• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3595-3600
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• 2016

Background: To investigate the association between preoperative pathological Ki-67 labeling index and serum tumor marker cancer antigen 15-3 (CA 15-3) with clinic-pathological parameters and treatment outcomes in early breast cancer. Materials and Methods: A retrospective study at 4 cancer centers in Saudi Arabia and Egypt was performed. Data were collected for female patients diagnosed with unilateral early breast cancer between March 2010 and October 2013. Cases treated with neoadjuvant chemotherapy (NACT) followed by surgery and radiotherapy were included. NACT included 6-8 cycles of anthracycline and taxane based regimens. Trastuzumab and hormonal treatments were added according to HER2 and hormone receptor status. Baseline serum CA15.3 and pathological Ki67 levels were evaluated and correlated with disease free survival (DFS) and overall survival (OS). Results: A total of 280 pts was included. The median age was 49 years (38-66 y) and median overall survival was 35 (20-38) months (mo). Estrogen receptors (ER), progesterone receptors (PR) and HER 2 receptors were positive in 233 (83.2%), 198 (70%) and 65 cases (23.2%), respectively. High preoperative Ki67 and CA15.3 were noted in 177 (63.2%) and 131 (46.8%). A total of 45 (16%) patients had distal or local recurrence and 24 (8.6%) died of their disease. Most of the relapsed cases had high preoperative Ki-67 (n=41, 91%) and CA15.3 (n=28, 62%) values. All of the patients who died had a high Ki-67 but CA15.3 was high in 9 (37%) only. Mean DFS/OS in patients with high preoperative Ki-67 was 32 months /32 months as compared to 37 months/35 months in those with normal Ki-67 (p<0.001). Correlation of preoperative CA15.3 and survival was statistically not significant. Conclusions:Preoperative Ki-67 can be a predictive and prognostic marker. Higher levels are associated with poor DFS and OS in patients with early BC.

• Journal of Korean Foot and Ankle Society
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• v.22 no.1
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• pp.21-25
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• 2018

Purpose: To analyze the correlation between a rupture of the hypovascular zone and early single heel raising after Achilles tendon repair. Materials and Methods: From January 2012 to August 2015, 68 patients, who underwent surgical treatment for a Achilles tendon rupture using Krackow method, were analyzed retrospectively. The patients were divided into two groups according to possibility of single heel raises within 3 months postoperatively. During the periodic outpatient observations, the visual analogue scale, Achilles tendon total rupture score (ATRS), and timing capable single heel raises were evaluated. In addition, the preoperative defect size and distance between the calcaneal osteotendinous junction and the rupture site were measured by ultrasound in all cases. Results: Twenty-three patients could perform a single heel raise within 3 months after surgery (early single heel raise group), and fortyfive patients could perform a single heel raise after 3 month postoperatively. The age, gender, body mass index, smoking, and operation delay were similar in the two groups. In addition, the defect size and distance between the calcaneal osteotendinous junction and rupture site as measured by preoperative ultrasound were similar (p=0.379 and p=0.631, respectively). On the other hand, when the rupture site was divided into the hypovascular zone (4~7 cm from calcaneal osteotendinous junction) and non-hypovascular zone, the hypovascular zone rupture rate was significantly lower in the early single heel raise group (60.9%, 14/23; 91.1%, 41/45; p=0.003). In logistic regression analysis, the odds of the hypovascular zone rupture group being capable of early single heel raise were 0.189 (p=0.017). The ATRS score at 3 months and 1 year after surgery were significantly higher in the early single heel raise group (p<0.001). Conclusion: Achilles tendon rupture at the hypovascular zone is a poor prognostic factor for early single heel raise and might affect the prognosis significantly after an Achilles tendon rupture operation.

