM algorithm to test hypotheses and to construct confidence intervals for the parameters. These methods were applied in an analysis of the recurrence time for treated melanoma patients.

Adult↗
PubMed1989

Percutaneous procedures for trigeminal neuralgia: microcompression versus radiofrequency thermocoagulation. Personal experience.

This paper reports the results achieved in the treatment of trigeminal neuralgia using two different percutaneous procedures: radiofrequency (RF) thermocoagulation (33 patients) and the new percutaneous microcompression (PMC; 74 patients) of the trigeminal ganglion. Acute pain relief was accomplished in 93.2% of the patients treated with PMC and in 81.8% of those treated with the RF method. Two years after the operation, neuralgia had recurred in 56% of the PMC patients and in 42.4% of the RF patients. The average recurrence time was 6.5 months after PMC and 18.5 months after RF. Side effects were essentially of 2 kinds: marked dysaesthesia that occurred after RF lesion in 24.2% and after PMC in 6.7% of the patients, and weakness of the masticatory muscles that was fairly common after PMC, although clinically relevant in only 1 case. The procedure has the benefit of simplicity and fewer side effects. The results obtained by using different compression times in different patients indicates that the most suitable compression time is between 4 and 6 min. When pain recurred the procedure was repeated unless the pain was in the third division, in which case an RF lesion was made. If the pain recurred a second time, RF lesions were made if the pain was in the second or third division.

Electrocoagulation↗
PubMed2000

[Effect of Cordyceps sinensis on the Th1/Th2 cytokines in patients with Condyloma Acuminatum].

OBJECTIVE: To investigate the effect of cordyceps sinensis (CS) on the Th1/Th 2 cytokines and recurrence in patients with Condyloma Acuminatum (CA). METHOD: Double-antibody sandwich ELISA was used to study the serum level of IL-2 and IL-10 in 34 patients treated with CS(CS group) and 29 patients in control group. The recurrence rate of CA was observed. RESULT: After treated with CS, the serum levels of IL-2 and IL-10 significantly increased and decreased respectively (P < 0.05 or 0.01). No significant change occurred in control group. The recurrence times of CA in patients of CS group after electrocauterization were significantly lower than control group (P < 0.05). CONCLUSION: CS might recover the balance of Th1/Th2 cytokines and enhance Th 1 immune response in patients with CA, and reduced the recurrence of CA.

Adjuvants, Immunologic↗