• Title/Summary/Keyword: Prognosis

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Microvascular Decompression for Primary Trigeminal Neuralgia : Short-Term Follow-Up Results and Prognostic Factors

  • Tucer, Bulent;Ekici, Mehmet Ali;Demirel, Serkan;Basarslan, Seyit Kagan;Koc, Rahmi Kemal;Guclu, Bulent
    • Journal of Korean Neurosurgical Society
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    • v.52 no.1
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    • pp.42-47
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    • 2012
  • Objective : The aim of this prospective study was to demonstrate the influence of some factors on the prognosis of microvascular decompression in 37 patients with trigeminal neuralgia. Methods : The results of microvascular decompression (MVD) in 37 patients with trigeminal neuralgia were evaluated at 6 months after surgery and were compared with clinical and operative findings. Results : The sex of the patient, the patient's age at surgery, the side of the pain, and the duration of symptoms before surgery did not play any significant roles in prognosis. Also, the visual analogue scale (VAS) of the patient, the duration of each pain attack, and the frequency of pain over 24 hours did not play any significant roles in prognosis. In addition, intraoperative detection of the type of conflicting vessel, the degree of severity of conflict, and the location of the conflict around the circumference of the root did not play any roles in prognosis. The only factors affecting the prognosis in MVD surgery were intraoperative detection of the site of the conflict along the root and neuroradiological compression signs on preoperative magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA). Conclusion : These findings demonstrated that if neurovascular compression is seen on preoperative MRI/MRA and/or compression is found intraoperative at the root entry zone, then the patient will most likely benefit from MVD surgery.

Effect of supportive periodontal therapy on the prevention of tooth loss in Korean adults

  • Kim, Sang-Yul;Lee, Jae-Kwan;Chang, Beom-Seok;Um, Heung-Sik
    • Journal of Periodontal and Implant Science
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    • v.44 no.2
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    • pp.65-70
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    • 2014
  • Purpose: The purpose of this retrospective study was to evaluate the effect of patient compliance with supportive periodontal therapy (SPT) on tooth loss in Korean adults. Methods: The periodontal records of 134 patients were reviewed for this study. They completed active periodontal treatment from 1999 to 2001 and were placed on a schedule of periodic follow-up visits for SPT. Patient compliance was classified into complete compliance (CC), erratic compliance (EC), and noncompliance (NC) groups. Re-examinations were carried out $11.0{{\pm}}0.8$ years after the active periodontal treatment. The prognosis for each tooth was determined as good, questionable, or hopeless according to the bone loss observed in pretreatment radiographs. Results: The rate of tooth loss of the CC group was significantly lower than that of the NC group. The tooth loss/patient and the tooth loss/patient/year were not significantly different between the three groups. The rates of tooth loss in the good, questionable, and hopeless prognosis groups were 6.7%, 9.5%, and 13.2%, respectively. For the teeth with a good prognosis, the rate of tooth loss of the CC group was significantly lower than that of the NC group (0.4% vs. 5.1%). For the teeth with a questionable prognosis, the CC group showed a significantly lower rate of tooth loss than did the EC group (4.1% vs. 30.7%) or the NC group (4.1% vs. 25.6%). For the teeth with a hopeless prognosis, the rates of tooth loss were not significantly different among the three groups. Conclusions: Within the limits of this study, the patients who showed a poor compliance with SPT were more likely to lose teeth than were the regularly compliant patients. However, the risk of tooth loss with a hopeless prognosis was high irrespective of the compliance.

Down-regulated MYH11 Expression Correlates with Poor Prognosis in Stage II and III Colorectal Cancer

  • Wang, Ren-Jie;Wu, Peng;Cai, Guo-Xiang;Wang, Zhi-Min;Xu, Ye;Peng, Jun-Jie;Sheng, Wei-Qi;Lu, Hong-Fen;Cai, San-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.7223-7228
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    • 2014
  • The MYH11 gene may be related to cell migration and adhesion, intracellular transport, and signal transduction. However, its relationship with prognosis is still uncertain. The aim of this study was to investigate correlations between MYH11 gene expression and prognosis in 58 patients with stage II and III colorectal cancer. Quantitative real-time polymerase chain reaction was performed in fresh CRC tissues to examine mRNA expression, and immunohistochemistry was performed with paraffin-embedded specimens for protein expression. On univariate analysis, MYH11 expression at both mRNA and protein levels, perineural invasion and lymphovascular invasion were related to disease-free survival (p<0.05; log-rank test). Cancers with lower MYH11 expression were more likely to have a poor prognosis. Otherwise, MYH11 expression was unrelated to patient clinicopathological features. On multivariate analysis, low MYH11 expression proved to be an independent adverse prognosticator (p<0.05). These findings show that MYH11 can contribute to predicting prognosis in stage II and III colorectal cancers.

