• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.1601-1607
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• 2013

A determination of circulating tumor cell (CTC) effectiveness for prediction of progression-free survival (PFS) and overall survival (OS) was conducted as an adjunct to standard treatment of care in breast cancer management. Between November 2008 and March 2009, 22 metastatic and 12 early stage breast carcinoma patients, admitted to Ankara Oncology Training and Research Hospital, were included in this prospective trial. Patients' characteristics, treatment schedules and survival data were evaluated. CTC was detected twice by CellSearch method before and 9-12 weeks after the initiation of chemotherapy. A cut-off value equal or greater than 5 cells per 7.5 ml blood sample was considered positive. All patients were female. Median ages were 48.0 (range: 29-65) and 52.5 (range: 35-66) in early stage and metastatic subgroups, respectively. CTC was positive in 3 (13.6%) patients before chemotherapy and 6 (27.3%) patients during chemotherapy in the metastatic subgroup whereas positive in only one patient in the early stage subgroup before and during chemotherapy. The median follow-up was 22.0 (range: 21-23) and 19.0 (range: 5-23) months in the early stage and metastatic groups, respectively. In the metastatic group, both median PFS and OS were significantly shorter in any time CTC positive patients compared to CTC negative patients (PFS: 4.0 vs 14.0 months, Log-Rank p=0.013; and OS: 8.0 months vs. 20.5 months, Log-Rank p<0.001). OS was affected from multiple visceral metastatic sites (p=0.055) and higher grade (p=0.044) besides CTC positivity (log rank p<0.001). Radiological response of chemotherapy was also correlated with better survival (p<0.001). As a result, CTC positivity was confirmed as a prospective marker even in a small patient population, in this single center study. Measurement of CTC by CellSearch method in metastatic breast carcinoma cases may allow indications of early risk of relapse or death with even as few as two measurements during a chemotherapy program, but this finding should be confirmed with prospective trials in larger study populations.

• Journal of Hospice and Palliative Care
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• v.5 no.2
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• pp.111-124
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• 2002

Purpose : Although the average life expectancy has increased due to advances in medicine, mortality due to cancer is on an increasing trend. Consequently, the number of terminally ill cancer patients is also on the rise. Predicting the survival period is an important issue in the treatment of terminally ill cancer patients since the choice of treatment would vary significantly by the patents, their families, and physicians according to the expected survival. Therefore, we investigated the prognostic factors for increased mortality risk in terminally ill cancer patients to help treat these patients by predicting the survival period. Methods : We investigated 31 clinical parameters in 157 terminally ill cancer patients admitted to in the Department of Family Medicine, National Health Insurance Corporation Ilsan Hospital between July 1, 2000 and August 31, 2001. We confirmed the patients' survival as of October 31, 2001 based on medical records and personal data. The survival rates and median survival times were estimated by the Kaplan-Meier method and Log-rank test was used to compare the differences between the survival rates according to each clinical parameter. Cox's proportional hazard model was used to determine the most predictive subset from the prognostic factors among many clinical parameters which affect the risk of death. We predicted the mean, median, the first quartile value and third quartile value of the expected lifetimes by Weibull proportional hazard regression model. Results : Out of 157 patients, 79 were male (50.3%). The mean age was $65.1{\pm}13.0$ years in males and was $64.3{\pm}13.7$ years in females. The most prevalent cancer was gastric cancer (36 patients, 22.9%), followed by lung cancer (27, 17.2%), and cervical cancer (20, 12.7%). The survival time decreased with to the following factors; mental change, anorexia, hypotension, poor performance status, leukocytosis, neutrophilia, elevated serum creatinine level, hypoalbuminemia, hyperbilirubinemia, elevated SGPT, prolonged prothrombin time (PT), prolonged activated partial thromboplastin time (aPTT), hyponatremia, and hyperkalemia. Among these factors, poor performance status, neutrophilia, prolonged PT and aPTT were significant prognostic factors of death risk in these patients according to the results of Cox's proportional hazard model. We predicted that the median life expectancy was 3.0 days when all of the above 4 factors were present, $5.7{\sim}8.2$ days when 3 of these 4 factors were present, $11.4{\sim}20.0$ days when 2 of the 4 were present, and $27.9{\sim}40.0$ when 1 of the 4 was present, and 77 days when none of these 4 factors were present. Conclusions : In terminally ill cancer patients, we found that the prognostic factors related to reduced survival time were poor performance status, neutrophilia, prolonged PT and prolonged am. The four prognostic factors enabled the prediction of life expectancy in terminally ill cancer patients.

