Kim, In-Soo;Choi, Nam-Gil;Jang, Seong-Joo;Han, Jae-Bok;Jang, Young-Ill
The Journal of the Korea Contents Association
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v.12
no.7
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pp.273-283
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2012
Drug-eluting stents (DES) have significantly reduced in-stent restenosis, compared to bare-metal stents (BMS). However, there remains concern for the increased risk of stent thrombosis (ST) associated with DES. The present study sought to evaluate the incidence, clinical characteristics and outcome of ST in patients with acute myocardial infarction (MI) during a 1-year follow-up. 80 patients who developed ST were divided into 2 groups according to stent type: group I (DES-ST, n = 57 ) and group II (BMS-ST, n = 23 ). There were no differences between group I and II in the overall incidence of ST (2.7% vs. 4.3%, p=0.064) and in the incidence of each type of ST: acute ST (8.8% vs. 2.3%), subacute ST (50.9% vs. 60.9%), late ST (19.3% vs. 8.7%), and very late ST (21.1% vs. 17.4%) (p=0.605). Predictors of 1-year mortality were the occurrence of ST (OR 8.12, 95% CI 2.83-23.61, p<0.001), left ventricular ejection fraction<40% (OR 6.41, 95% CI 2.42-16.96, p<0.001), and age${\geq}$75 years (OR 4.98, 95% CI 1.95-12.74, p=0.001).
Purpose: The prognosis of neonates with cholestasis is not clear. Some factors, such as high peak bilirubin levels and liver histologic findings have been claimed to affect the prognosis adversely. Our study aims to define which factors influence the prognosis of neonatal intrahepatic cholestasis. Methods: Retrospective reviews of the medical records were performed in 32 cases with neonatal intrahepatic cholestasis, who were admitted to Department of Pediatrics, Pusan National University Hospital from July 1995 to July 2002. Neonates were classified into 2 groups according to the duration of elevated serum alanine aminotransferase (ALT) levels more or less than 6 months. The data, such as biochemical, histopathologic and radiologic findings, were compared in both groups. Biochemical data included mean peak level of serum ALT, total bilirubin, direct bilirubin, and alkaline phosphatase. Histologic parameters related to lobular architecture, fibrosis, inflammatory infiltration and degenerative features of hepatocytes were arbitrary estimated on a scale of 1 to 3. Results: There were 19 males and 13 females, whose mean age was 48 days (14~77 days). The peak serum ALT levels were higher in the poor outcome group. Ductular proliferation and portoportal bridging were more severe in the poor outcome group. But the degree of multinucleated hepatocytes, hepatocellular swelling and canalicular plug did not appear to be significantly related to the long-term outcome. The DISIDA scintigraphy by visualization time of gall bladder and intestine was not useful in predicting outcome of neonatal intrahepatic cholestasis. Conclusion: Neonates who have intrahepatic cholestasis with high serum ALT levels, severe ductular proliferation and portoportal bridging in the liver biopsy specimen should be carefully followed up because they may have a poor prognosis.
Nowadays there were two tendencies of studies about prognostic factors in stroke. One way was to define prognostic factors according to the radiological features. And the other way was to define according to the mental state, recognition, perception, motors, language, urinary&bowel incontinence etc.. The former could be objectively investigated, while the latter was difficult. The purpose of this study was to determine which variables would be predictors of stroke and which factors would be affect predictions most. The subjects of this study were 32 patients who were admitted to the Dept. of Internal Medicine, Dongguk Univ. College of Oriental Medicine whthin 48 hours from attack, Medical records were reviewed FIM, CNS, NIH stroke scale. We compared each sub-items of FIM, CNS, NIH stroke scale about mental state, recognition, perception, motors, language, urinary&bowel incontinence with MBI score at 4 weeks from admission. Also, we analyzed the correlations of sub-items and groups which devided into 5 according to independence of MBI score. And we found out the most influent factors with multiple regression analysis. The major results were as follows; 1. In mean of MBI score at 4 weeks of each groups devided low, middle, high score at mental state, recognition, perception, motors, language, urinary&bowel incontinence items, there were statistical differences in all items. 2. The mental state and lim ataxia sub-items had no significant correlations with groups divided according to independence of MBI score. All the other items were significantly correlated. 3. The most influent factors was recognition. The second was sensory and the third was bowel incontinence. 4. The most influent scales was FIM, and the second was CNS, and NlH had no statistical significancy.
