• Title/Summary/Keyword: Poor grade

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Clinicopathological Significance of Large Tumor Suppressor (LATS) Expression in Gastric Cancer

  • Son, Myoung Won;Song, Geum Jong;Jang, Si-Hyong;Hong, Soon Auck;Oh, Mee-Hye;Lee, Ji-Hye;Baek, Moo Jun;Lee, Moon Soo
    • Journal of Gastric Cancer
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    • v.17 no.4
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    • pp.363-373
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    • 2017
  • Purpose: The aims of this study were to evaluate the expression of the large tumor suppressor (LATS) genes LATS1 and LATS2 by immunohistochemical staining of gastric cancer, and to evaluate the clinicopathological significance of LATS expression and its correlation with overall survival (OS). Materials and Methods: LATS1 and LATS2 expression in a tissue microarray was detected by immunohistochemistry, using 264 gastric cancer specimens surgically resected between July 2006 and December 2009. Results: Low expression of LATS1 was significantly associated with more advanced American Joint Committee on Cancer (AJCC) stage (P=0.001) and T stage (P=0.032), lymph node (LN) metastasis (P=0.040), perineural invasion (P=0.042), poor histologic grade (P=0.007), and diffuse-type histology by the Lauren classification (P=0.033). Low expression of LATS2 was significantly correlated with older age (${\geq}65$, P=0.027), more advanced AJCC stage (P=0.001) and T stage (P=0.001), LN metastasis (P=0.004), perineural invasion (P=0.004), poor histologic grade (P<0.001), and diffuse-type histology by the Lauren classification (P<0.001). Kaplan-Meier survival analysis revealed significantly poor OS rates in the groups with low LATS1 (P=0.037) and LATS2 (P=0.037) expression. Conclusions: Expression of LATS1 or LATS2 is a significant marker for a good prognosis in patients with gastric cancer.

Effectiveness of Endoscopic Dilatation & Silicone Stent Insertion for Tracheobronchial stenoses : Preliminary study (기관-기관지 협착에서 내시경적 확장술 및 실리콘 스텐트의 유용성 : 예비보고)

  • Lee, Kyong-Soo;Park, Dong-Wook;Kim, Kyu-Hun;Kim, Jae-Wook;Koh, Yoon-Woo;Kim, Do-Jin;Lee, Seung-Won
    • Korean Journal of Bronchoesophagology
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    • v.15 no.1
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    • pp.50-55
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    • 2009
  • Objectives: Endoscopic airway dilatation and stenting has been developed to treat the airway stenosis without potential morbidities of open surgery. We report the clinical results of endoscopic airway dilatation with silicone stenting in patients with posttuberculous bronchial stenosis(PTBS) and with severe main tracheal stenosis who have poor general conditions Methods : A prospective observation study of five patients, who have undergone endoscopic airway dilatation and silicone stenting between Feb 2007 and Feb 2009. A total of twelve patients were treated with endoscopic airway dilatation, among them 5 patients were included in this study. three patients were treated with newly designed silicone stent (Natural stent: TNO Co., Seoul, South Korea) because of poor surgical conditions and longer stenotic segment Results: 3 patients were grade III PTBS, and the other 2 patients were grade IV post tracheotomy main tracheal stenosis. One patient of PTBS were treated with silicone stent following endoscopic dilatation because of longer stenotic segment. Two patients of main tracheal stenosis patients were treated with silicone stent because of tracheal lumen collapse. There was no severe postoperative complications except mild granulation tissue formations Conclusions : Endoscopic dilatation including silicone stenting could be a useful method for treating patients with PTBS, and for main tracheal stenosis patients with poor general surgical conditions

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The Clinical and Radiological Analysis of Shunt-Dependent Hydrocephalus after Acute Hydrocephalus in Surgical Aneurysmal Patients (뇌동맥류 수술 환자에서 급성 수두증 병발후 단락술이 요하는 만성 수두증 합병의 임상적 및 형태학적 비교)

