• Journal of Korean Neurosurgical Society
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• v.50 no.4
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• pp.327-331
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• 2011

Objective : The aim of this study is to investigate the clinical outcomes of surgery and coiling and analyze the predicting factors affecting the clinical outcomes of ruptured posterior inferior cerebellar artery (PICA) aneurysms. Methods : During the last 15 years, 20 consecutive patients with ruptured PICA aneurysms were treated and these patients were included in this study. The Fisher's exact test was used for the statistical significance of Glasgow Outcome Scale (GOS) according to initial Hunt-Hess (H-H) grade, treatment modalities, and the presence of acute hydrocephalus. Results : Eleven (55%) and nine (45%) patients were treated with surgical clipping and endovascular treatment, respectively. Among 20 patients, thirteen (65.0%) patients had good outcomes (GOS 4 or 5). There was the statistical significance between initial poor H-H grade, the presence of acute hydrocephalus and poor GOS. Conclusion : In our study, we suggest that initial H-H grade and the presence of acute hydrocephalus may affect the clinical outcome rather than treatment modalities in the ruptured PICA aneurysms.

• Archives of Craniofacial Surgery
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• v.24 no.5
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• pp.211-217
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• 2023

Background: Oral cavity cancers, the second most common type in India, are responsible for 10% of the overall cancer burden. With a recurrence rate of 30% to 40% and a 5-year survival rate of 50%, these malignancies account for substantial morbidity and mortality. Despite advances in treatment modalities, survival rates following treatment completion have not improved significantly. The present study aimed to establish specific epidemiological and pathological factors responsible for recurrence after treatment completion in buccal mucosa cancers. Methods: A retrospective analysis of the data of 116 patients treated for biopsy-proven cancers of the buccal mucosa was undertaken 1 year after treatment completion. Factors such as age, sex, education, lymphovascular invasion, extranodal extension (ENE), perineural invasion, depth of invasion, and pathological margin status were compared between patients who presented with recurrence and those who did not. Statistical significance was set at p< 0.05. Results: Of the 116 patients, 40 (34.5%) developed a recurrent disease within 1 year. The mean age of the study population was 43.3 years, and males constituted 91.4% of the included patients. Ipsilateral buccal mucosa was the commonest site of disease recurrence. Neck node metastasis, ENE, and margins of resection < 5 mm were significantly related to the recurrence of disease. However, surprisingly, lymphovascular invasion, perineural invasion, and depth of invasion > 10 mm did not show statistically significant associations. Conclusion: Neck node metastasis, ENE, and margins of resection < 5 mm were the histopathological factors associated with recurrence in cancers of the buccal mucosa.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.1445-1448
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• 2016

Purpose: The current study aimed at assessing the association between neutrophil-lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) for the prognosis of the surgical outcome of epithelial ovarian cancer (EOC). Materials and Methods: EOC patient medical records of surgical operations between January, 2005 and December, 2015 were reviewed and their data of clinicopathological complete blood counts (CBCs) and surgical outcomes were collected. To assess their effects on surgical outcomes, PLR and NLR optimal predictive values were determined and then compared with each other. Results: A statistically significant relation was found between surgical outcomes and NLR and PLR (p<0.001 and p<0.001), for which new cutoff points were gained (PLR: 192,3,293; NLR: 3). The sensitivity and specificity were 0.74 and 0.67, respectively for PLR and 0.74 and 0.58, for NLR. Conclusions: NLR and PLR seem to be useful methods for the prediction of surgical outcomes in patients with EOCs. Increased NLR and PLR proved to be beneficial for poor surgical outcomes. Moreover, PLR increase showed further help in the predicting outcome of EOC suboptimal debulking.

