• Title/Summary/Keyword: Clinical progression

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Surgical Results of Intramedullary Spinal Cord Ependymomas in Adults : Retrospective Analysis of 51 Cases

  • Son, Young-Je;Chung, Chun-Kee;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.40 no.3
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    • pp.164-168
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    • 2006
  • Objective : The goal of treatment for spinal cord ependymoma is complete removal without postoperative neurological deficit. The authors analyzed the surgical results and factors influencing the postoperative prognosis. Methods : Fifty-one cases of primary spinal cord ependymoma, surgically treated between 1979 and 2003, were retrospectively analyzed. The mean follow-up period was 44 months. Results : Gross total removal was achieved in 42 patients and incomplete removal in nine. The proportion of complete surgical removals was influenced by tumor location and histology. Disease progression was observed in five cases [9.8%], the mean progression free interval after surgical removal was 48 months and the 5-year progression free rate was 68%. Disease progression was found in none of the 42 cases who underwent complete removal, and in 5 of 9 cases who hadincomplete removal group [P<0.001]. Statistically significant disease-progression factors by multivariate analysis were the surgical extent of removal [P=0.012]. preoperative functional status [P=0.032] the presence of intratumoral cysts [P=0.007] and postoperative radiation therapy [P=0042]. Of those patients who underwent incomplete removal, radiation therapy was found to significantly improve the clinical result [P=0042]. Conclusion : In the surgical treatment of spinal cord ependymoma, preoperative functional status, the presence of intratumoral cysts, the extent of removal, and postoperative radiation therapy were found to be significant prognostic factors of postoperative outcome.

Core decompression for early-stage avascular necrosis of the humeral head: current concepts and techniques

  • Michael D. Scheidt;Saleh Aiyash;Dane Salazar;Nickolas Garbis
    • Clinics in Shoulder and Elbow
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    • v.26 no.2
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    • pp.191-204
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    • 2023
  • Avascular necrosis (AVN) of the humeral head is a rare, yet detrimental complication. Left untreated, humeral head AVN frequently progresses to subchondral fracturing and articular collapse. Cases of late-stage humeral head AVN commonly require invasive procedures including humeral head resurfacing, hemiarthroplasty, and total shoulder arthroplasty (TSA) to improve clinical outcomes. However, in cases of early-stage AVN, core decompression of the humeral head is a viable and efficacious short-term treatment option for patients with pre-collapse AVN of the humeral head to improve clinical outcomes and prevent disease progression. Several techniques have been described, however, a percutaneous, arthroscopic-assisted technique may allow for accurate staging and concomitant treatment of intraarticular pathology during surgery, although further long-term clinical studies are necessary to assess its overall outcomes compared with standard techniques. Biologic adjunctive treatments, including synthetic bone grafting, autologous mesenchymal stem cell/bone marrow grafts, and bone allografts are viable options for reducing the progression of AVN to further collapse in the short term, although long-term follow-up with sufficient study power is lacking in current clinical studies. Further long-term outcome studies are required to determine the longevity of core decompression as a conservative measure for early-stage AVN of the humeral head.

Rapid Progression of Unilateral Moyamoya Disease

  • Kim, Tae-Wan;Seo, Bo-Ra;Kim, Jae-Hyoo;Kim, Young-Ok
    • Journal of Korean Neurosurgical Society
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    • v.49 no.1
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    • pp.65-67
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    • 2011
  • The detailed clinical characteristics of unilateral moyamoya disease (MMD) have not been fully elucidated. It has been reported that some patients with unilateral MMD progress to bilateral involvement, while others remain with the unilateral variant In this series, we present a case of unilateral MMD that progressed to bilateral involvement over the course of just one month.