• Journal of The Korean Society of Clinical Toxicology
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• v.5 no.2
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• pp.99-105
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• 2007

Purpose: Pyrethroid is an insecticide that produces moderate intoxication in mammals, with neither exposure to skin nor inhalation resulting in severe systemic manifestations. In 2005 we made a nationwide survey of agrichemical human intoxication. The object of this study is to analyze pyrethroid intoxications based on the 2005 survey. Methods: We prospectively collected data from 1 August 2005 to 31 July 2006 by a standard investigation protocol. We analyzed demographic data, exposure data (cause, amount, ingredients), clinical features, and courses. Results: A total of 125 cases of pyrethroid intoxication were surveyed. The mean patient age was $56.78{\pm}16.158$ years old, and the mean amount ingested was $121.85{\pm}110.732ml$. Patients were classified into four severity groups according to symptoms and mental status: the asymptomatic group (27 patients, 21.6%), the mild symptom group (48, 38.4%), the moderate symptom group (21, 16.8%), and the severe symptom group (7, 5.6%). There were statistically significant differences in mental status, severity, and mean ICU days between two groups. Admission days by severity grade for the asymptomatic, mild, moderate, and severe symptom groups were $5.49{\pm}16.051,\;3.65{\pm}4.143,\;4.59{\pm}3.335,\;and\;8.14{\pm}7.199days$, respectively (p=0.047). Conclusion: Nationwide surveillance was extremely telling in uncovering a high frequency of agrichemical intoxication in Korea. In pyrethroid intoxication, severity grading can be a useful prognostic tool.

• The Journal of the Korean bone and joint tumor society
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• v.13 no.2
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• pp.67-74
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• 2007

Purpose: To evaluate association of giant cell tumors recurrence between markers of proliferation cells (MCM3, Ki-67 and HH3) Materials and Methods: Ten case of giant cell tumor of bone were reviewed. The patients were six males and four females (mean age: 33 yrs). All patients were done operation after biopsy. The radiologic grading was determined according to Enneking grading system. The immunohistochemical stains of MCM3, HH3, and Ki-67 were done with Microarray block. Results: The three cases of 10 cases (30%) were recurred at same sites. Two case of recurrence was grade II according to radiologic features. The remaining case was grade I. The expression rate of immunohistochemical markers in radiologic grade 2 and 3 were more increased than grade 1. But there was not association between radiologic grading and proliferation of tumor cells because result data was not coherence. Mean MCM3 labeling index of non-recurred case was 11.2%, recurred case was 7.2%. Ki-67 was 12% vs. 8.9%, respectively and HH3 was 66.9 % vs. 75.4%, respectively. Thus there was no association between local recurrence and immunohistochemical Ki-67, MCM3 expression rate. But HH3 marker expression rate was increased in recurred cases compared to non-recurred cases. Conclusion: Our study suggests that HH3 immunohistochemical marker can be a useful prognostic factor.

• Journal of Cardiovascular Imaging
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• v.31 no.2
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• pp.85-95
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• 2023

BACKGROUND: The prognostic utility of follow-up transthoracic echocardiography (FU-TTE) in patients with hypertrophic cardiomyopathy (HCM) is unclear, specifically in terms of whether changes in echocardiographic parameters in routine FU-TTE parameters are associated with cardiovascular outcomes. METHODS: From 2010 to 2017, 162 patients with HCM were retrospectively enrolled in this study. Using echocardiography, HCM was diagnosed based on morphological criteria. Patients with other diseases that cause cardiac hypertrophy were excluded. TTE parameters at baseline and FU were analyzed. FU-TTE was designated as the last recorded value in patients who did not develop any cardiovascular event or the latest exam before event development. Clinical outcomes were acute heart failure, cardiac death, arrhythmia, ischemic stroke, and cardiogenic syncope. RESULTS: Median interval between the baseline TTE and FU-TTE was 3.3 years. Median clinical FU duration was 4.7 years. Septal trans-mitral velocity/mitral annular tissue Doppler velocity (E/e'), tricuspid regurgitation velocity, left ventricular ejection fraction (LVEF), and left atrial volume index (LAVI) at baseline were recorded. LVEF, LAVI, and E/e' values were associated with poor outcomes. However, no delta values predicted HCM-related cardiovascular outcomes. Logistic regression models incorporating changes in TTE parameters had no significant findings. Baseline LAVI was the best predictor of a poor prognosis. In survival analysis, an already enlarged or increased size LAVI was associated with poorer clinical outcomes. CONCLUSIONS: Changes in echocardiographic parameters extracted from TTE did not assist in predicting clinical outcomes. Cross-sectionally evaluated TTE parameters were superior to changes in TTE parameters between baseline and FU at predicting cardiovascular events.