• Tuberculosis and Respiratory Diseases
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• v.44 no.4
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• pp.756-765
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• 1997

Background : To study the prognosis of patients with lung cancer, many investigators have reported the methods to detect cell proliferation in tissues including PCNA, thymidine autoradiography, flow cytometry and Ki-67. PCNA, also known as cyclin, is a cell related nuclear protein with 36KD intranuclear polypeptide that is maximally elevated in S phase of proliferating cells. In this study, PCNA was identified by paraffin-embedding tissue using immunohistochemistry which has an advantage of simplicity and maintenance of tissue architecture. The variation of PCNA expression is known to be related with proliferating fraction, histologic type, anatomic(TNM) stage, degree of cell differentiation, S-phase fraction and survival rate. We analyzed the correlation between PCNA expression and S-phase fraction, survival. Method : To investigate expression of PCNA in primary lung cancer, we used immunohistochemical stain to paraffin-embedded sections of 57 resected primary non-small cell lung cancer specimen and the results were analyzed according to the cell type, cell differentiation, TNM stage, S-phase fraction and survival. Results : PCNA expression was divided into five group according to degree of staging(-, +, ++, +++, ++++). Squamous cell type showed high positivity than in adenocarcinoma. Nonsignificant difference related to TNM stage was noticed. Nonsignificant difference related to degree of cell differentiation was noticed. S-phase fraction was increased with advance of PCNA positivity, but it could not reach the statistic significance. The 2 year survival rate and median survival time were -50% 13 months, +75% 41.3 months, ++73% 33.6 months, +++67% 29.0 months, ++++25% 9 months with statistic significance (P<0.05, Kaplan-Meier, generalized Wilcox). Conclusion : From this study, PCNA expression was high positive in squamous cell cancer. And, there was no relationship between PCNA positivity and TNM stage, cellular differentiation or S-phase fraction. But, the patients with high positive PCNA staining showed poor survival rate than the patients with lower positive PCNA staining (p<0.05). It was concluded that PCNA immunostaining is a simple and useful method for survival prediction in paraffin embedded tissue of non-small cell lung cancer.

• Progress in Medical Physics
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• v.34 no.3
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• pp.23-32
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• 2023

Purpose: In radiomics analysis, to evaluate features, and predict genetic characteristics and survival time, the pixel values of lesions depicted in computed tomography (CT) and magnetic resonance imaging (MRI) images are used. CT and MRI offer three-dimensional images, thus producing three-dimensional features (Features_3d) as output. However, in reports, the superiority between Features_3d and two-dimensional features (Features_2d) is distinct. In this study, we aimed to investigate whether a difference exists in the prediction accuracy of radiomics analysis of lung cancer using Features_2d and Features_3d. Methods: A total of 38 cases of large cell carcinoma (LCC) and 40 cases of squamous cell carcinoma (SCC) were selected for this study. Two- and three-dimensional lesion segmentations were performed. A total of 774 features were obtained. Using least absolute shrinkage and selection operator regression, seven Features_2d and six Features_3d were obtained. Results: Linear discriminant analysis revealed that the sensitivities of Features_2d and Features_3d to LCC were 86.8% and 89.5%, respectively. The coefficients of determination through multiple regression analysis and the areas under the receiver operating characteristic curve (AUC) were 0.68 and 0.70 and 0.93 and 0.94, respectively. The P-value of the estimated AUC was 0.87. Conclusions: No difference was found in the prediction accuracy for LCC and SCC between Features_2d and Features_3d.

