• Title/Summary/Keyword: Prognosis

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Discordance between Physician and the General Public Perceptions of Prognostic Disclosure to Children with Serious Illness: a Korean Nationwide Study

  • Kim, Min Sun;Lee, Jihye;Sim, Jin-Ah;Kwon, Jung Hye;Kang, Eun Joo;Kim, Yu Jung;Lee, Junglim;Song, Eun-Kee;Kang, Jung Hun;Nam, Eun Mi;Kim, Si-Young;Yun, Hwan-Jung;Jung, Kyung Hae;Park, June Dong;Yun, Young Ho
    • Journal of Korean Medical Science
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    • v.33 no.49
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    • pp.327.1-327.10
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    • 2018
  • Background: It is difficult to decide whether to inform the child of the incurable illness. We investigated attitudes of the general population and physicians toward prognosis disclosure to children and associated factors in Korea. Methods: Physicians working in one of 13 university hospitals or the National Cancer Center and members of the general public responded to the questionnaire. The questionnaire consisted of the age appropriate for informing children about the prognosis and the reason why children should not be informed. This survey was conducted as part of research to identify perceptions of physicians and general public on the end-of-life care in Korea. Results: A total of 928 physicians and 1,241 members of the general public in Korea completed the questionnaire. Whereas 92.7% of physicians said that children should be informed of their incurable illness, only 50.7% of the general population agreed. Physicians were also more likely to think that younger children should know about their poor prognosis compared with the general population. Physicians who opposed incurable illness disclosure suggested that children might not understand the situation, whereas the general public was primarily concerned that disclosure would exacerbate the disease. Physicians who were women or religious were more likely to want to inform children of their poor prognosis. In the general population, gender, education, comorbidity, and caregiver experience were related to attitude toward poor prognosis disclosure to children. Conclusion: Our findings indicate that physicians and the general public in Korea differ in their perceptions about informing children of poor prognosis.

Prognostic Value of Biochemical Response Models for Primary Biliary Cholangitis and the Additional Role of the Neutrophil-to-Lymphocyte Ratio

  • Yoo, Jeong-Ju;Cho, Eun Ju;Lee, Bora;Kim, Sang Gyune;Kim, Young Seok;Lee, Yun Bin;Lee, Jeong-Hoon;Yu, Su Jong;Kim, Yoon Jun;Yoon, Jung-Hwan
    • Gut and Liver
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    • v.12 no.6
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    • pp.714-721
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    • 2018
  • Background/Aims: Recently reported prognostic models for primary biliary cholangitis (PBC) have been shown to be effective in Western populations but have not been well-validated in Asian patients. This study aimed to compare the performance of prognostic models in Korean patients and to investigate whether inflammation-based scores can further help in prognosis prediction. Methods: This study included 271 consecutive patients diagnosed with PBC in Korea. The following prognostic models were evaluated: the Barcelona model, the Paris-I/II model, the Rotterdam criteria, the GLOBE score and the UK-PBC score. The neutrophil-to-lymphocyte ratio (NLR) was analyzed with reference to its association with prognosis. Results: For predicting liver transplant or death at the 5-year and 10-year follow-up examinations, the UK-PBC score (areas under the receiver operating characteristic curve [AUCs], 0.88 and 0.82) and GLOBE score (AUCs, 0.85 and 0.83) were significantly more accurate in predicting prognosis than the other scoring systems (all p<0.05). There was no significant difference between the performance of the UK-PBC and GLOBE scores. In addition to the prognostic models, a high NLR (>2.46) at baseline was an independent predictor of reduced transplant-free survival in the multivariate analysis (adjusted hazard ratio, 3.74; p<0.01). When the NLR was applied to the prognostic models, it significantly differentiated the prognosis of patients. Conclusions: The UK-PBC and GLOBE scores showed good prognostic performance in Korean patients with PBC. In addition, a high NLR was associated with a poorer prognosis. Including the NLR in prognostic models may further help to stratify patients with PBC.