Drug holiday as a prognostic factor of medication-related osteonecrosis of the jaw

  • Kim, Yoon Ho;Lee, Ho Kyung;Song, Seung Il;Lee, Jeong Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.5
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    • pp.206-210
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    • 2014
  • Objectives: To identify post-treatment prognostic factors for medication-related osteonecrosis of the jaw (MRONJ). Materials and Methods: We evaluated 54 MRONJ patients who visited the Department of Dentistry, Ajou University Hospital, from May 2007 to March 2014. Twenty-one patients were surgically managed with debridement or sequestrectomy and 33 patients were conservatively managed using antibiotics. Correlations of age, sex, stage, bisphosphonate duration and type, and drug holiday with the prognosis of MRONJ were investigated. Correlations were verified by logistic regression analysis and t-tests with a significance level of 0.05. Results: Clinical outcomes were evaluated on the basis of both clinical and radiographic findings. Twelve out of 21 surgically managed patients showed a favorable prognosis and nine patients relapsed. Thirty-one of the 33 conservatively managed patients showed no specific change in prognosis, and two patients worsened. Statistical analyses of the conservative management group did not reveal any correlation of the above factors with the prognosis of conservative management. Drug holiday was the only prognostic factor in the surgical management group (P=0.031 in logistic regression analysis, P=0.004 in t-test). Conclusion: Drug holiday is a prognostic factor in the surgical management of MRONJ. Because the drug holiday in the patients of the poor prognosis group occurred 1.5 to 4 months prior to surgical management, we recommend a drug holiday more than 4 months before surgery.

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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Identification of prognosis-specific network and prediction for estrogen receptor-negative breast cancer using microarray data and PPI data (마이크로어레이 데이터와 PPI 데이터를 이용한 에스트로겐 수용체 음성 유방암 환자의 예후 특이 네트워크 식별 및 예후 예측)

  • Hwang, Youhyeon;Oh, Min;Yoon, Youngmi
    • Journal of the Korea Society of Computer and Information
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    • v.20 no.2
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    • pp.137-147
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    • 2015
  • This study proposes an algorithm for predicting breast cancer prognosis based on genetic network. We identify prognosis-specific network using gene expression data and PPI(protein-protein interaction) data. To acquire the network, we calculate Pearson's correlation coefficient(PCC) between genes in all PPI pairs using gene expression data. We develop a prediction model for breast cancer patients with estrogen-receptor-negative using the network as a classifier. We compare classification performance of our algorithm with existing algorithms on independent data and shows our algorithm is improved. In addition, we make an functionality analysis on the genes in the prognosis-specific network using GO(Gene Ontology) enrichment validation.

Supraventricular Arrhythmias in the Surgical Intensive Care Unit (외과계 중환자실에서 발생한 상심실성 부정맥)

  • Yang, Song-Soo;Hong, Suk-Kyung
    • 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.

Usefulness of presepsin in predicting the prognosis of patients with sepsis or septic shock: a retrospective cohort study

  • Koh, Jeong Suk;Kim, Yoon Joo;Kang, Da Hyun;Lee, Jeong Eun;Lee, Song-I
    • Journal of Yeungnam Medical Science
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    • v.38 no.4
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    • pp.318-325
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    • 2021
  • Background: The diagnosis and prediction of prognosis are important in patients with sepsis, and presepsin is helpful. In this study, we aimed to examine the usefulness of presepsin in predicting the prognosis of sepsis in Korea. Methods: Patients diagnosed with sepsis according to the sepsis-3 criteria were recruited into the study and classified into surviving and non-surviving groups based on in-hospital mortality. A total of 153 patients (32 and 121 patients with sepsis and septic shock, respectively) were included from July 2019 to August 2020. Results: Among the 153 patients with sepsis, 91 and 62 were in the survivor and non-survivor groups, respectively. Presepsin (p=0.004) and lactate (p=0.003) levels and the sequential organ failure assessment (SOFA) score (p<0.001) were higher in the non-survivor group. Receiver operating characteristic curve analysis revealed poor performances of presepsin and lactate in predicting the prognosis of sepsis (presepsin: area under the curve [AUC]=0.656, p=0.001; lactate: AUC=0.646, p=0.003). The SOFA score showed the best performance, with the highest AUC value (AUC=0.751, p<0.001). The prognostic cutoff point for presepsin was 1,176 pg/mL. Presepsin levels higher than 1,176 pg/mL (odds ratio [OR], 3.352; p<0.001), higher lactate levels (OR, 1.203; p=0.003), and higher SOFA score (OR, 1.249; p<0.001) were risk factors for in-hospital mortality. Conclusion: Presepsin levels were higher in non-survivors than in survivors. Thus, presepsin may be a valuable biomarker in predicting the prognosis of sepsis.