The effects of zoledronic acid on the progression of experimental periodontitis in rats: histological and microtomographic analyses

  • de Marcelos, Priscylla Goncalves Correia Leite;da Cruz Perez, Danyel Elias;Soares, Diego Moura;de Araujo, Samuel Silva;Evencio, Liriane Baratella;Pontual, Maria Luiza dos Anjos;Ramos-Perez, Flavia Maria de Moraes
    • Journal of Periodontal and Implant Science
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    • v.51 no.4
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    • pp.264-275
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    • 2021
  • Purpose: Periodontitis is considered a local risk factor for medication-related osteonecrosis of the jaws (MRONJ). However, little is known about the progression of periodontitis in the presence of zoledronic acid (ZOL). The aim of this study was to evaluate the effects of the systemic use of ZOL on the progression of experimental periodontitis (EP) in rats, as ZOL could modulate the progression of periodontitis and concomitantly cause MRONJ in individuals with periodontitis. Methods: Forty-eight male Wistar rats were randomly distributed in 6 groups (n=8 each). To induce EP, ligatures were placed around the right first mandibular molars. Three groups were treated with ZOL (0.15 mg/kg/week, intraperitoneal), and 3 with 0.9% saline solution (controls). In the ZOL/Lig30 and ZOL/Lig 15 groups, after 4 weeks of treatment with ZOL, EP was induced and euthanasia was performed after 30 and 15 days of EP induction, respectively. In both groups, the animals continued to receive ZOL after EP until the end of the experiment. In the Lig/ZOL group, EP was induced first, and 15 days later, ZOL was administered for 8 weeks, with euthanasia 1 week after the last dose. After euthanasia, the mandibles were evaluated using micro-computed microtomography (micro-CT) and histomorphometry. Bone loss was measured, and the presence of osteonecrosis was evaluated histologically. The data were evaluated using the Student t-test and the Mann-Whitney test, with a significance level of 5%. Results: In the Lig/ZOL group, micro-CT revealed less alveolar bone resorption in the distal root (P<0.01) than in the control group (Lig/Con). Histomorphometric analysis confirmed less alveolar bone resorption in the Lig/ZOL group (P=0.001). Histologically, osteonecrosis was more common in the ZOL groups. Conclusion: ZOL decreased alveolar bone resorption in rats with EP. However, it presented a higher risk for MRONJ.

Current Advancement of Oral Cancer Research and its Clinical Implications (구강암의 연구동향 및 임상적 의의)

  • Kwon, Tae-Geon;Kim, Chin-Soo
    • The Journal of the Korean dental association
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    • v.48 no.8
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    • pp.576-586
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    • 2010
  • Recent advancement in molocular biology enhanced further understanding of the carcinogenesis of oral cancer and its relation with various genetic backgrounds. Familial risk factors includes similar habits of the family and polymorphic variations of the genes. Recently, human papilloma virus has been suggested to be linked with oral cancer progression. Enhancement of understanding of the damage or alteration in molecular pathway in various cellular response of oral cancer progression would lead the targeted therapy or precise early diagnosis of the oral cancer.

Whole-genome doubling is a double-edged sword: the heterogeneous role of whole-genome doubling in various cancer types

  • Eunhyong Chang;Joon-Yong An
    • BMB Reports
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    • v.57 no.3
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    • pp.125-134
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    • 2024
  • Whole-genome doubling (WGD), characterized by the duplication of an entire set of chromosomes, is commonly observed in various tumors, occurring in approximately 30-40% of patients with different cancer types. The effect of WGD on tumorigenesis varies depending on the context, either promoting or suppressing tumor progression. Recent advances in genomic technologies and large-scale clinical investigations have led to the identification of the complex patterns of genomic alterations underlying WGD and their functional consequences on tumorigenesis progression and prognosis. Our comprehensive review aims to summarize the causes and effects of WGD on tumorigenesis, highlighting its dualistic influence on cancer cells. We then introduce recent findings on WGD-associated molecular signatures and genetic aberrations and a novel subtype related to WGD. Finally, we discuss the clinical implications of WGD in cancer subtype classification and future therapeutic interventions. Overall, a comprehensive understanding of WGD in cancer biology is crucial to unraveling its complex role in tumorigenesis and identifying novel therapeutic strategies.