Comparison of Genetic Profiles and Prognosis of High-Grade Gliomas Using Quantitative and Qualitative MRI Features: A Focus on G3 Gliomas

  • Eun Kyoung Hong;Seung Hong Choi;Dong Jae Shin;Sang Won Jo;Roh-Eul Yoo;Koung Mi Kang;Tae Jin Yun;Ji-hoon Kim;Chul-Ho Sohn;Sung-Hye Park;Jae-Kyoung Won;Tae Min Kim;Chul-Kee Park;Il Han Kim;Soon-Tae Lee
    • Korean Journal of Radiology
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    • v.22 no.2
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    • pp.233-242
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    • 2021
  • Objective: To evaluate the association of MRI features with the major genomic profiles and prognosis of World Health Organization grade III (G3) gliomas compared with those of glioblastomas (GBMs). Materials and Methods: We enrolled 76 G3 glioma and 155 GBM patients with pathologically confirmed disease who had pretreatment brain MRI and major genetic information of tumors. Qualitative and quantitative imaging features, including volumetrics and histogram parameters, such as normalized cerebral blood volume (nCBV), cerebral blood flow (nCBF), and apparent diffusion coefficient (nADC) were evaluated. The G3 gliomas were divided into three groups for the analysis: with this isocitrate dehydrogenase (IDH)-mutation, IDH mutation and a chromosome arm 1p/19q-codeleted (IDHmut1p/19qdel), IDH mutation, 1p/19q-nondeleted (IDHmut1p/19qnondel), and IDH wildtype (IDHwt). A prediction model for the genetic profiles of G3 gliomas was developed and validated on a separate cohort. Both the quantitative and qualitative imaging parameters and progression-free survival (PFS) of G3 gliomas were compared and survival analysis was performed. Moreover, the imaging parameters and PFS between IDHwt G3 gliomas and GBMs were compared. Results: IDHmut G3 gliomas showed a larger volume (p = 0.017), lower nCBF (p = 0.048), and higher nADC (p = 0.007) than IDHwt. Between the IDHmut tumors, IDHmut1p/19qdel G3 gliomas had higher nCBV (p = 0.024) and lower nADC (p = 0.002) than IDHmut1p/19qnondel G3 gliomas. Moreover, IDHmut1p/19qdel tumors had the best prognosis and IDHwt tumors had the worst prognosis among G3 gliomas (p < 0.001). PFS was significantly associated with the 95th percentile values of nCBV and nCBF in G3 gliomas. There was no significant difference in neither PFS nor imaging features between IDHwt G3 gliomas and IDHwt GBMs. Conclusion: We found significant differences in MRI features, including volumetrics, CBV, and ADC, in G3 gliomas, according to IDH mutation and 1p/19q codeletion status, which can be utilized for the prediction of genomic profiles and the prognosis of G3 glioma patients. The MRI signatures and prognosis of IDHwt G3 gliomas tend to follow those of IDHwt GBMs.

Utility of the APACHE II score as a neurological prognostic factor for glufosinate-intoxicated patients with alert mental status (의식이 명료한 글루포시네이트 중독환자의 신경학적 예후인자로서 APACHE II의 유용성)

  • Rok Lee;Tae Yong Shin;Hyung Jun Moon;Hyun Jung Lee;Dongkil Jeong;Dongwook Lee;Sun In Hong;Hyun Joon Kim
    • Journal of The Korean Society of Clinical Toxicology
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    • v.21 no.2
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    • pp.135-142
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    • 2023
  • Purpose: In patients with glufosinate poisoning, severe neurological symptoms may be closely related to a poor prognosis, but their appearance may be delayed. Therefore, this study aimed to determine whether the Acute Physiology and Chronic Health Evaluation II (APACHE II) score could predict the neurological prognosis in patients with glufosinate poisoning who present to the emergency room with alert mental status. Methods: This study was conducted retrospectively through a chart review for patients over 18 years who presented to a single emergency medical center from January 2018 to December 2022 due to glufosinate poisoning. Patients were divided into groups with a good neurological prognosis (Cerebral Performance Category [CPC] Scale 1 or 2) and a poor prognosis (CPC Scale 3, 4, or 5) to identify whether any variables showed significant differences between the two groups. Results: There were 66 patients (67.3%) with good neurological prognoses and 32 (32.8%) with poor prognoses. In the multivariate logistic analysis, the APACHE II score, serum amylase, and co-ingestion of alcohol showed significant results, with odds ratios of 1.387 (95% confidence interval [CI], 1.027-1.844), 1.017 (95% CI, 1.002-1.032), and 0.196 (95% CI, 0.040-0.948), respectively. With an APACHE II score cutoff of 6.5, the AUC was 0.826 (95% CI, 0.746-0.912). The cutoff of serum amylase was 75.5 U/L, with an AUC was 0.761 (95% CI, 0.652-0.844), and the AUC of no co-ingestion with alcohol was 0.629 (95% CI, 0.527-0.722). Conclusion: The APACHE II score could be a useful indicator for predicting the neurological prognosis of patients with glufosinate poisoning who have alert mental status.

