• Title/Summary/Keyword: Nomogram

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Postoperative Radiotherapy Improves Survival in Gastric Signet-Ring Cell Carcinoma: a SEER Database Analysis

  • Wei, Feng;Lyu, Hongwei;Wang, Shuoer;Chu, Yan;Chen, Fengyuan
    • Journal of Gastric Cancer
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    • v.19 no.4
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    • pp.393-407
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    • 2019
  • Purpose: To identify the potential therapeutic role of postoperative radiotherapy (RT) in patients with locally advanced (stage II and stage III) gastric signet ring cell carcinoma (SRC). Materials and methods: Patients with locally advanced gastric SRC from the Surveillance, Epidemiology, and End Results program database between 2004 and 2012 were included in our study. Univariate and multivariate Cox proportional models were performed, and survival curves were generated to evaluate the prognostic effect of postoperative RT and surgery alone on SRC patients. Propensity score matching (PSM) was used to avoid selection bias among the study cohorts. Results: We found that patients with postoperative RT had better probability of survival compared with those who did not receive RT (overall survival [OS], P<0.001; cancer-specific survival [CSS], P<0.001). After PSM, analysis of both overall and CSS showed that patients who underwent postoperative RT had better prognosis than those receiving surgery alone in the matched cohort (OS, P=0.00079; CSS, P=0.0036). Multivariate Cox proportional model indicated that postoperative RT had better effect on prognosis compared with surgery alone with respect to both overall (hazard ratio [HR], 0.716; 95% confidence interval [95% CI], 0.590-0.87; P=0.001) and CSS (HR, 0.713; 95% CI, 0.570-0.890; P=0.003). Conclusions: Postoperative RT had better prognosis compared with surgery alone for both overall and CSS for patients with locally advanced gastric SRC.

Sonographic renal length and volume of normal Thai children versus their Chinese and Western counterparts

  • Rongviriyapanich, Chantima;Sakunchit, Thanarat;Sudla, Chirawat;Mungkung, Supamas;Pongnapang, Napapong;Yeong, Chai Hong
    • Clinical and Experimental Pediatrics
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    • v.63 no.12
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    • pp.491-498
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    • 2020
  • Background: Renal size is an important indicator in the diagnosis of renal diseases and urinary tract infections in children. Purpose: The purpose of this study is twofold. First, it aimed to measure the renal length and calculate the renal volume of normal Thai children using 2-dimensional ultrasonography (2D-US) and study their correlations with somatic parameters. Second, it aimed to compare the age-specific renal size of normal Thai children with the published data of their Western and Chinese counterparts. Methods: A total of 321 children (150 boys, 171 girls; age, 6-15 years) with a normal renal profile were prospectively recruited. All subjects underwent 2D-US by an experienced pediatric radiologist and the renal length, width, and depth were measured. Renal volume was calculated using the ellipsoid formula as recommended. The data were compared between the left and right kidneys, the sexes, and various somatic parameters. The age-specific renal lengths were compared using a nomogram derived from a Western cohort that is currently referred by many Thailand hospitals, while the renal volumes were compared with the published data of a Chinese cohort. Results: No statistically significant difference (P<0.05) was found between sexes or the right and left kidneys. The renal sizes had strong correlations with height, weight, body surface area, and age but not with body mass index. The renal length of the Thai children was moderately correlated (r=0.59) with that of the Western cohort, while the age-specific renal volume was significantly smaller (P<0.05) than that of the Chinese children. Conclusion: Therefore, we concluded that the age-specific renal length and volume obtained by 2D-US would vary between children in different regions and may not be suitably used as an international standard for diagnosis, although further studies may be needed to confirm our findings.

