• Title/Summary/Keyword: 예후 지표

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Impact of Asymmetric Middle Cerebral Artery Velocity on Functional Recovery in Patients with Transient Ischemic Attack or Acute Ischemic Stroke (일과성허혈발작 및 급성뇌경색환자에서 경두개도플러로 측정된 중간대뇌동맥 비대칭 지수가 환자 예후에 미치는 영향)

  • Han, Minho;Nam, Hyo Suk
    • Korean Journal of Clinical Laboratory Science
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    • v.50 no.2
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    • pp.126-135
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    • 2018
  • This study examined whether the difference in the middle cerebral artery (MCA) velocities can predict the prognosis of stroke and whether the prognostic impact differs among stroke subtypes. Transient ischemic attack (TIA) or acute ischemic stroke patients, who underwent a routine evaluation and transcranial Doppler (TCD), were included in this study. The MCA asymmetry index was calculated using the relative percentage difference in the mean flow velocity (MFV) between the left and right MCA: (|RMCA MFV-LMCA MFV|/mean MCA MFV)${\times}100$. The stroke subtypes were determined using the TOAST classification. Poor functional outcomes were defined as a mRS score ${\geq}3$ at 3 months after the onset of stroke. A total of 988 patients were included, of whom 157 (15.9%) had a poor functional outcome. Multivariable analysis showed that only the MCA asymmetry index was independently associated with a poor functional outcome. ROC curve analysis showed that adding the MCA asymmetry index to the prediction model improved the discrimination of a poor functional outcome from acute ischemic stroke (from 88.6% [95% CI, 85.2~91.9] to 89.2% [95% CI, 85.9~92.5]). The MCA asymmetry index has an independent prognostic value for predicting a poor short-term functional outcome after an acute cerebral infarction. Therefore, TCD may be useful for predicting a poor functional outcome in patients with acute ischemic stroke.

Expression of Several Biologic Markers as Prognostic Markers in Non-Small Cell Lung Cancers (폐암조직에서 생물학적 지표들의 예후인자로서의 비교검토)

  • Kim, Sun-Young;Cho, Hai-Jeong;Suh, Ji-Won;Kim, Nam-Jae;Kim, Ju-Ock
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.2
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    • pp.142-148
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    • 1995
  • Background: Despite modern diagnostic, staging, and therapeutic advances, esp. with molecular biologic techniques, the 5-year survival rate of all cases of lung cancer does not exceed 15%. Also, the incidence of lung cancer of both sex in Korea is increasing year by year and the lung cancer is one of the leading causes of cancer death. Therefore, it is strongly needed to develop the new combination of treatment modalities including neoadjuvant chemotherapy and to identify tumor specific characteristics with staging or prognostic markers. Here we present the clinical significance of several biologic tumor markers to use as a prognostic markers in patients with non-small cell lung cancers. Method: The survival has correlated with the expressibility of proliferative cell nuclear antigen (PCNA), epidermal growth factor receptor(EGFR), p53 and/or blood group antigen A(BGAA) using immunohistochemistry in 46 patients with non-small cell lung cancers. Results: 1) The expression rates of PCNA, EGFR, p53 and BGAA were 80.6%, 61.3%, 45.9% and 64.3%, respectively and those were not correlated to cell types or clinical stges. 2) The expression of BGAA was correlated with better survival in median survival and in 2-year survival rate and that of PCNA was correlated with worse survival in median survival and 2-year survival rate. 3) The expression of EGFR or p53 was not valuable to predict prognosis in non-small cell lung cancers. 4) With simultaneous applications of PCNA, EGFR and p53 immunostain, the patients with 2 or more negative expressions showed better prognosis than the patients with 2 or more positive expressions. Conclusion: It is suggested that the expression of blood group antigen may be a positive prognostic factor and that of PCNA may be a negative prognostic factor. Also, the combination of expressions of PCNA, EGFR and p53 may be used as a negative prognostic factor.