• Journal of Korean Neurosurgical Society
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• v.29 no.9
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• pp.1215-1221
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• 2000

Objective : The clinical prognosis and biological behavior of atypical and especially malignant meningiomas are well known to be worse than benign meningioma, but the degree of biological aggressiveness in each classical subtypes of benign meningioma is controversy. This study was performed to see whether there is a difference in the proliferative activity between each different histological subtypes of benign meningioma as well as atypical meningioma. Methods : Paraffin-embedded surgical specimens of 27 meningiomas, including two recurrent tumors, were studied to evaluate proliferative activity by immunohistochemical method with monoclonal antibodies to proliferating cell nuclear antigen(PCNA) and MIB-1. The specimens consisted of 8 cases of meningothelial, 9 cases of transitional, 5 cases of fibroblastic subtypes and 5 cases of atypical meningiomas. Results : Mean PCNA labeling indices of meningothelial, transitional and fibroblastic meningiomas were $4.82{\pm}5.10%$, $9.01{\pm}4.25%$ and $5.66{\pm}5.32%$, but that of atypical meningiomas was $27.62{\pm}19.67%$, noting a higher value compared to all three subtypes of benign meningiomas. Mean Ki-67 labeling indices of the above 3 subtypes were $0.43{\pm}0.85%$, $0.44{\pm}1.08%$ and $0.24{\pm}0.18%$, and that of atypical meningiomas was also revealed to be of higher value ($0.84{\pm}0.59%$). PCNA and Ki-67 labeling indices were not statistically different between histological subtypes of benign meningioma(p>0.05), but the differences of both immunolabeling between benign and atypical meningiomas were statistically significant(p<0.05). Conclusion : Immunolabeling of PCNA and Ki-67 in intracranial meningiomas reveals no prognostic difference between meningothelial, transitional and fibroblastic subtypes in classical benign meningiomas by measuring expression of PCNA and Ki-67, but it seems to be helpful in differentiating benign and atypical meningioma, later showing more proliferative activity and biological aggressiveness.

• Radiation Oncology Journal
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• v.12 no.3
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• pp.393-399
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• 1994

Spinal cord compression, an oncologic emergency, is a rare complication of hematologic malignancy Our experience was obtained with a series 32 Patients following retrospective analysis for assessing the role of radiation therapy and identifying the prognostic factors affecting on treatment outcome. Diagnosis was usually made by means of radiologic study such as myelography or computerized tomography (CT) or magnetic resonance imaging (MRI) and neurologic examination. Five cases were diagnosed by subjective symptom only with high index of suspicion. In 31 cases, the treatment consisted in radiation therapy alone and the remained one patient had laminectomy before radiation therapy because of diagnostic doubts. Total treatment doses ranged from 800 cGy to 4000 cGy with median of 2000 cGy. Initially large fraction size more than 250 cGy were used in 13 patients with rapidly progressed neurologic deficit. The clinical parameters considered in evaluating the response to treatment were backache, motor-sensory performance and sphincter function. Half of all patients showed good response. Partial response and no response were noted in $37.5\%$ and $12.5\%$, respectively. Our results showed higher response rate than those of other solid tumor series. The degree of neurologic deficit at that time of diagnosis was the most important predictor of treatment outcome. The elapsed time from development of symptoms to start of treatment was significantly affected on the outcome. But histology of primary tumor total dose and use of initial large fraction size were not significantly affect on the outcome. These results confirmed the value of early diagnosis and treatment especially in radiosensitive hematologic malignancy.