  • Shin, Yong Hwan;Hwang, Jeong Hyun;Hamm, In Suk;Sung, Joo Kyung;Hwang, Sung Kyoo;Park, Yeun Mook;Kim, Seung Lae
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1476-1483
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    • 2000
  • Objectives : The incidence of acute hydrocephalus(AHC) after aneurysmal subarachnoid hemorrhage reported as 13-31%. The AHC resolves spontaneously in some cases(simple AHC), but about 30% of the AHC progresses to shunt-dependent hydrocephalus(SDHC). The aim of this study was to understand clinical predisposing factors causing SDHC with performing differential clinical analyses between 2 subgroups, the simple AHC and the progresed SDHC. Methods : The 250 surgically treated patients with aneurysmal SAH over last two years were evaluated. Forty four patients(17.6%) of them showed the AHC. Of theses 37 cases were retrospectively analyzed, excluding 7 patients who died within 2 weeks after hemorrhage attack. Of the 37 AHC cases, 21 patient(56.8%) were complicated with the simple AHC, and 16 cases(43.2%) were progressed SDHC. Results : The older age(p<0.05), poor clinical grade(p=0.03), larger amount of SAH in perimesencephalic cistern on CT scan(p=0.005) were significantly related to the SDHC. No significant difference was noted in aneurysm location, multiplicity, rebleeding, hypertension and Fisher grade between 2 subgroups. Conclusion : Of the total 37 AHC, the simple AHC was 56.8% and the progressed SDHC 43.2%. The older age, poor clinical grade, large amount of SAH in perimesencephalic cistern were significant predisposing factors causing the SDHC. The large amount of SAH in perimesencephalic cistern is the single most important predisposing factor developing the progressed SDHC.

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Does Age Influence the Poor Prognosis after Aneurysmal SAH Surgery in Elderly Patients?

  • Sim, Jong-Eun;Kim, Hyung-Dong;Song, Young-Jin;Noh, Seung-Jin
    • Journal of Korean Neurosurgical Society
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    • v.40 no.5
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    • pp.357-362
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    • 2006
  • Objective : The incidence of aneurysmal subarachnoid hemorrhage has been increasing. At the same time, surgical results for elderly patients are unsatisfactory and no guidelines of treatment are available. We carried out a study comparing variable factors and surgical results between young and old age groups to find ways to improve prognosis. Methods : A retrospective study was carried out on 754 patients who were operated on between 1990 and 2004 by the same surgeon in our hospital. The patients were divided into seven groups according to age : 93 patients below 40 years of age [Group I], 419 patients aged $40{\sim}59$ [Group II], 115 patients aged $60{\sim}64$ [Group III], 82 patients aged $65{\sim}69$ [Group IV], 28 patients aged $70{\sim}74$ [Group V], 12 patients aged $75{\sim}79$ [Group VI] and 5 patients over the age of 80 [Group VII]. We then checked their medical history, Fisher's grade, Hunt-Hess grade, postoperative complications, and Glasgow Outcome Scale. Results : Age was not a statistically significant factor among patients below 70 years of age [P $value{\ge}0.05$]. But for those aged 70 and older, the age factor had a statistical value [P $value{\le}0.001$]. In addition, there was a close correlation between Hunt-Hess grade IV and V patients, and those with vasospasm, and hydrocephalus after surgery, with poor prognosis in elderly patients as well as young patients [P $value{\le}0.001$]. Conclusion : Advanced age [under the age of 70] dose not precluded adequate surgical treatment in patient with AN SAH, and we should be also alert to preventable causes of delayed neurological deterioration for improving the outcome in all elderly groups.

Elective neck dissection versus observation in early stage oral squamous cell carcinoma: recurrence and survival

  • Kim, Dong Wook;Lee, Ba-Da;Lim, Jung Hwan;Park, Jung-Hyun;Nam, Woong;Kim, Hyung Jun;Cha, In-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.6
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    • pp.358-364
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    • 2016
  • Objectives: To evaluate the results of elective neck dissection versus those of observation in the treatment of early stage oral squamous cell carcinoma and to identify factors related to recurrence and survival. Materials and Methods: This was a retrospective study of 52 patients who underwent elective neck dissection and 27 who did not receive neck dissection. Results: In survival analyses, elective neck dissection showed a benefit in overall recurrence (P=0.027), especially in stage I patients (P=0.024). With regard to survival, the benefit was statistically insignificant (P=0.990). In multivariable analysis, overall recurrence was independently related to poor histologic grade (odds ratio [OR]=9.65, P=0.006), and cancer-specific death was independently related to advanced age (OR=6.3, P=0.022), higher clinical T stage (OR=15.2, P=0.01), and poorly differentiated histologic grade (OR=6.6, P=0.025). Conclusion: Though there was lower recurrence in the elective neck dissection group, there were no statistically significant results on survival. The characteristics of the tumor itself, such as clinical T stage and poor histologic grade, may be more important in cancer-specific survival.