Pseudoprogression and Pseudoresponse in the Management of High-Grade Glioma : Optimal Decision Timing According to the Response Assessment of the Neuro-Oncology Working Group

  • Chang, Ji Hyun;Kim, Chae-Yong;Choi, Byung Se;Kim, Yu Jung;Kim, Jae Sung;Kim, In Ah
    • Journal of Korean Neurosurgical Society
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    • v.55 no.1
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    • pp.5-11
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    • 2014
  • Objective : We evaluated pseudoprogression (PsPD) following radiation therapy combined with concurrent temozolomide (TMZ), and we assessed pseudoresponse following anti-angiogenic therapy for patients with recurrent disease using the Response Assessment of the Neuro-Oncology Working Group. Methods : Patients who were pathologically confirmed as having high-grade glioma received radiotherapy with concurrent TMZ followed by adjuvant TMZ. Bevacizumab (Avastin) with CPT-11 were used as a salvage option for cases of radiologic progression. Magnetic resonance imaging (MRI) was routinely performed 1 month after concurrent radiochemotherapy (CRT) and every 3 months thereafter. For cases treated with the bevacizumab-containing regimen for progressive disease, MRI was performed every 2 months. Results : Of 55 patients, 21 (38%) showed radiologic progression within 4 weeks after CRT. Of these patients, 16 (29%) showed progression at second post-CRT MRI (etPD) and five (9%) showed improvement (PsPD). Seven of thirty-four initially non-progressed patients showed progression at the second post-CRT MRI (ltPD). No difference in survival was observed between the etPD and ltPD groups (p=0.595). Five (50%) of ten patients showed a radiological response after salvage bevacizumab therapy. Four of those patients exhibited rapid progression immediately after discontinuation of the drug (drug holiday). Conclusion : Twelve weeks following treatment could be the optimal timing to determine PsPD or true progression. MRI with gadolinium enhancement alone is not sufficient to characterize tumor response or growth. Clinical correlation with adequate follow-up duration and histopathologic validation may be helpful in discriminating PsPD from true progression.

Ultrasonography as a Tool for Monitoring the Development and Progression of Cholangiocarcinoma in Opisthorchis viverrini/Dimethylnitrosamine-Induced Hamsters

  • Plengsuriyakarn, Tullayakorn;Eursitthichai, Veerachai;Labbunruang, Nipawan;Na-Bangchang, Kesara;Tesana, Smarn;Aumarm, Waraporn;Pongpradit, Ananya;Viyanant, Vithoon
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.87-90
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    • 2012
  • Cholangiocarcinoma (CCA) is the most common cancer in northeastern Thailand. At present, effective diagnosis of CCA either in humans or animals is not available. Monitoring the development and progression of CCA in animal models is essential for research and development of new promising chemotherapeutics. Ultrasonography has been widely used for screening of bile duct obstruction in CCA patients. In this study, we preliminarily investigated the applicability of ultrasonography to monitor the development and progression of CCA in Syrian golden hamsters (n=8) induced by Opisthorchis viverrini (OV)/dimethylnitrosamine (DMN) administration. Ultrasonography and histopathological examination of hamsters was performed at week 0, 20, 24 and 28 of OV infection or at the start of water/Tween-80 administration to controls. The ultrasonographic images of liver parenchyma and gallbladders of OV/DMN-induced CCA hamsters showed sediments in gallbladder, thickening of gallbladder wall, and hypoechogenicity of liver parenchyma cells. The ultrasonographic images of liver tissues were found to correlate well with histopathological examination. Although ultrasonography does not directly detect the occurrence of CCA, it reflects the thickening of bile ducts and abnormality of liver tissues. It may be applied as a reliable tool for monitoring the development and progression of CCA in animal models in research and development of new promising chemotherapeutics for CCA.