Predicting serum acetaminophen concentrations in acute poisoning for safe termination of N-acetylcysteine in a resource-limited environment (약물농도를 알 수 없는 환경에서 acetaminophen 급성 중독환자의 안전한 N-acetylcysteine 치료 종료를 위한 혈중약물 검출 예측)

  • Dahae Kim;Kyungman Cha;Byung Hak So
    • Journal of The Korean Society of Clinical Toxicology
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    • v.21 no.2
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    • pp.128-134
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    • 2023
  • Purpose: The Prescott nomogram has been utilized to forecast hepatotoxicity from acute acetaminophen poisoning. In developing countries, emergency medical centers lack the resources to report acetaminophen concentrations; thus, the commencement and cessation of treatment are based on the reported dose. This study investigated risk factors that can predict acetaminophen detection after 15 hours for safe treatment termination. Methods: Data were collected from an urban emergency medical center from 2010 to 2020. The study included patients ≥14 years of age with acute acetaminophen poisoning within 15 hours. The correlation between risk factors and detection of acetaminophen 15 hours after ingestion was evaluated using logistic regression, and the area under the curve (AUC) was calculated. Results: In total, 181 patients were included in the primary analysis; the median dose was 150.9 mg/kg and 35 patients (19.3%) had acetaminophen detected 15 hours after ingestion. The dose per weight and the time to visit were significant predictors for acetaminophen detection after 15 hours (odds ratio, 1.020 and 1.030, respectively). The AUCs were 0.628 for a 135 mg/kg cut-off value and 0.658 for a cut-off 450 minutes, and that of the combined model was 0.714 (sensitivity: 45.7%, specificity: 91.8%). Conclusion: Where acetaminophen concentrations are not reported during treatment following the UK guidelines, it is safe to start N-acetylcysteine immediately for patients who are ≥14 years old, visit within 15 hours after acute poisoning, and report having ingested ≥135 mg/kg. Additional N-acetylcysteine doses should be considered for patients visiting after 8 hours.

Predictive modeling algorithms for liver metastasis in colorectal cancer: A systematic review of the current literature

  • Isaac Seow-En;Ye Xin Koh;Yun Zhao;Boon Hwee Ang;Ivan En-Howe Tan;Aik Yong Chok;Emile John Kwong Wei Tan;Marianne Kit Har Au
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.1
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    • pp.14-24
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    • 2024
  • This study aims to assess the quality and performance of predictive models for colorectal cancer liver metastasis (CRCLM). A systematic review was performed to identify relevant studies from various databases. Studies that described or validated predictive models for CRCLM were included. The methodological quality of the predictive models was assessed. Model performance was evaluated by the reported area under the receiver operating characteristic curve (AUC). Of the 117 articles screened, seven studies comprising 14 predictive models were included. The distribution of included predictive models was as follows: radiomics (n = 3), logistic regression (n = 3), Cox regression (n = 2), nomogram (n = 3), support vector machine (SVM, n = 2), random forest (n = 2), and convolutional neural network (CNN, n = 2). Age, sex, carcinoembryonic antigen, and tumor staging (T and N stage) were the most frequently used clinicopathological predictors for CRCLM. The mean AUCs ranged from 0.697 to 0.870, with 86% of the models demonstrating clear discriminative ability (AUC > 0.70). A hybrid approach combining clinical and radiomic features with SVM provided the best performance, achieving an AUC of 0.870. The overall risk of bias was identified as high in 71% of the included studies. This review highlights the potential of predictive modeling to accurately predict the occurrence of CRCLM. Integrating clinicopathological and radiomic features with machine learning algorithms demonstrates superior predictive capabilities.