Prioritization of Alternatives by Quantifying the Effect on Water Quanity and Quality using PCSWMM (PCSWMM 모형의 수량 및 수질 측면의 효과분석 결과를 이용한 대안의 우선순위 제시)

  • Hong, Won-Pyo;Chung, Eun-Sung;Kim, SangUg;Park, Kyung-Shin;Lee, Kil Seong
    • Journal of Korean Society on Water Environment
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    • v.25 no.1
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    • pp.37-47
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    • 2009
  • This study analyzes the effect of alternatives and estimates alternatives evaluation index (AEI) using PCSWMM and weighted summation method. PCSWMM considering combined sewer overflows (CSOs) in the Mokgamcheon watershed was used and effectiveness analysis of alternative was conducted to develop not only flowrate but also the pollutant of BOD and SS. Indicators of AEI are selected using sustainability evaluation concept, driver-pressure-state-impact-response (DPSIR) framework and calculated by weighted summation method. After estimating AEI, alternatives was classified into three groups G (Good), A (Acceptable) and P (Poor) grade. As a results, it is analyzed that alternatives applied to Oryucheon were G grade and those of Yeokgokcheon were P grade and the remainings were 'A' grade. This result will be effective to the integrated watershed management for sustainablility.

The Results of Partial Meniscectomy according to the Grade of the Articular Cartilage Injury (관절 연골 손상 정도에 따른 반월상 연골 부분절제술의 결과)

  • Choi, Nam-Yong;Yang, Young-Jun;Nah, Ki-Ho;Yang, Hyuk-Jae;Song, Hyun-Seok
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.22-27
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    • 2009
  • Purpose: To identify the damage of the articular cartilage and analyze the clinical results of the partial medial meniscectomy. Materials and Methods: From January 2001 to December 2004, forty-eight patients in the degenerative arthritis and medial meniscal tear of knee who undertook arthroscopic partial meniscectomy and were able to keep pace with the times follow-up for more than 3 years were enrolled in this study. Six cases were men and 42 were women, and the mean age was 55.7 years (40~78 years). The patients were classified into two groups according to the Outerbridge grade. Grade I and II were classified into group 1 and grade III and IV into group 2. Group 1 included 30 cases and group 2 included 18 cases. The result were analyzed according to the Tapper & Hoover classification and Lysholm knee scoring scale. And we measured the distance of medial joint space in standing anteroposterior (AP) view of both sides at the pre-operative and the last follow-up. Results: According to the Tapper & Hoover classification, 28 cases were excellent, 7 cases good, 8 cases fair, and 5 cases poor. Among group 1, 25 cases were excellent, 2 cases good, 2 cases fair, 1 case poor. However, among group 2, 3 cases were excellent, 5 cases good, 6 cases fair, 4 cases poor. Average Lysholm knee score was improved from 62.4 preoperatively to 94 postoperatively in group 1, and from 58 preoperatively to 77.9 postoperatively in group 2. The joint space narrowing showed no statistically significant difference in both knees standing AP view. Conclusion: The arthroscopic partial meniscectomy for a patient with the degenerative articular cartilage was an effective treatment. However, we could not satisfy the results, in cases of Outerbridge grade III and IV. In grade III and IV, the partial meniscectomy was not aggravated the cartilage damage.

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One Year Follow-up Evaluation of Metastatic Brain Tumors - with Relevant to the Poor Prognosis (전이성 뇌종양의 1년간 추적 관찰연구-불량한 예후와의 연관성)

