• Journal of The Korean Society of Emergency Medicine
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• v.29 no.5
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• pp.519-528
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• 2018

Objective: Delayed neuropsychiatric sequelae (DNS) following carbon monoxide (CO) poisoning, which may result from a demyelinating leukoencephalopathy, is a disease with a poor prognosis. This study examined the factors affecting the long-term prognosis of DNS and the efficacy of hyperbaric oxygen therapy (HBOT) in patients with DNS. Methods: This retrospective study included 84 patients with DNS following CO poisoning from January 2013 to June 2016. HBOT was given to 24 patients. The patients were divided into an improvement group and non-improvement group based on their clinical condition on a telephone interview at intervals between 3 months and 3 years after the onset of DNS. The improvement group was defined as having Cerebral Performance Category (CPC) scores in their daily life that improve to 1 or 2 grade. Results: Of the 594 patients, DNS were found in 18.2%, and 70.2% (59 of 84) of the patients with DNS improved. The prognostic factors for the improvement of DNS were an age of 45 years or less (odds ratio [OR], 12.068; 95% confidence interval [CI], 2.393-60.858; P<0.005), CPC score of 1 or 2 group at the time of DNS onset (OR, 12.361; 95% CI, 3.161-48.330; P<0.005), and a lucid interval longer than 20 days (OR, 5.164; 95% CI, 1.393-19.141; P<0.01). HBOT was not associated with the improvement of DNS in CO poisoning (OR, 0.467; 95% CI, 0.172-1.269; P>0.1). Conclusion: Patients aged less than 45 years, low grade CPC score of 1 and 2, and lucid interval longer than 20 days are more likely to have a good prognosis. On the other hand, HBOT failed to produce a benefit for DNS patients.

• Journal of Chest Surgery
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• v.56 no.5
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• pp.328-335
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• 2023

Background: Thromboangiitis obliterans (TAO) poses a higher risk of amputation than atherosclerosis obliterans. It is characterized by onset at a relatively young age. There are currently no clear treatment guidelines for TAO other than smoking cessation. In this study, we aimed to identify factors that could influence a favorable prognosis of TAO. Methods: From January 2009 to December 2019, we retrospectively reviewed the initial symptoms, characteristics, treatments, and disease course of 37 patients (45 limbs) with TAO. Logistic regression analysis was performed to investigate factors affecting the course of symptoms that persisted or worsened despite treatment. Results: Patients' mean age was 37.2±11.4 years, and all patients were men. The mortality rate was 0% during the follow-up period (76.9±51.1 months). All patients were smokers at the time of diagnosis, and 19 patients (51.4%) successfully quit smoking during treatment. When comparing the Rutherford categories before and after treatment, 23 limbs (51.1%) showed improvement, the category was maintained in 11 limbs (24.4%), and 11 limbs (24.4%) worsened. Symptom persistence or exacerbation despite treatment was associated with a higher initial Rutherford category (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.04-2.42; p=0.03) and a higher score of the involved below-knee artery at the time of diagnosis (OR, 2.26; 95% CI, 1.10-4.67; p=0.03). Conclusion: The degree of disease progression at the time of diagnosis significantly affected patients' prognosis. Therefore, early diagnosis and intervention are important to improve the course of TAO.

• Journal of Chest Surgery
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• v.27 no.9
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• pp.785-792
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• 1994

In this study, the authors analyzed the prognostic value of four clinical variables[age and sex of patients, association with myasthenia gravis and clinical stage] and histological type in 30 consecutive patients with thymoma, histologically classified as cortical[10],medullary[5] and mixed[15]type according to Marino and Muller-Hermelink classification. There were significant differences between the histological types in the frequency of the different tumor stages and myasthenia gravis and prognosis.Most of the cortical thymomas were at stage III and all of the medullary and most of the mixed tumors at stage I or II.Myasthenia gravis occurred more commonly in patients with cortical[30%] and mixed thymoma[60%] than in patients with medullary thymoma[10%]. Follow-up was conducted in 30 patients,with follow-up range from 3 months to 120 months[mean,47.3months]. 5 year actuarial survival was 100% for medullary thymoma, 73% for mixed thymoma, and 47% for cortical thymoma.The overall survival curve shows that 87.6% of the patients are alive at 2 years and 72.8% at 5 years. And 7 patients was dead during follow-up periods.By Kaplan-Meier technique, we found that the patients who had myasthenia gravis had better prognosis[P<0.05]. Medullary thymoma is a comparatively rare, benign tumor, and usually not associated with myasthenia gravis. Cortical thymoma must be regarded as malignant. Mixed thymoma is intermediate in its behavior between medullary and cortical thymoma. But these tumors should be considered potentially malignant despite of presence as stage I of II disease. Also, the patients with stageI,II had good prognosis and the patients with total resection had good prognosis[P<0.05].