Evaluation of Biochemical Recurrence-free Survival after Radical Prostatectomy by Cancer of the Prostate Risk Assessment Post-Surgical (CAPRA-S) Score

  • Aktas, Binhan Kagan;Ozden, Cuneyt;Bulut, Suleyman;Tagci, Suleyman;Erbay, Guven;Gokkaya, Cevdet Serkan;Baykam, Mehmet Murat;Memis, Ali
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2527-2530
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    • 2015
  • Background: The cancer of the prostate risk assessment (CAPRA) score has been defined to predict prostate cancer recurrence based on the pre-clinical data, then pathological data have also been incorporated. Thus, CAPRA post-surgical (CAPRA-S) score has been developed based on six criteria (prostate specific antigen (PSA) at diagnosis, pathological Gleason score, and information on surgical margin, seminal vesicle invasion, extracapsular extension and lymph node involvement) for the prediction of post-surgical recurrences. In the present study, biochemical recurrence (BCR)-free probabilities after open retropubic radical prostatectomy (RP) were evaluated by the CAPRA-S scoring system and its three-risk level model. Materials and Methods: CAPRA-S scores (0-12) of our 240 radical prostatectomies performed between January 2000-May 2011 were calculated. Patients were distributed into CAPRA-S score groups and also into three-risk groups as low, intermediate and high. BCR-free probabilities were assessed and compared using Kaplan-Meier analysis and Cox proportional hazards regression. Ability of CAPRA-S in BCR detection was evaluated by concordance index (c-index). Results: BCR was present in 41 of total 240 patients (17.1%) and the mean follow-up time was $51.7{\pm}33.0$ months. Mean BCR-free survival time was 98.3 months (95% CI: 92.3-104.2). Of the patients in low, intermediate and high risk groups, 5.4%, 22.0% and 58.8% had BCR, respectively and the difference among the three groups was significant (P = 0.0001). C-indices of CAPRA-S score and three-risk groups for detecting BCR-free probabilities in 5-yr were 0.87 and 0.81, respectively. Conclusions: Both CAPRA-S score and its three-risk level model well predicted BCR after RP with high c-index levels in our center. Therefore, it is a clinically reliable post-operative risk stratifier and disease recurrence predictor for prostate cancer.

A Determination of the Maximum Potential Runoff of Small Rural Basins (소하천(小河川) 유역(流域)의 잠재유출량(潛在流出量) 결정(決定))

  • Yoon, Yong Nam;Hong, Chang Seon
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.2 no.1
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    • pp.53-62
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    • 1982
  • An effort of preliminary type has been made to develope a practical method for the waterway area determination of a drainage outlet in rural or agricultural areas. The Seoul meteorological station was selected as tile index station, and the maximum rainfalls-duration-frequency (R-D-F) relation of short-time intense rainfalls was first established. A frequency analysis of the daily rainfalls for the 75 stations selected throughout the country resulted the 50-year daily rainfall for each station. The rainfall factor, which is defined here as the ration of 50-year daily rainfalls of individual station and the index station, was determined for the 8 climatological regions divided in this study. Following the US SCS method the runoff number of a watershed was given based on the soil type, land-use pattern, and the surface treatment. With this runoff number and the R-D-F relationship the runoff factors for the index station were computed and hence a nomogram could be drawn which makes it possible to determine the runoff factor for a given rainfall number and a rainfall of specific duration and frequency. With this done, the potential runoff of a watershed for a given rainfall duration could be calculated, based on the unit hydrograph theory, by multiplying the rainfall factor, the runoff factor, and the drainage area of the watershed under consideration. Then, the maximum runoff potential was determined by varying the rainfall duration and finding out the duration which results the peak discharge of a gived return period.

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Correlations Between Height and Forced Expiratory Flow Curve Parameters (신장과 노력성 호기곡선 지표간의 상관성)