Park Jae-Hyun;Kim Pyung-Kil;Jeong Hyeon-Joo;Choi In-Joon
Childhood Kidney Diseases
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v.1
no.1
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pp.17-23
/
1997
After the first description of IgA nephropathy by Berger in 1968, the prognosis of this disease was considered favourable. However recent studies have revealed that IgA nephropathy result in end stage renal desease in 25-30% by 20 years. Heavy proteinuria, hypertension, histological high class are regarded as poor prognostic factors. In 1996, Yagame et al reported the new histopathologic grading with a strong correlation between the grading, heavy proteinuria, high s-Cr level and renal survival. The aims of this study are to determine whether the pathological grading and other clinical parameters could contribute to predicting the outcome of this disease eventhough pediatric patients. Seventy nine patients (59 males, 20 females) with IgA nephropathy were examined. Patients were 2.08-15.17 years of age ($9.85{\pm}2.83$). The mean follow-up duration were $27{\pm}28$ months. Six of seventy nine patients progressed to chronic renal failure during the follow-up periods. High 24h urinary protein excretion at diagnosis were significantly higher in chronic renal failure patients (p<0.05). Hypertension at diagnosis were the significant associated factors in progression of chronic renal failure (p<0.05). Histological changes of IgA nephropathy in light microscopy were classified into five classes by WHO classification, four grades in Yagame's gradings. Among the seventy nine patients, 24 were as class 1, 30 as class 2, 23 as class 3; 4 as class 4, 0 as class 5 by WHO classification. 23 were classified grade 1, 31 as grade 2, 24 as grade 3, 1 as grade 4 by Yagame's grading. Among six patients who progressed to chronic renal failure, 1 clssified as class 1, 1 as class 2, 3 as class 3, 1 as class 4, 0 as class 5 by WHO Classification. 1 patients were classified as grade 1, 1 as grade 2, 3 as grade 3, 1 as grade 4 by Yagame's grading. (p>0.05) In conclusion, hypertension and heavy proteinuria at initial presentation were significantly associated with progression of chronic renal failure. The classification of WHO & Yagame's grading has no significant association with the progression of chronic renal failure in pediatric patients.
The Journal of the Korean bone and joint tumor society
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v.17
no.1
/
pp.30-35
/
2011
Purpose: This study was designed to evaluate the treatment results of malignant melanoma and to analyze the factors influencing prognosis. Materials and Methods: Thirty one cases of malignant melanoma were included in this study. They were treated in our hospital surgically, medically and immunologically from January 1996 to December 2005, and were followed more than 5 years. We compared 5 year survival rate (5YSR) according to the age, gender, anatomical site, depth of tumor, TNM stage, involvement of lymph node and immuno-chemotherapy. Results: Overall 5YSR was 80.6%. 5YSR of the age group below 65 years was 89.7% and 66.7% for the age group over 65 (p=0.033). 5YSR for men was 75% and 90.9% for women. 5YSR according to the site of occurrence showed 66.7% in upper extremities, 89.5% in lower extremities, and 66.7% in other site. 5YSR was 100% for the Clark level below III and 62.5% for the level above IV (p=0.032). 5YSR was 53.8% for lymph node metastasis group and 100% for non-lymph node metastasis group (p=0.021). Conclusion: We concluded that early diagnosis and wide excision was the most important in treatment of malignant melanoma. The prognostic fractors of malignant melanoma were age, depth of tumor (Clark's stage) and metastasis of lymph node.
The Journal of the Korean bone and joint tumor society
/
v.17
no.2
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pp.58-64
/
2011
Purpose: The purpose of this study is to observe unicameral bone cyst (UBC) outcome after the fracture has healed and if there is any identifiable prognostic factors. Materials and Methods: 13 UBC patients with pathologic fracture from 2001 to 2010 were reviewed. The mean follow up were 26 months (3-90 months). There were 11 male and 2 female patients and the mean age of the patients were 10.2 years old (6-16 years). 9 involved proximal humerusand 2 involved humerus shaft and 1 involved proximal femur and 1 involved proximal tibia. The treatment of UBC fracture was conservative cast application to heal the fracture initially, and 1 patient was treated with primary auto bone graft and open reduction with internal fixation. 5 patients were treated with steroid injection during follow up period and 2 patients with auto bone graft. We analyzed the change of UBC during pathologic fracture healing period and prognostic factor about age, the size of UBC, the involvement of physis. Results: The mean duration of the fracture healing was 8.2 months. Complete healing were occurred at 4 patients (31%). No statiscal difference was checked with age about UBC healing (p=0.42). But, more larger size about UBC and more closer to physis, the healing was difficult (p=0.05, p=0.03). Conclusion: While pathologic fracture of UBC was possibly healed, active treatment should be applied especially those cysts that involvescloser area of the physis or large size.