• 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.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.2091-2095
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• 2013

Background: The $7^{th}$ TNM staging is the first authoritative standard for evaluation of effectiveness of treatment of gastric cancer worldwide. However, revision of pN classification within TNM needs to be discussed. In particular, the N3 sub-stage is becoming more conspicuous. Methods: Clinical data of 302 pN3M0 stage gastric cancer patients who received radical gastrectomy in Tianjin Medical University Cancer Institute and Hospital from January 2001 to May 2006 were retrospectively analyzed. Results: Location of tumor, depth of invasion, extranodal metastasis, gastric resection, combined organs resection, lymph node metastasis, rate of lymph node metastasis, negative lymph nodes count were important prognostic factors of pN3M0 stage gastric cancers. TNM stage was also associated with prognosis. Patients at T2N3M0 stage had a better prognosis than other sub-classification. T3N3M0 and T4aN3aM0 patients had equal prognosis which followed the T2N3M0. T4aN3bM0 and T4bN3aM0 had lower survival rate than the formers. T4bN3bM0 had worst prognosis. In multivariate analysis, TNM stage group and rate of lymph node metastasis were independent prognostic factors. Conclusions: The sub-stage of N3 may be useful for more accurate prediction of prognosis; it should therefore be applied in the TNM stage system.

• Childhood Kidney Diseases
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• v.21 no.2
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• pp.61-68
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• 2017

Purpose: To investigate differences in clinical features, blood/urinary findings, and prognosis in different age groups of patients with Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP). Methods: A total of 469 patients with HSP were analyzed retrospectively from June 2003 to February 2016. We classified patients into child or adult groups based on their age. Results: The adult group had more patients with anemia (child vs. adult; 7.5% vs. 16.4%), and higher immunoglobulin A (IgA) (30.0% vs. 50.0%) levels, C-reactive protein (34.2% vs. 54.0%) and uric acid (3.1% vs. 12.1%) levels than the child group. The child group was highly positive for Mycoplasma pneumoniae immunoglobulin M (IgM) (34.4%). More patients in the child group presented with high levels of antistreptolysin O (24.7% vs. 2.9%) and high C4 (11.5% vs. 4.2%). Low C3 (1.1% vs. 10.2%) levels, and renal involvement with gross hematuria (8.6% vs. 21.5 %), nonnephrotic proteinuria (1.1% vs. 11.2%), and nephrotic syndrome (1.1% vs. 6.0%) were common in the adult group. Adults also had poorer renal outcomes [persistent hematuria/proteinuria (10.5% vs. 32.8%), and chronic kidney disease (0% vs. 11.2%)] than the child group. Risk factors for renal involvement such as older age and higher level of uric acid were only found in the child group. The risk factors for poor renal outcome were nephrotic syndrome in the child group and gross hematuria in the adult group. Conclusion: In this study, child and adult groups presented with different clinical manifestations of HSP. We found that risk factors for renal involvement included age and high uric acid level in the child group. Moreover, nephrotic syndrome in the child group and gross hematuria in the adult group increased the risk of poor renal outcome.

• Journal of Chest Surgery
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• v.29 no.7
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• pp.734-740
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• 1996

The relative importance of various factors influencing the prognosis and survival in the treatment of thymoma is still controversial. Sixty ave patients operated on for thymoma from Jan. 1981 to Dec. 1994 were evaluated, 28 patients (43.1 %) with myasthenia gravis and 37 patients (56.9%) without. Masaoka staging revealed stage I disease in 28 patie ts(4).1%) , stage ll in 1) patients(20.0%), stage 111 In 22 patients(33.8%), stage IVa in 1 patients(1.5%), and stage IVb in 1 patient(1.5%). There was no operative mortality. A complete resection was performed in 48 patients (73.8%) patients, associated in 10 patients (15.4%) with postoperative adjuvant treatment(radiotherapy 5; chemotherapy 1: radio- and chemotherapy 4). Thymomas were found to be predominantly of the epithelial type in 16 patients(24.6%), predominantly Iymphocytic type in 18 patients(27.7%), and mlxed in 22 patients (33.9%). The overall 5- and 10-year survival rates were 87% and 82%, respectively, Factors indicating a poor prognosis included local invasion, incomplete excision, thymic carcinoma, advanced staging and myasthenia gravis. The de- gree of tumor invasion turned out to be the main prognostic factor, and treatment should be planned ac- cordingly. The prognosis is best predicted by the stage of the tumor as determined intraoperatively and is poorer in patie ts with incomplete resection than in those with complete resection of the thynoma. No recurrence developed In patients with stage I disease.