  • Yi, Hyeong Joong;Kim, Choong Hyun;Kim, Jae Min;Bak, Koang Hum;Oh, Suck Jun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.9
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    • pp.1108-1114
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    • 2001
  • Objective : Prognostic factors of metastatic brain tumors have been widely reported and their operative indications also have been extended gradually even to the poor grade patients. Authors intended to analyze the causative factors for the clinical outcome of metastatic brain tumors, especially with relevant to the poor prognosis by one year follow-up evaluation. Patients and Methods : The authors retrospectively studied the clinical characteristics of 46 cases(35 patients) with metastatic brain tumors among 466 cases(437 patients) which were operated on due to the brain tumor, during the period between January 1994 to June 1999. Statistical analysis was performed by using SPSS 8.0$^{(R)}$. A p-value of less than 0.05 was considered clinically significant. Result : Among the variable clinical factors in patients with metastatic brain tumors, Karnofsky Performance Scale (KPS) score of less than 70(16 patients), uncontrolled primary tumor(8 patients), and surgical resection without further adjuvant therapy(9 patients) showed statistically significant poor prognosis ; p value of 0.002, 0.032, and 0.001, respectively. Other tested variables, such as old age(greater than 65 years ; 10 patients), gender(male ; 20 patients), type of primary cancer(primary undefined ; 6 patients, lung cancer ; 15 patients), location(infratentorial ; 9 patients, sellar ; 5 patients), number of lesion(multiple ; 12 patients), and number of operation(multiple craniotomy ; 7 patients) were not related to the poor prognosis. Conclusions : The most common primary site of distant metastasis was lung. The poorer prognosis was highly correlated with various factors including low KPS score(<70), no postoperative adjuvant therapy, and uncontrolled primary tumors.

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Risk Factor for Recurrence in Completely Resected Stage IB Non-small Cell Lung Cancer (완전 절제된 IB기 비소세포폐암에서 수술 후 재발의 위험 인자)

  • Seok, Yang-Ki;Lee, Eung-Bae
    • Journal of Chest Surgery
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    • v.40 no.10
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    • pp.680-684
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    • 2007
  • Background: Complete surgical resection is the most effective treatment for stage IB non-small cell lung cancer (NSCLC). Recurrence accounts for the disappointing survival rates after resection. There has been renewed interest in adjuvant therapy after complete resection. Appropriate selection of effective adjuvant therapy will depend on the prognostic factors for recurrence. Material and Method: The study included 114 patients with completely resected stage IB NSCLC. The variables selected for the study were gender, age, the type of resection, cell type, the degree of differentiation, the tumor size and the presence of visceral pleura invasion. The Kaplan-Meier method was used to estimate the survival and disease-free survival rate. The results were compared using the log rank test. Multivariate analysis was performed by Cox's proportional hazard model. Two-sided p-valves < 0.05 were considered to be statistically significant. Result: The 3-year overall survival and the disease-free survival rates were 87.0% and 79.4%, respectively. The degree of differentiation showed a significant influence on disease-free survival according to the univariate analysis. According to the multivariate analysis, a poor grade of differentiation was a significant poor prognostic factor. Conclusion: These results demonstrate that poor differentiation may be a poor prognostic factor for patients with completely resected IB NSCLC. Therefore, the patients with a poor grade of differentiation may require adjuvant therapies.

Evaluation of Hemoglobin A1c Levels in Endometrial Cancer Patients: a Retrospective Study in Turkey

  • Karaman, Erbil;Karaman, Yasemin;Numanoglu, Ceyhun;Ark, Hasan Cemal
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.1817-1820
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    • 2015
  • Background: Hemoglobin A1c(HgA1c) is a marker of poor gylcemic control and elevation HgA1c is associated with increased risk of many cancers. We aimed to determine the HgA1c levels in endometrial cancer cases and any relationship with stage and grade of disease. Materials and Methods: A retrospective data review was performed between June 2011 and October 2012 at a tertiary referral center in Turkey. The study included 35 surgically staged endometrial cancer patients and 40 healthy controls. Preoperative HgA1c levels drawn within 3 months before surgery were compared. Also the relationships between HgA1c levels and stage, grade and hystologic type of cancer cases were evaluated. Results: The mean HgA1c levels were statistically significantly higher at $6.19{\pm}1.44$ in endometrial cancer cases than the $5.61{\pm}0.58$ in controls (p=0.027). With endometrial cancer cases, the mean HgA1c level was found to be $6.62{\pm}1.40$ for stage I and $6.88{\pm}1.15$ for stages II-IV (p=0.07). The figures were $6.74{\pm}1.65$ for endometrioid and $6.63{\pm}1.41$ for non-endometrioid type tumors (p=0.56). Mean HgA1c levels of $6.72{\pm}1.14$ for grade 1 and $6.62{\pm}1.42$ for grade 2-3 were observed (p=0.57). Conclusions: HgA1c levels in endometrial cancer patients were statistically higher than healthy controls. However, HgA1c did not show any significant correlation with stage, grade and histologic type in endometrial cancer cases.