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Retrospective Study of Mortality Rates and Prognostic Indicators of Equine Colic in Korea (한국에서 산통마의 치명률과 예후인자의 회귀적 분석)

  • Lee, Eun-Bee;Kim, Joon-Gyu;Kim, Jin-Kap;Jang, Jong-Duck;Yun, Young-Min;Lee, Kyoung-Kap
    • Journal of Veterinary Clinics
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    • v.32 no.1
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    • pp.36-40
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    • 2015
  • Equine colic is a major concern in equine industry due to high morbidity and mortality rates. The purpose of this study was to establish mortality rates during medically and surgically treated colic and to identify potential prognostic indicators for mortality of equine colic in Korea. The overall mortality rate was 18/119 (15%). The 93 cases (78%) were treated medically and 26 cases (22%) surgically out of the 119 records reviewed. The mortality rate in small intestinal lesion was 7/9 (78%) and strangulating lesion was 10/11 (91%). The significance between individual factors and prognosis of equine colic was not valid but high frequency rate was found in ${\leq}3$ years age (59%) and male (50%). In dead group showed higher, rectal temperature and heart rate than those of survived group. The mortality rate was significantly high in the pale mucous membrane color and severe pain and decreased intestinal motility. In laboratory factors, dead group showed lower level of platelet than survived group, and had higher values of RBC, hemoglobin, PCV with significance (P < 0.05). Group with increased enzyme activity of CK, LDH, glucose showed poor prognosis.

성인 남자 흡연자와 비흡연자의 혈중 무기질 비교

  • 김순경;연보영;최미경
    • Proceedings of the KSCN Conference
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    • 2003.05a
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    • pp.138-138
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    • 2003
  • 흡연은 각종 암의 발병율을 높이고 동맥경화증, 혈전증과 같은 관상심장질환의 주요 발병요인이 되는 것으로 알려져 있다. 흡연자에게 보여지는 지질과산화작용에 의한 LDL의 산화는 구리나 철과 같은 항산과 관련 무기질에 의해 촉진되며, 특히 구리는 매우 연관성이 높은 물질로 보고되었다. 따라서 흡연자의 혈중 무기질 함량의 측정은 항산화 능력과 심혈관계 질병의 진단 및 예후 판정에 민감한 지표로 사용할 수 있을 것으로 사료된다. (중략)

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Expression of VEGF, p53, Apaf-1 and Caspase-9 in Head and Neck Squamous Cell Carcinoma (두경부 편평세포암에서 VEGF, p53, Apaf-1 and Caspase-9의 발현)

  • Lee, Sung Hak;Kang, Yeo Ju;Jo, Ui Ju;Lee, Youn Soo;Kang, Chang Suk
    • Korean Journal of Head & Neck Oncology
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    • v.28 no.2
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    • pp.107-113
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    • 2012
  • 배 경 편평상피암은 두경부의 악성종양 중 가장 흔하며, 임상적인 경과가 불량하다. 따라서 나쁜 예후를 가지는 환자군을 조기에 선별하여 더 적극적인 치료의 시행을 결정짓는 표지자의 필요성이 대두된다. 우리는 일련의 두경부 편평세포암 검체에서 몇몇 분자 표지자의 예후적 유용성을 평가하고자 하였다. 방 법 23예의 두경부 편평세포암 검체를 대상으로 VEGF, p53, Apaf-1, caspase-9의 발현과 몇몇 임상병리학적 지표들간의 연관성을 면역조직화학염색을 통해 조사하였다. 결 과 환자군은 남성이 더 많았으며 평균연령은 63.7세였다. 1기가 5예, 2기가 2예, 3기가 8예, 4기가 8예였다. 평균생존기간은 37.3개월이었다. VEGF단백 발현은 종양의 크기와 통계적으로 유의한 연관성을 보였다. 이와 더불어 VEGF단백 발현은 병기, 그리고 림프관 침습과 연관적인 경향성을 보였다. 그러나 VEGF단백 발현과 생존기간과는 관련성이 없었다. 또한, Apaf-1과 caspase-9의 단백발현은 다른 임상지표, 환자의 생존기간과는 관련이 없었다. 결 론 VEGF단백 발현은 두경부 편평세포암 환자에서 나쁜 임상경과를 예측할 수 있게 하는 표지자로서의 역할을 할 수 있다. 또한 본 연구는 두경부 편평세포암에서 별로 연구되지 않은 Apaf-1과 caspase-9의 발현상태를 밝힌 점에서 의의가 있다.