  • Jin, Bok Hee;Park, Sun Young;Park, Hyea Lim
    • Korean Journal of Clinical Laboratory Science
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    • v.36 no.2
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    • pp.199-204
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    • 2004
  • Height has become one of the most important factors to determine the pulmonary function test index, and there is a high correlation between them, so that they have been utilized for evaluating pulmonary function test predictive value or nomogram. Therefore, we have tried to find out that difference and if there is any correlation and linear relationship between height and forced expiratory flow curve. There were a total of 163 subjects, male 93 and female 70. This study was done at the Department of Pulmonary Function Test of Jeon-Ju Presbyterian Hospital and we measured the index at the forced expiratory flow curve of FVC, $FEV_{1.0}$, $FEV_{1.0}$/FVC, $FEF_{25-75%}$, and $FEF_{200-1200m{\ell}}$. When we subjected the group of height more than 160cm, there were gradual increments at FVC(p<0.001), $FEV_{1.0}$(p<0.001), $FEF_{25-75%}$(p<0.05) and $FEF_{200-1200m{\ell}}$(p<0.001), but no changes at $FEV_{1.0}$/FVC in terms of forced expiratory flow curve index. We have analyzed the relationship between height and forced expiratory flow curve, there was a close relationship at FVC(r=0.670, p<0.01), $FEV_{1.0}$(r=0.491, p<0.01), $FEF_{25-75%}$ (r=0.175, p<0.05) and $FEF_{200-1200m{\ell}}$(r=0.370, p<0.01) but there was reciprocal relationship at $FEV_{1.0}$/FVC(r=-0.215, p<0.01). We have tried simple regression analysis to see if height affects forced expiratory flow curve index as a sector, and the result was $FVC(\ell)=0.0642{\times}height(cm)-7.2978$(p<0.01, $R^2=0.449$), $FEV_{1.0}(\ell)=0.0407{\times}height(cm)-4.2774$ (p<0.01, $R^2=0.2411$), $FEV_{1.0}/FVC(%)=-0.2892{\times}height(cm)+121.44$(p<0.01, $R^2=0.0464$), $FEF_{25-75%}(\ell/sec)=0.0176{\times}height(cm)-0.7876$(p<0.05, $R^2=0.0237$), $FEF_{200-1200m{\ell}}(\ell/sec)=0.0967{\times}height(cm)-11.037$(p<0.01, $R^2=0.1214$) this was approved statistically. According to this study, if height is taller than average, forced expiratory flow curve index were increased, there was a close relationship between height and forced expiratory flow curve, and there was a linear relationship as sector between height and forced expiratory flow curve index. Therefore, researches that study other factors such as sex, age, weight, body surface area, and obesity indexes other than height should be done to see if there are any further relationships.

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Nomogram to predict the number of oocytes retrieved in controlled ovarian stimulation

  • Moon, Kyoung Yong;Kim, Hoon;Lee, Joong Yeup;Lee, Jung Ryeol;Jee, Byung Chul;Suh, Chang Suk;Kim, Ki Chul;Lee, Won Don;Lim, Jin Ho;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.43 no.2
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    • pp.112-118
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    • 2016
  • Objective: Ovarian reserve tests are commonly used to predict ovarian response in infertile patients undergoing ovarian stimulation. Although serum markers such as basal follicle-stimulating hormone (FSH) or random $anti-M{\ddot{u}}llerian$ hormone (AMH) level and ultrasonographic markers (antral follicle count, AFC) are good predictors, no single test has proven to be the best predictor. In this study, we developed appropriate equations and novel nomograms to predict the number of oocytes that will be retrieved using patients' age, serum levels of basal FSH and AMH, and AFC. Methods: We analyzed a database containing clinical and laboratory information of 141 stimulated in vitro fertilization (IVF) cycles performed at a university-based hospital between September 2009 and December 2013. We used generalized linear models for prediction of the number of oocytes. Results: Age, basal serum FSH level, serum AMH level, and AFC were significantly related to the number of oocytes retrieved according to the univariate and multivariate analyses. The equations that predicted the number of oocytes retrieved (log scale) were as follows: model (1) $3.21-0.036{\times}(age)+0.089{\times}(AMH)$, model (2) $3.422-0.03{\times}(age)-0.049{\times}(FSH)+0.08{\times}(AMH)$, model (3) $2.32-0.017{\times}(age)+0.039{\times}(AMH)+0.03{\times}(AFC)$, model (4) $2.584-0.015{\times}(age)-0.035{\times}(FSH)+0.038{\times}(AMH)+0.026{\times}(AFC)$. model 4 showed the best performance. On the basis of these variables, we developed nomograms to predict the number of oocytes that can be retrieved. Conclusion: Our nomograms helped predict the number of oocytes retrieved in stimulated IVF cycles.