• Journal of Rhinology
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• v.59 no.2
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• pp.173-180
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• 2021

Background: Neutrophils present as major inflammatory cells in refractory chronic rhinosinusitis with nasal polyps (CRSwNP), regardless of the endotype. However, their role in the pathophysiology of CRSwNP remains poorly understood. We investigated factors predicting the surgical outcomes of CRSwNP patients with focus on neutrophilic localization. Methods: We employed machine-learning methods such as the decision tree and random forest models to predict the surgical outcomes of CRSwNP. Immunofluorescence analysis was conducted to detect human neutrophil elastase (HNE), Bcl-2, and Ki-67 in NP tissues. We counted the immunofluorescence-positive cells and divided them into three groups based on the infiltrated area, namely, epithelial, subepithelial, and perivascular groups. Results: On machine learning, the decision tree algorithm demonstrated that the number of subepithelial HNE-positive cells, Lund-Mackay (LM) scores, and endotype (eosinophilic or non-eosinophilic) were the most important predictors of surgical outcomes in CRSwNP patients. Additionally, the random forest algorithm showed that, after ranking the mean decrease in the Gini index or the accuracy of each factor, the top three ranking factors associated with surgical outcomes were the LM score, age, and number of subepithelial HNE-positive cells. In terms of cellular proliferation, immunofluorescence analysis revealed that Ki-67/HNE-double positive and Bcl-2/HNE-double positive cells were significantly increased in the subepithelial area in refractory CRSwNP. Conclusion: Our machine-learning approach and immunofluorescence analysis demonstrated that subepithelial neutrophils in NP tissues had a high expression of Ki-67 and could serve as a cellular biomarker for predicting surgical outcomes in CRSwNP patients.

• Journal of Trauma and Injury
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• v.21 no.2
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• pp.85-90
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• 2008

Purpose: Supraventricular arrhythmia is a well-known complication of cardiothoracic surgery, and is common in patients wirth underlying cardiovascular disease. Also, it's treatment and prognosis are well known. However the incidence, the contributing factors, and the prognosis for supraventricular arrhythmias in noncardiothoracic surgical patients are less well known. This study was undertaken to investigate the incidence, the clinical presentation, the prognosis, and the factors comtributing to the prognosis for supraventricular arrhythmia in the surgical intensive care unit. Methods: We performed a retrospective study of 34 patients with newly developed or aggravated supraventricular arrhythmias in the surgical intensive care unit between March 2004 and February 2005. The incidence, the risk factors, and the prognosis of supraventricular arrhythmias were analyzed. Results: During a 12month period, the incidence of supraventricular arrhythmia was 1.79% (34/1896). Most patients had pre-existing cardiovascular disease and sepsis. The mortality rate was 29.4%, and the most common cause of death was multiple organ failure due to septic shock. The mean value of the APACHE II score was 20.9, and the surgical intensive care unit and the hospital lengths of stay were 9.9 days and 25.8 days, respectively. The APACHE II score measured when the arrhythmia developed was a significant factor in predicting mortality, Conclusion: Supraventricular arrhythmias result in increased mortality and increased length of stay in both the surgical intensive care unit and the hospital. The arrhythmia itself did not cause death, but a high APACHE II score incicated a poor prognosis. This may reflect the severity of the illness rather than an independent contributor to mortality.

• Journal of Chest Surgery
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• v.28 no.4
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• pp.371-375
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• 1995

Surgical resection of lung cancer or other disease is recently required in patients with severely impaired lung function resulting from chronic obstructive pulmonary disease or disease extension. So prediction of pulmonary function after lung resection is very important in thoracic surgeon. We studied the accuracy of the prediction of postoperative pulmonary function using perfusion lung scan with 99m technetium macroaggregated albumin in 22 patients who received the pneumonectomy. The linear regression line derived from correlation between predicting[X and postoperative measured[Y values of FEV1 and FVC in patients are as follows: 1 Y[ml =0.713X + 381 in FEV1 [r=0.719 ,[P<0.01 2 Y[ml =0.645X + 556 in FVC [r=0.675 ,[P<0.01 In conclusion,the perfusion lung scan is noninvasive and very accurate for predicting postpneumonectomy pulmonary function.

• Korean Journal of Artificial Intelligence
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• v.6 no.2
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• pp.11-15
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• 2018

Breast cancer is one of the leading causes of cancer related death among women. So prediction of overall survival status is important into decided in adjuvant treatment. Deep belief network is a kind of artificial intelligence (AI). We intended to construct prediction model by deep belief network using associated clinicopathologic factors. 103881 cases were found in the Korean Breast Cancer Registry. After preprocessing of data, a total of 15733 cases were enrolled in this study. The median follow-up period was 82.4 months. In univariate analysis for overall survival (OS), the patients with advanced AJCC stage showed relatively high HR (HR=1.216 95% CI: 0.011-289.331, p=0.001). Based on results of univariate and multivariate analysis, input variables for learning model included 17 variables associated with overall survival rate. output was presented in one of two states: event or cencored. Individual sensitivity of training set and test set for predicting overall survival status were 89.6% and 91.2% respectively. And specificity of that were 49.4% and 48.9% respectively. So the accuracy of our study for predicting overall survival status was 82.78%. Prediction model based on Deep belief network appears to be effective in predicting overall survival status and, in particular, is expected to be applicable to decide on adjuvant treatment after surgical treatment.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.17
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• pp.7383-7387
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• 2014