Prediction of Splint Therapy Efficacy Using Bone Scan in Patients with Unilateral Temporomandibular Disorder (편측성 측두하악관절장애 환자에서 골스캔을 이용한 교합안정장치 치료효과 예측)

  • Lee, Sang-Mi;Lee, Won-Woo;Yun, Pil-Young;Kim, Young-Kyun;Kim, Sang-Eun
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.2
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    • pp.143-149
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    • 2009
  • Purpose: It is not known whether bone scan is useful for the prediction of the prognosis of patients with temporomandibular disorders(TMD). The aim of the present study was to identify useful prognostic markers on bone scan for the pre-therapeutic assessment of patients with unilateral TMD. Materials and Methods: Between January 2005 and July 2007, 55 patients(M:F=9:46; mean age, $34.7{\pm}14.1$ y) with unilateral TMD that underwent a pre-therapeutic bone scan were enrolled. Uptake of Tc-99m HDP in each temporomandibular joint(TMI) was quantitated using a $13{\times}13$ pixel-square region-of-interest over TMJ and parietal skull area as background. TMJ uptake ratios and asymmetric indices were calculated. TMD patients were classified as improved or not improved and the bone scan findings associated with each group were investigated. Results: Forty-six patients were improved, whereas 9 patients were not improved. There was no significant difference between the two groups of patients regarding the TMJ uptake ratio of the involved joint, the TMJ uptake ratio of the non-involved joint, and the asymmetric index(p>0.05). However, in a subgroup analysis, the patients with an increased uptake of Tc-99m HDP at the disease-involved TMJ, by visual assessment, could be easily identified by the asymmetric index; the patients that improved had a higher asymmetric index than the patients that did not improve($1.32{\pm}0.35$ vs. $1.08{\pm}0.04$, p=0.023), Conclusion: The Tc-99m HDP bone scan may help predict the prognosis of patients with unilateral TMD after splint therapy when the TMD-involved joint reveals increased uptake by visual assessment.

Statistical analysis on a specific student group and their responses to sub-health questionnaire (특정 수강집단 학생들과 아건강 설문지 응답과의 통계적 분석)

  • Shin, Jae-Kyoung
    • Journal of the Korean Data and Information Science Society
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    • v.26 no.4
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    • pp.895-906
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    • 2015
  • Nowadays, many people have much interest in health and quality of life. They can get information on foods known to have remedial value for certain illness from many healthcare experts on TV health related shows. Moreover, a lot of studies on these foods and their remedial value are consistently published. Thus, this study, on the ground that if we know prognosis of a certain disease in advance we can lead a better life without suffering from diseases, statistically analyzes specific students' responses to sub-health questionnaire. The analysis reveals that results of testing the equality of gender and 10 diagnosis indexes shows significant difference within 5% of significance level in 9 diagnosis indexes except for respiratory system. And the result of testing the equality of age and 10 diagnosis indexes indicates that there is no significant difference within 5% of significance level. In the study, students are divided into two age category. However, the age of 20s could be regarded as one category, which could be the reason why there is no significant difference.

Clinical Outcome and Prognostic Factors of Acute Respiratory Distress Syndrome in Children (소아 급성 호흡곤란 증후군의 치료 성적 및 예후 인자)

  • Ko, Jung-Min;Ha, Eun-Ju;Lee, Eun-Hee;Lee, So-Youn;Kim, Hyo-Bin;Hong, Soo-Jong;Park, Seong-Jong
    • Clinical and Experimental Pediatrics
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    • v.48 no.6
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    • pp.599-605
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    • 2005
  • Purpose : The purpose of this study was to examine the causes, clinical courses and outcomes in children with acute respiratory distress syndrome(ARDS), and evaluate the physiologic variables as prognostic factors in the patients. Methods : Retrograde medical chart review was carried out in 24 patients who were diagnosed with ARDS at the pediatric intensive care unit(PICU) during 20-month period. Results : The incidence of ARDS among all PICU admission was 3.7 percent and the mortality rate was 37.5 percent, which was 14.8 percent of overall deaths in PICU. The most common causes of ARDS were pneumonia and sepsis. We found significant differences between survivors and nonsurvivors in $PaO_2/FiO_2$ ratio(P/F ratio), alveolar arterial oxygen gradient and oxygenation index(OI) on the second day from the onset of ARDS. Therapies for ARDS such as high frequency oscillator ventilation(HFOV), recruitment maneuver and low dose corticosteroid improved the P/F ratio and OI, especially in survivors. Conclusion : The mortality rate of children with ARDS was 37.5 percent; an important cause of death in PICU. HFOV, recruitment maneuver and low dose corticosteroid seemed to be effective in pediatric ARDS. The P/F ratio, alveolar arterial oxygen gradient and OI on the second day from the onset of ARDS may be useful as prognostic factors.