• Korean Journal of Psychosomatic Medicine
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• v.2 no.1
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• pp.10-21
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• 1994

The author reviewed the effect of psychological factors on the development and course of cancer. Cancer is a bilogical disease, but it also has a large number of psychological aspects. There have been no reports that specific personality types had tendency to cause cancer. In some studies, however, type A personality was reported to have relevance to a higher incidence of cancer and a better prognosis. And in other studies, type C personality was reported to have relevance to a higher incidence of cancer. It was reported that people who had strong tendency to control their anger and regarded the rationality and antiemotionality in their behavior as important things were susceptable to cancer. In the course of cancer, the patients who had more positive and aggressive attitude and 'fighting spirit' to their disease tended to have a better prognosis than those who accepted their disease as fate. Some studies showed that feeling of helplessness and loss of control had a negative offset on cancer. It was reported that, in the early stage of cancer, the psychological factors had great influence on the prognosis, but in the middle and late stage, the influence decreased. For the future studies, cancer should not be regarded as a single disease and a single condition. The kinds and stages of cancer should be difined for studies. The scales for psychological evaluation for cancer patients should be sensitive and selected carefully, considering the complexity of the cancer patients mind. The need for prospective studies is emphasized. Finally, as the cured cancer patients have great difficulties in returning to their work and daily life, rehabilitation of cancer patients is also emphasized.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.6
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• pp.2495-2499
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• 2015

Mitogen-activated protein kinase/extracellular signal-regulated kinase kinase kinase 3 (MEKK3) is an important serine/threonine protein kinase and a member of the MAPK family. MEKK3 can effectively activate the MEK/ERK signaling pathway and promote an autocrine growth loop critical for tumor genesis, cell proliferation, terminal differentiation, apoptosis and survival. To explore the relationship between MEKK3 and cell apoptosis, clinicopathology and prognosis, we characterize the expression of MEKK3, pERK and FoxP3 in the renal clear cell carcinoma (RCCC). Protein expression was detected by tissue microarray and immunochemistry in 46 cases of RCCC and 28 control cases. Expression levels of CD3+,CD3+CD4+,CD3+CD8+,CD4+CD25+, CD4+CD25+ FoxP3+ were assessed by flow cytometry and analyzed for their association with pathological factors, correlation and prognosis in RCCC. Expression of MEKK3, pERK and FoxP3 was significantly up-regulated in RCCC as compared to control levels (p<0.01), associated with pathological grade (p<0.05)and clinical stage (p<0.05). CD4+CD25+ Foxp3+ Treg cells were also significantly increased in RCCC patients (p<0.05). Cox multivariate regression analysis showed that MEKK3, pERK expression and patholigical stage were independent prognostic factors in patients with RCCC (p<0.05). MEKK3 can be used as an important marker of early diagnosis and prognostic evaluation in RCCC. It may be associated with imbalance of anti-tumor immunity and overexpression of pERK. Expression of MEKK3 and pERK are significantly increased in RCCC, with protein expression and clinical stage acting as independent prognostic factors.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.10
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• pp.4233-4238
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• 2014

Background: The aim of this study was to investigate the relationship of body mass index with overall and progression-free survival as well as other prognostic factors of breast cancer in patients with non-metastatic breast cancer. Materials and Methods: We retrospectively reviewed 456 patients diagnosed with breast cancer in the Radiation Oncology department of Kayseri Teaching Hospital between 2005 and 2013. We investigated relationship of body mass index with prognosis and other prognostic factors. Results: The study included 456 patients (447 women and 9 men). Mean age at presentation was 55.6 years. Of the cases, 96.9% underwent modified radical mastectomy and 95.0% received chemotherapy, while 82.4% received radiotherapy and 60.0% were given hormone therapy. Body mass index was >25 mg/kg2 in 343 cases. Five- and 10-years overall survival rates were 77% and 58% whereas progression-free survival rates were 65% and 49%, respectively. In univariate analyses, factors including stage (p=0.046), tumor diameter (p=0.001), lymph node metastasis (p=0.006) and body mass index (p=0.030) were found to be significantly associated with overall survival, while perinodal involvement was found to be significantly associated with progression-free survival (p=0.018). In multivariate analysis, stage (p=0.032; OR: 3.8; 95% CI: 1.1-13), tumor diameter (p<0.000; OR: 0.0; 95% CI: 0.0-0.3), lymph node metastasis (p=0.005; OR: 0.0; 95% CI: 0.0-0.5) and BMI (p=0.027; OR: 0.02; 95% CI: 0.0-0.8) remained as significantly associated with OS. Conclusions: In our study, it was seen that overall survival time was shorter in underweight and obese patients when compared to normal weight patients.