Proposal on the Process and Prognosis of Popular Diseases (질병의 경과와 예후 판별에 대한 제언)

  • Kwon, Ki-Rok
    • Journal of Pharmacopuncture
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    • v.11 no.1
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    • pp.201-209
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    • 2008
  • Objectives : This study was designed to make beneficial proposal for clinical application on some of the most common disorders treated by Oriental medicine by analyzing treatment process and prognosis. Methods : Number of peculiar attributes pertaining to a specific disorder were analyzed and based on those attributes, patterns associated with process and prognosis were interpreted in reference with classical literatures. Results : 1. Factors which can influence the progression and prognosis include time of onset, intensity of symptoms, course of passage, effects of risk factors, condition of the patient's righteous qi(正氣), accuracy of differential diagnosis made by the practitioner, accuracy of treatment methods, and other unexpected external influences. 2. Correlation between the condition of disorders and treatment progression is closely associated with proper treatment procedures and performances. The time of onset and intensity play critical roles in the treatment process and prognosis and showed pattern tendency with mutual interactions. 3. When there is complication of various disorders, it is ideal to give priority to more urgent illness and take care of moderate illness later. If there isn't any correlation between disorders, treat them in the order of acute to chronic disorders. The approach is reversed when disorders are related, treating in the order of most chronic to most acute. 4. In a case of complication of various disorders, depending on the disorder being acute or chronic, intensity, and accuracy of treatments, either a domino effect or gradual fade out of symptoms were witnessed. 5. The concept of "Five Evils Theory" according to Nan Jing(Difficult Classic) is essential in grasping disease progression due to interrelationships between zangfu organs. Conclusions : Predicting of disease process and prognosis for vast array of disorders treated by Oriental medicine is a very difficult task, yet evaluating the disorder's peculiar properties and influential factors resulted in few principles which can be effectively applied into clinical applications.

Possible Role of HER-2 in the Progression of Prostate Cancer from Primary Tumor to Androgen Independence

  • Murray, Nigel P;Reyes, Eduardo;Fuentealba, Cynthia;Jacob, Omar;Orellana, Nelson
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6615-6619
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    • 2015
  • Background: The expression of HER-2 in prostate cancer has been linked to disease progression. We analysed the presence of HER-2 expression in primary tumors in men undergoing radical prostatectomy, its association with clinical and pathological findings, and its expression in secondary circulating prostate cells (CPCs) during follow up, as well as links with biochemical failure and the effects of androgen blockade. Materials and Methods: Consecutive men undergoing radical prostatectomy for histologically confirmed prostate cancer were analyzed. HER-2 expression in the primary tumor was assessed using the HercepTest(R), CPCs were identified from blood samples using standard immunocytochemistry with anti-PSA and positive samples with the HercepTest(R) to determine HER-2 expression. The influence of HER-2 expression on the frequency of biochemical failure and effects of androgen blockade was determined. Results: 144 men with a mean age of $64.8{\pm}10.3$ years participated, with a median follow up of 8.2 years. HER-2 was expressed in 20.8% of primary tumors; it was associated with vascular infiltration and older age, but not with other clinical pathological findings. Some 40.3% of men had secondary CPCs detected, of which 38% expressed HER-2. Men CPC (+) had a higher frequency of biochemical failure, but there was no difference in HER-2 expression of CPCs with the frequency of biochemical failure. After androgen blockade, men with HER-2 (+) positive secondary CPCs had a higher frequency of disease progression to castrate resistant disease. Conclusions: HER-2 plays a dual role in the progression of prostate cancer; firstly it may increase the potential of tumor cells to disseminate from the primary tumor via the blood by increasing vascular infiltration. In the presence of androgens, there is no survival advantage of expressing HER-2, but once biochemical failure has occurred and androgen blockade started, HER-2 positive cells are resistant to treatment, survive and grow leading to castration resistant disease.