The Clinicopathological Factors That Determine a Local Recurrence of Rectal Cancers That Have Been Treated with Surgery and Chemoradiotherapy (직장암의 수술 후 방사선 치료 시 국소 재발의 임상 병리적 예후 인자)

  • Choi, Chul-Won;Kim, Min-Suk;Lee, Seung-Sook;Yoo, Seong-Yul;Cho, Chul-Koo;Yang, Kwang-Mo;Yoo, Hyung-Jun;Seo, Young-Seok;Hwang, Dae-Yong;Moon, Sun-Mi;Kim, Mi-Sook
    • Radiation Oncology Journal
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    • v.24 no.4
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    • pp.255-262
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    • 2006
  • $\underline{Purpose}$: To evaluate the pathological prognostic factors related to local recurrence after radical surgery and adjuvant radiation therapy in advanced rectal cancer. $\underline{Materials\;and\;Methods}$: Fifty-four patients with advanced rectal cancer who were treated with radical surgery followed by adjuvant radiotherapy and chemotherapy between February 1993 and December 2001 were enrolled in this study. Among these patients, 14 patients experienced local recurrence. Tissue specimens of the patients were obtained to determine pathologic parameters such as histological grade, depth of invasion, venous invasion, lymphatic invasion, neural invasion and immunohistopathological analysis for expression of p53, Ki-67, c-erb, ezrin, c-met, phosphorylated S6 kinase, S100A4, and HIF-1 alpha. The correlation of these parameters with the tumor response to radiotherapy was statistically analyzed using the chi-square test, multivariate analysis, and the hierarchical clustering method. $\underline{Results}$: In univariate analysis, the histological tumor grade, venous invasion, invasion depth of the tumor and the over expression of c-met and HIF-1 alpha were accompanied with radioresistance that was found to be statistically significant. In multivariate analysis, venous invasion, invasion depth of tumor and over expression of c-met were also accompanied with radioresistance that was found to be statistically significant. By analysis with hierarchical clustering, the invasion depth of the tumor, and the over expression of c-met and HIF-1 alpha were factors found to be related to local recurrence. Whereas 71.4% of patients with local recurrence had 2 or more these factors, only 27.5% of patients without local recurrence had 2 or more of these factors. $\underline{Conclusion}$: In advanced rectal cancer patients treated by radical surgery and adjuvant chemo-radiation therapy, the poor prognostic factors found to be related to local recurrence were HIF-1 alpha positive, c-met positive, and an invasion depth more than 5.5 mm. A prospective study is necessary to confirm whether these factors would be useful clinical parameters to measure and predict a radio-resistance group of patients.

Significance of Corticosteroids and Their Relationship with Other Parameters in Patients with Sepsis (패혈증에서 혈중 스테로이드의 의의 및 기타 혈중 지표와의 연관성)

  • Lee, Keu Sung;Baik, Seung Hee;Lee, Hyoung No;Park, Joo Hun;Oh, Yoon Jung;Sheen, Seung Soo;Choi, Young Hwa;Park, Kwang Joo;Hwang, Sung Chul
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.4
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    • pp.356-365
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    • 2006
  • Background: Corticosteroids are known to be significant prognostic parameters in sepsis. Recently, an absolute and relative insufficiency of the corticosteroids system has often been reported to often develop particularly in severe sepsis. Degree of such an adrenal insufficiency not only has prognostic implications but also can be used to guide corticosteroids replacement therapy. The 24-hour urinary cortisol levels as well as serum cortisol concentrations were measured to assess the clinical significance and their relationship with the other parameters of sepsis, and also evaluated the clinical implications of the relative adrenal insufficiency. Methods: 26 consecutive patients with sepsis were enrolled. The basal random serum cortisol, ACTH, ADH, lactate levels and 24-hour urinary free cortisol amount were measured. The rapid ACTH ($250{\mu}g$) stimulation test was also performed. Results: Basal serum cortisol levels were higher in the non-survivors than in the survivors. The 24-hour urinary free cortisol levels were higher in the patients with severe sepsis than in those without. The serum cortisol levels strongly correlated with the serum ADH and lactate levels. The 24-hour urinary free cortisol levels strongly correlated with the serum cortisol and lactate levels. The fractional changes in the cortisol levels after the rapid ACTH stimulation tests correlated with the serum cortisol, ADH, and lactate levels. Conclusion: Both the serum cortisol and 24-hour urinary cortisol were found to be significant prognostic factors in sepsis, and showed a strong correlation with the other parameters. The relative adrenal insufficiency might also be an important clinical parameter.