Background: To determine rates of residual disease along with influencing factors in women with stage IA to IB1 cervical carcinoma after conization. Materials and Methods: A retrospective study was conducted of medical records of 198 stage IA to IB1 cervical carcinoma patients who had undergoing cervical conization followed by primary surgical treatment during 2006-2013. Independent factors correlating with residual carcinoma in subsequent surgical specimens were analyzed by stepwise regression analysis. Results: Mean age was 48.9 years. Cone specimens demonstrated free margins in 36 women (18.8%). In case of having disease at margin, high-grade cervical intraepithelial neoplasia (CIN) and carcinoma were evidenced in 58 and 97 women, respectively. Pathology of subsequent specimens revealed residual carcinoma in 78 women (39.4%), high-grade CIN or adenocarcinoma in situ (AIS) in 45 (22.7%), and no residual pathology in 75 (37.9%). Age more than 35 years, postmenopausal status, having symptoms, diseases or invasive lesions at conization margins or disease on endocervical aspect, and higher stage were significantly correlated with residual cancer in surgical treatment specimens. On regression analysis, postmenopause and stage were independent factors associated with residual carcinoma.Conclusions: Patient and tumor characteristics are predictive factors for residual cancer in the studied group of women.

• Journal of Korean Dental Science
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• v.16 no.1
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• pp.80-86
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• 2023

We report two rare cases of extensive bilateral subcutaneous emphysema that occurred during ordinary dental procedures. An air-driven high-speed handpiece, routinely used in dental procedures may cause subcutaneous emphysema when high pressure air is introduced into the loose connective tissues below the dermal layer. The first case occurred with surgical extraction of the lower third molar. The air introduced into the fascial spaces near the surgical field spread to the contralateral spaces, as well as the neck and chest areas. The second case also showed extensive bilateral subcutaneous emphysema caused by the introduction of compressed air from the handpiece during crown preparation without any invasive procedure. Cases where the emphysema extends beyond the treatment site to involve the contralateral cervicofacial areas have been rarely reported. Predicting the occurrence of subcutaneous emphysema is difficult, so it is important to exercise caution during routine dental treatment. If significant bilateral cervicofacial swelling is suspected to be due to subcutaneous emphysema, prompt diagnosis with securing the patient's airway will be necessary.

• Journal of Gastric Cancer
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• v.11 no.2
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• pp.116-121
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• 2011

Purpose: Gastric cancer surgery is a common operation in East Asia, such as Korea and Japan, and there has been a significant increase in the need for this procedure due to the aging population. As a result, surgery for the treatment of gastric cancer for elderly patients is expected to increase. This study examined the effect of old age on gastric cancer surgery, and analyzed the operative risk factors for elderly patients. Materials and Methods: From November 2008 to August 2010, 590 patients, who underwent a curative resection for gastric cancers, were enrolled. Patients who underwent palliative or emergency surgery were excluded. A retrospective analysis of the correlation between surgical outcomes and age was performed. The elderly were defined as patients who were over the age of 65 years. Results: The mean age of all patients was 58.3 years, and complications occurred in 87 cases (14.7%). The most common complication was wound infection and severe complications requiring surgical, endoscopic, or radiologic intervention developed in 52 cases (8.8%). The rate of complications increased with increasing age of the patients. Univariate analysis revealed age, comorbidity, extent of resection, operation time, and combined resection to be associated with surgical complications. In particular, age over 75 years old, operation time, and comorbidity were predictive factors in multivariate analysis. In the elderly, only comorbidity was associated with surgical complications Conclusions: The patients' age is the most important factor for predicting surgical complications. Surgeons should pay an attention to the performance of gastric cancer surgery on elderly patients. In particular, it must be performed carefully for elderly patients with a comorbidity.