• Journal of Astronomy and Space Sciences
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• v.34 no.4
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• pp.289-302
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• 2017

The key risk analysis technologies for the re-entry of space objects into Earth's atmosphere are divided into four categories: cataloguing and databases of the re-entry of space objects, lifetime and re-entry trajectory predictions, break-up models after re-entry and multiple debris distribution predictions, and ground impact probability models. In this study, we focused on reentry prediction, including orbital lifetime assessments, for space situational awareness systems. Re-entry predictions are very difficult and are affected by various sources of uncertainty. In particular, during uncontrolled re-entry, large spacecraft may break into several pieces of debris, and the surviving fragments can be a significant hazard for persons and properties on the ground. In recent years, specific methods and procedures have been developed to provide clear information for predicting and analyzing the re-entry of space objects and for ground-risk assessments. Representative tools include object reentry survival analysis tool (ORSAT) and debris assessment software (DAS) developed by National Aeronautics and Space Administration (NASA), spacecraft atmospheric re-entry and aerothermal break-up (SCARAB) and debris risk assessment and mitigation analysis (DRAMA) developed by European Space Agency (ESA), and semi-analytic tool for end of life analysis (STELA) developed by Centre National d'Etudes Spatiales (CNES). In this study, various surveys of existing re-entry space objects are reviewed, and an efficient re-entry prediction technique is suggested based on STELA, the life-cycle analysis tool for satellites, and DRAMA, a re-entry analysis tool. To verify the proposed method, the re-entry of the Tiangong-1 Space Lab, which is expected to re-enter Earth's atmosphere shortly, was simulated. Eventually, these results will provide a basis for space situational awareness risk analyses of the re-entry of space objects.

• Journal of Korea Entertainment Industry Association
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• v.4 no.4
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• pp.72-76
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• 2010

Clinical nomogram is a graphical representation of numeric formula, constructed from clinical cases database of followed patients' treatment, which is used for medical predication. For a clinical nomogram to contribute patient care, it is required to accumulate as many as clinical cases and to extract medical prediction knowledge. It needs to be equipped with an effective method to build medical nomogram with high predication accuracy. It is desirable for medical nomogram to be accessible at patient care point. This paper proposes a medical nomogram service system architecture which takes into account the above-mentioned issues. The proposed system architecture includes a web-based database subsystem to maintain and keep track of clinical cases. On the periodic basis, a new clinical nomogram is reconstructed for the updated clinical database. For the convenient use of patient care practice environment, an app-based program is provided which makes prediction based on the most recent clinical nomogram constructed in the service system. The proposed method has been applied to a clinical nomogram service system development for recurrence and survival prediction in bladder cancer patients.

• Archives of Plastic Surgery
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• v.38 no.6
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• pp.808-814
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• 2011

Purpose: Despite wide clinical use of breast implants, there is continued concern about the lifespan of these devices. The causes of explantation were infection, deflation of implant and patient's want. The deflation of saline-filled breast implant was related to strength and durability of implant shell. The purpose of this study is to evaluate the clinical durability of saline-filled breast implant through the analysis of duration until deflation occurred, causes, incidence and influencing factors. Methods: Retrospective analyses were conducted on clinical records for 19 cases of deflation of saline-filled breast implant from 201 cases of breast reconstruction with saline-filled implant between May 1995 and June 2011. The authors had been analyzed the causes of deflation, survival duration, symptom, sign, nipple excision, volume of implant, saline filling, method of reoperation, breast cancer stage and combined capsular contracture. Results: The causes of deflation were attributed to the cases that cannot be evaluated the causes in 15 cases, fall down in 1 case, mammography in 2 cases, accidental needle injury in 1 case. Mean survival duration was 4 years and 5 months. The duration of survival was less than 1 year for 5 cases, 1 year to 10 years for 10 cases, more than 10 years for 4 cases. The volume between 201 and 250 cc of deflated breast implant was rated as high by 14.0 percent. The deflation rate of underfilled implants was 11.4 percent, adequate filled implants was 9.3 percent. None of overfilled implant was deflated. The deflation of smooth surface implant was 5 of 152 cases. Textured implant was 14 of 49 cases. The capsular contracture of non-deflated breast implant was 28 of 182 cases and that of deflated breast implant was 6 of 19 cases. Conclusion: The patients who underwent saline-filled breast implant implantation should be informed that their implant could deflate. The analysis of clinical durability and causes of deflation in breast implant was important for the prediction and prevention of reopeation. The authors could suppose the causes of deflation of saline-filled breast implant through history, duration of survival, inspection of the shell of implant.