Cho, Sang-Hyun;Lee, Soo Yong;Jeon, Dae-Geun;Song, Won-Seok;Kong, Chang-Bae;Lee, Jung-Dong;Cho, Wan-Hyeong
The Journal of the Korean bone and joint tumor society
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v.18
no.2
/
pp.66-71
/
2012
Purpose: We analyzed treatment result to examine the outcome for patients with sacral chordoma and to determine relevant prognostic factors. Materials and Methods: We retrospectively reviewed 19 patients with sacral chordoma seen at out institution between 1990 and 2010. There were 9 men and 10 women with mean age of 56 years. The average follow up was 63 months (range, 25-144 months). 15 patient received surgical treatment, six of these patient had wide, eight had marginal, one had intralesional margin and 4 patient treated with Radiation therapy only. Results: The disease free and overall survival rate for all 19 patients was 34.7% and 79.7% at 5-years, respectively. Statistical analysis using the log-rank test revealed no significant difference between the surgery and radiation therapy groups in overall survival (p=0.54). Nine of 19 patients had local recurrence at a median of 2.5 years postoperatively. Seven of these 9 patients had distant metastasis at a median of 4.5 years postoperatively. Among the variables, tumor size (p=0.033) and tumor involvement of above S3 (p=0.032) were independent prognostic factor for overall survival. Nine of 15 patients who received surgical treatment had postoperative complication such as voiding difficulty and incontinence. Conclusion: Careful consideration of the patient general condition and predictable complication of the treatment might be the best way to improve patient's survival and quality of life.
Purpose : Graves' disease is the most common cause of hyperthyroidism in children and adolescents. In this study, we investigated the natural course and the prognostic factors of Graves' disease in Korean children and adolescents. Methods : One-hundred thirteen (88 girls and 25 boys) patients were included in this study. A retrospective analysis was made of all patients who were diagnosed with Graves' disease. The following parameters were recorded and analyzed: patient's sex, age at diagnosis, duration of disease, laboratory findings, symptoms and signs, and family history of autoimmune thyroid disease. Results : All patients were initially treated with antithyroid drugs, either methimazole (93.8%) or propylthiouracil (6.2%). Antithyroid drugs had been discontinued in 75 (66.4%) of 113 patients. Of these 75 patients, 23 (20.4%) relapsed after $25.5{\pm}33.7$ months. Thirteen (11.5%) of 23 patients, who experienced the first relapse, showed a second remission. However, 2 (1.8%) of 13 patients relapsed again. Euthyroid state could not be achieved by antithyroid drugs in 1 patient, and radioactive iodine therapy was performed. The older the patient at diagnosis, the greater the likelihood of remission ($P$=0.034). Conclusion : Age at diagnosis seems to be a prognostic factor in Korean children and adolescents with Graves' disease, and should be taken into account in treatment plan determination.
Kim, Yong Sung;Kong, Chang-Bae;Cho, Wan-Hyeong;Jeon, Dae-Geun;Kim, Kyung Hoon;Song, Won Seok
Journal of the Korean Orthopaedic Association
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v.55
no.5
/
pp.397-404
/
2020
Purpose: The purpose of this study was to evaluate the treatment outcome of leiomyosarcoma (LMS) of the somatic soft tissue and investigate the prognostic factors. Materials and Methods: Seventy-two patients with soft tissue LMS (extremities and trunk) between 2001 and 2017 were reviewed retrospectively. The local recurrence and metastasis after treatment were examined. The survival rates and prognostic factors affecting survival were investigated. Only patients followed-up more than one year were included. The mean follow-up time was 41 months (range, 7-163 months). Results: The overall survival rates at five-year and 10-year were 73.6% and 66.2%, respectively. The tumor size (p=0.018), grade (p=0.017), and local recurrence (p=0.04) affected survival. Metastases developed in 31.9% (23/72) and the median post metastasis survival was 15.6 months (range, 3-78 months). Conclusion: LMS of the soft tissue developed mainly at the lower extremity. The tumor size, grade, and local recurrence were associated with survival. Post metastatic survival was generally poor despite treatment.
Cardiovascular disease (CVD) has been identified as one of the most important factors influencing the long-term prognosis of patients with chronic kidney disease (CKD). However, in pediatric CKD, the clinical importance of CVD tends to be overlooked due to the lack of typical manifestations of CVD in this population. The literature has identified several traditional risk factors of CVD that originate from CKD, including hypertension, diabetes mellitus, dyslipidemia and obesity, in addition to new and non-traditional risk factors including anemia, secondary hyperparathyroidism, oxidative stress and inflammation. In cases of pediatric CKD, cardiovascular disease is usually restricted to subclinical manifestations such as left ventricular hypertrophy, thickening of intimal media on the carotid artery and calcification of the coronary artery. Therefore, risk factors of CVD in pediatric CKD patients should be closely monitored.
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