A Nutritional Study of Tube-fed Patients with Severe Neurodevelopmental Disability (뇌병변장애환자의 경관영양에 대한 연구)

  • Cho, Sung Sook;Choi, Su Jung;Sul, Seung Min;Shin, Sun Mi
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.1
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    • pp.58-64
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    • 2006
  • Purpose: The purpose of this cross-sectional study was to assess the nutritional states and investigate the energy intake of tube-fed patients with severe neurodevelopmental disability. Methods: Eighty six tube-fed patients with severe neurodevelopmental disability were studied. Heights were measured by flexible scale segmentally. Nutritional parameters of weight, triceps skinfold thickness and mid-arm circumference were also measured. Total caloric intakes through the tube were calculated. Results: The anthropometric results showed that nutritional states of tube-fed patients with severe neurodevelopmental disability were poor. The mean daily caloric intake was much less than daily energy requirement (mean=45.2% of requirement). The caloric intake was 7.2 kcal/height (cm), 57.0 kcal/weight (kg). Height was more related with caloric intake (r=0.476) than weight (r=0.263). Conclusion: These results provide that tube-fed patients with severe neurodevelopmental disability were growth retarded and their energy intakes were much less than daily energy requirements. The preliminary evidence was that they need adequate nutritional supply.

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Head to Head Comparison of the Chun Nomogram, Percentage Free PSA and Primary Circulating Prostate Cells to Predict the Presence of Prostate Cancer at Repeat Biopsy

  • Murray, Nigel P;Reyes, Eduardo;Orellana, Nelson;Fuentealba, Cynthia;Jacob, Omar
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2941-2946
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    • 2016
  • Background: The limitations of total serum PSA values remain problematic, especially after an initial negative prostate biopsy. In this prospective study of Chilean men with a continued suspicion of prostate cancer due to a persistently elevated total serum PSA, abnormal digital rectal examination and initial negative prostate biopsy were compared with the use of the on-line Chun nomagram, detection of primary malignant circulating prostate cells (CPCs) and free percent PSA to predict a positive second prostate biopsy. We hypothesized that men negative for circulating prostate cells have a small risk of clinically significant prostate cancer and thus may be conservatively observed. Men positive for circulating prostate cells should undergo biopsy to confirm prostate cancer. Materials and Methods: Consecutive men with a continued suspicion of prostate cancer underwent 12 core TRUS prostate biopsy; age, total serum PSA and percentage free PSA and Chun nomagram scores were registered. Immediately before biopsy an 8ml blood simple was taken to detect primary mCPCs. Mononuclear cells were obtained by differential gel centrifugation and identified using double immunostaining with anti-PSA and anti-P504S. Biopsies were classifed as cancer/no-cancer, mCPC detecton test as negative/positive and the total number of cells/8ml registered. Areas under the curve (AUC) for percentage free PSA, Chun score and CPCs were calculated and compared. Diagnostic yields were calculated with reference to the number of possible biopsies that could be avoided and the number of clinically significant cancers that would be missed. Results: A total of 164 men underwent a second biopsy; 41 (25%) had cancer; the AUCs were 0.65 for free PSA, 0.76 for the Chun score and 0.87 for CPC detection, the last having a significantly superior prediction value (p=0.01). Using cut off values of free PSA <10%, Chun score >50% and ${\geq}1$ CPC detected, CPC detection had a higher diagnostic yield. Some 4/41 cancers complied with the criteria for active surveillance, free PSA and the Chun score missed a higher number of significant cancers when compared with CPC detection. Conclusions: Primary CPC detection outperformed the use of free PSA and the Chun nomagram in predicting clinically significant prostate cancer at repeat prostate biopsy.