• Journal of Hospice and Palliative Care
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• v.14 no.4
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• pp.197-203
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• 2011

Purpose: Pain is the most common and influential symptom in cancer patients. Few studies concerning pain intensity in the terminally ill cancer patients have been done. This study aimed to identify factors related with more than moderate pain. Methods: This study used secondary data of 162 terminal cancer inpatients at the palliative ward of six training hospitals in Korea. Physician-assessed pain assessment was by 10 point numeric rating scale. Substantial pain was defined more than moderate intensity by the Korean National Guideline for cancer pain. The Korean version of the MD Anderson Symptom Inventory was self-administered to assess symptoms. Survival prediction was estimated by the attending physicians at the time of admission. Results: Less than six weeks of predicted survival and more than numeric rating of six for worst drowsiness in the previous 24 h were significantly related to substantial pain (P=0.012 and P=0.046, respectively). The dose of opioid analgesics was positively related to substantial pain (P=0.004). Conclusion: Factors positively related to substantial pain were less than six weeks of predicted survival and considerable drowsiness. Careful monitoring and active preparation for pain are required in terminal cancer patients having those factors.

• Radiation Oncology Journal
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• v.7 no.2
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• pp.171-183
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• 1989

A general effect for cell proliferation has been incorporated into Roesch's survival equation (Accumulation Model). From this an isoeffect formula for the low dose-rate regimen is obtained. The prediction for total doses equivalent to 60Gy delivered at the constant dose-rate over 7 days agrees well with the dose-time data of Paterson and of Green, when the parameter ratio A/B (${\approx}{\alpha{\mu}}/2{\beta}\;where\;{\mu}$ is the repair rate) is chosen to be 0.7Gy/h. When a constant proliferation rate and known facts of division delay are assumed, an isoeffect relation between low dose-rate treatment and acute dose-rate treatment can be derived. This formula in the regimens where proliferation is negligible predicts exactly the data of Ellis that 8 fractions of 5 Gy/day for 7 days are equivalent to continuously applied 60Gy over 7days, provided the A/B ratio is 0.7 Gy/h and the $\alpha/\beta$ ratio is 4Gy. Overall agreement between the clinical data and the predictions made by the formula at the above parameter values suggests that the biologcal end points used as the tolerance level in the studies by Paterson, Green, and Ellis all agree and they are not entirely the early effects as generally assumed. The absence of dose-rate effects observed in the mouse KHT sarcoma can better be explained in terms of a large value for the A/B ratio. Similarly, the same total dose used independently of the dose-rate to treat head and neck tumors by Pierquin can be justified.

• Journal of the Institute of Electronics Engineers of Korea SC
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• v.48 no.4
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• pp.1-9
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• 2011

Hemorrhagic shock is a clinically widespread syndrome characterized by inadequate oxygenation and supply. It is important to diagnose hemorrhagic shock in its early stage for improving treatment effects and survival rate. However, an accurate diagnosis and treatment could be delayed in the early stage of hemorrhagic shock by evaluating only vital signs such as heart rate and blood pressure. There have been many studies for the early diagnosis of hemorrhagic shock, reporting that lactate concentration and perfusion were useful variables for tissue hypoxia and metabolic acidosis. In this study, we measured both perfusion using a laser Doppler flowmeter and lactate concentration from the volume controlled hemorrhagic shock using rats. We also proposed a new shock index which was calculated by dividing lactate concentration by perfusion for early diagnosis. As a result of the survival prediction by the proposed index with the receiver operating characteristic curve method, the sensitivity, specificity, and accuracy of survival were 90.0, 96.7 and 94.0%, respectively. The proposed index showed the fastest significant difference among the other parameters such as blood pressure and heart rate. It could offer early diagnosis and effective treatment for human hemorrhagic shock if it is applicable to humans.