Providing Reliable Prognosis to Patients with Gastric Cancer in the Era of Neoadjuvant Therapies: Comparison of AJCC Staging Schemata

  • Kim, Gina;Friedmann, Patricia;Solsky, Ian;Muscarella, Peter;McAuliffe, John;In, Haejin
    • Journal of Gastric Cancer
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    • v.20 no.4
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    • pp.385-394
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    • 2020
  • Purpose: Patients with gastric cancer who receive neoadjuvant therapy are staged before treatment (cStage) and after treatment (ypStage). We aimed to compare the prognostic reliability of cStage and ypStage, alone and in combination. Materials and Methods: Data for all patients who received neoadjuvant therapy followed by surgery for gastric adenocarcinoma from 2004 to 2015 were extracted from the National Cancer Database. Kaplan-Meier (KM)curves were used to model overall survival based on cStage alone, ypStage alone, cStage stratified by ypStage, and ypStage stratified by cStage. P-values were generated to summarize the differences in KM curves. The discriminatory power of survival prediction was examined using Harrell's C-statistics. Results: We included 8,977 patients in the analysis. As expected, increasing cStage and ypStage were associated with worse survival. The discriminatory prognostic power provided by cStage was poor (C-statistic 0.548), while that provided by ypStage was moderate (C-statistic 0.634). Within each cStage, the addition of ypStage information significantly altered the prognosis (P<0.0001 within cStages I-IV). However, for each ypStage, the addition of cStage information generally did not alter the prognosis (P=0.2874, 0.027, 0.061, 0.049, and 0.007 within ypStages 0-IV, respectively). The discriminatory prognostic power provided by the combination of cStage and ypStage was similar to that of ypStage alone (C-statistic 0.636 vs. 0.634). Conclusions: The cStage is unreliable for prognosis, and ypStage is moderately reliable. Combining cStage and ypStage does not improve the discriminatory prognostic power provided by ypStage alone. A ypStage-based prognosis is minimally affected by the initial cStage.

Clinical Characteristics and Prognosis of Differentiated Thyroid Carcinoma with Small Foci of Anaplastic Transformation

  • Ahn, Hwa Young;Jung, Kyeong Choen;Park, Do Joon;Park, Young Joo;Cho, Bo Youn
    • International journal of thyroidology
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    • v.10 no.2
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    • pp.96-101
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    • 2017
  • Background and Objectives: Anaplastic thyroid carcinoma (ATC) is commonly related with concurrent differentiated thyroid carcinoma (DTC). We aimed to examine the clinicopathologic characteristics, prognosis and gene expression of DTC with anaplastic foci. Materials and Methods: Eighteen patients with DTC with anaplastic foci were enrolled in this study. To compare the clinicopathologic characteristics and prognosis of anaplastic foci subjects with conventional ATC or DTC, we additionally included 12 ATC and 1030 DTC patients who diagnosed during same period. Immunohistochemistry was performed to check the gene expression in anaplastic foci and DTC component. Results: In anaplastic foci group, tumor size was larger ($2.5{\pm}1.3$ vs. $1.2{\pm}0.9cm$, p=0.001), distant metastasis was more frequent (11.1 vs. 0%, p=0.000) and 1-year survival rate was low (88.9 vs. 100%, p=0.000) than DTC group. In contrast, compared with ATC group, anaplastic foci group showed younger age at diagnosis ($50{\pm}16$ vs. $63{\pm}18years$, p=0.039), smaller tumor size ($2.5{\pm}1.3$ vs. $3.8{\pm}1.4cm$, p=0.027), less distant metastasis (11.1 vs. 41.7%, p=0.084) and longer 1-year survival rate (88.9 vs. 25.0%, p=0.001). Expression of p53 protein was observed in 100% of anaplastic foci, ATC and 12.5% of papillary thyroid carcinoma component. Conclusion: DTC with foci of anaplastic transformation has a worse prognosis than DTC, but a better prognosis than ATC. Our results support that DTC with anaplastic foci was intermediate state from DTC to ATC.