Overview of Exercise electrocardiogram in terms of insurance medicine (운동부하 검사의 보험의학적 이해와 의의)

  • Hyun, Hyeyun
    • The Journal of the Korean life insurance medical association
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    • v.32 no.1
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    • pp.15-20
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    • 2013
  • The exercise ECG test is a well-established, inexpensive, and non-invasive procedure for answering important clinical questions related to heart problems. The heart disease is directly led to mortality and serious issue to insurance medicine. Here is some evidence for interpretation of exercise ECG test results can determine prognosis of the heart disease.

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Triple Negative Breast Cancer

  • Cetin, Idil;Topcul, Mehmet
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2427-2431
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    • 2014
  • Triple-negative breast cancers (TNBC), characterized by absence of the estrogen receptor (ER) and progesterone receptor (PR) and lack of overexpression of human epidermal growth factor receptor 2 (HER2), have a poor prognosis. To overcome therapy limitations of TNBC, various new approaches are needed. This mini-review focuses on discovery of new targets and drugs which might offer new hope for TNBC patients.

Small Cell Carcinoma of the Esophayus (식도의 소세포함 치험 1례)

  • 백효채
    • Journal of Chest Surgery
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    • v.27 no.12
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    • pp.1056-1059
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    • 1994
  • Small cell carcinoma is a highly malignant esophageal tumor composed of anaplastic small cells with features very similar to those of its pulmonary counterpart. The prognosis is poorer than that of squamous carcinoma of the esophagus because of its propensity of generalized spread and metastasis. Once the diagnosis of small cell carcinoma was established, surgery should be undertaken as early as possible. We have described an experience of small cell carcinoma of the lower esophagus in a 72 year old male patient with a review of the literatures regarding treatment methods and prognosis.

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Pulmonary Arterial Hypertension (폐동맥 고혈압)

  • Park, Yong Bum
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.3
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    • pp.177-182
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    • 2009
  • Pulmonary arterial hypertension is a progressive, symptomatic, and ultimately fatal disorder for which substantial advances in treatment have been made during the past decade. This article reviews the recent advances in the field of pulmonary arterial hypertension (PAH). Epidemiology, genetics, treatment and prognosis will be the main focus of this update.

A rare case of primary ovarian mesenchymal chondrosarcoma in pregnancy

  • Sepideh Azizi;Elena Ghotbi;Setare Nassiri
    • Clinical and Experimental Reproductive Medicine
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    • v.49 no.4
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    • pp.285-288
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    • 2022
  • Mesenchymal chondrosarcoma is a rare tumor that is more common in young people; it is an uncommon type of chondrosarcoma with a poor prognosis. In two-thirds of cases, it affects the bone, especially the spine. However, parts of the body other than the skeletal system are occasionally involved. These rarer types have a worse prognosis, with a high likelihood of metastasis and death. Due to the possible misdiagnosis of mesenchymal chondrosarcoma, the integrated use of imaging, immunohistochemistry, and pathology can be helpful.

Clinical Characteristics and Prognosis of Heat Stroke (열사병의 임상적 특징 및 예후에 관한 연구)

  • Park, Noh Han;Ryoo, Hyun Wook;Seo, Kang Suk;Park, Jung Bae;Chung, Jae Mung
    • Journal of Trauma and Injury
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    • v.19 no.2
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    • pp.113-120
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    • 2006
  • Purpose: The aim of this study was to evaluate the clinical characteristics of classic heat stroke in Korea and to identify factors of prognosis for heat stroke by comparing a survival group with a non-survival group. Methods: We retrospectively analyzed 27 patients with heat stroke who visited the Emergency Department of Kyungpook National University Hospital from March 2001 to February 2005. First, we divided the patients into two groups, the classic heat stroke group and the exertional heat stroke group, and compared them. Second, we compared the survival group with the non-survival group. Age, sex, cause, place where patients were found, underlying diseases, cooling time, performance of endotracheal intubation, initial Glasgow Coma Scale, initial vital sign, and laboratory findings were reviewed. Results: Five of 27 patients in heat stroke died. The classic heat stroke group had 20 patients. They were old and had more patients in the bathroom than the exertional heat stroke group had. The non-survival group showed lower blood pressure, lower initial GCS score, and higher respiratory rate than the survival group. In laboratory findings, the non-survival group also showed lower$HCO_3-$ level, lower albumin level, lower glucose level, more prolonged PT, and higher CK-MB level than the survival group. Delay in recognition of heat stroke and cooling were poor prognostic factors in heat stroke. Conclusion: The classic heat stroke group had patients who were old and found in the bathroom. Early recognition and treatment of heat stroke is important to reduce mortality. Cooling time, initial GCS score, mean arterial pressure, resipratory rate, $HCO_3-$, PT, CK-MB, and albumin seem to be meaningful when forming a prognosis for heat stroke patients.