• Tuberculosis and Respiratory Diseases
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• v.44 no.1
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• pp.93-103
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• 1997

Background : Malnutrition is a common finding in patients with chronic obstructive pulmonary disease, especially in the emphysema group. Although the mechanism of malnutrition is not confirmed, it is believed to be a relative deficiency caused by hypermetabolism due to increased energy requirements of the respiratory muscles, rather than a dietary deficiency. Malnutrition in chronic obstructive pulmonary disease is not a merely coincidental finding. It is known that the nutritional status correlates with physiologic parameters including pulmonary function, muscular power, and exercise performance, and is one of the important and independent prognostic factors of the disease. Methods : Patients with chronic obstructive pulmonary disease Yongdong Severance Hospital from May, 1995 to March, 1996 and age-matched healthy control group were studied. Survey of nutritional intake, anthropometric measurements and biochemical tests were done to assess nutritional status. Relationship between nutritional status and FEV1 (forced expiratory volume at one second), which was a significant functional parameter, was assessed. Results : 1) The patient group was consisted of 25 males with mean age of 66.1years and FEV1 of $42{\pm}14%$ of predicted values. The control group was consisted of 26 healthy males with normal pulmonary function, whose mean age was 65.0 years. 2) The ratio of calorie intake/calorie requirement per day was $107{\pm}28%$ in the patient group, and $94{\pm}14%$ in the control group, showing a tendency of more nutritional intake in patient group(B=0.06). 3) There were significant differences between the patient group and control group in percent ideal body weight(92.8% vs 101.6%, p=0.024), body mass index($20.0kg/m^2$ VS $21.9kg/m^2$, p=0.015), and handgrip strength(29.0kg vs 34.3kg, p=0.003). However, there were no significant differences in triceps skinfold thickness, mid-arm muscle circumference, albumin, and total lymphocyte count between two groups. Percentage of underweight population was 40%(10/25) in the patient group, and 15%(4/26) in the control group. 4) The percent ideal body weight, triceps skinfold thickness, and mid-arm muscle circumference had significant correlation with FEV1. Conclusion : The patients with chronic obstructive pulmonary disease showed significant depletion in nutritional parameters such as body weight and peripheral muscle strength, while absolute amount of dietary intake was not insufficient. Nutritional parameters were well correlated with FEV1.

• Journal of radiological science and technology
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• v.31 no.2
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• pp.161-169
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• 2008

Since measuring the size of kidney with sonography becomes an important index for diagnosis, treatment, and prognostic prediction in kidney disease, the accurate measurement and evaluation on this are clinically very important. Accordingly, the purpose of this study was to increase reproducibility and objectivity in measuring the size of kidney by enumerating factors that have an impact for measurement. It targeted 44 adults in Korea at the age of 21-27. It measured in order for both kidneys to be seen most largely while changing a subject-examiner's position in a state of fasting for 8 hours and a transducer's approaching direction. It compared a size of kidney by measuring, respectively, with the same method in 30 minutes and in 1 hour after drinking water in 700-1,000cc. In case of the lateral approach scan in decubitus position, the average length of the kidney both to the right and the left and the deviation of measurement to be the largest. In NPO(None Per Oral) state, the average length in the right kidney was 10.19cm, and the average length in the left kidney was 10.33cm. In 60 minutes after taking moisture, the average length in the right kidney was 10.94cm, and the average length in the left kidney was 11.13cm. In comparing the average length of the kidney in NPO state and its average length in 60 minutes after taking moisture, the size swelled by 7.3% for the length in the right kidney and by 7.7% in the left, thereby having been indicated to be statistically significant(P<0.003). The measurement in a size of kidney by using ultrasound may be measured differently depending on a patient's state of taking moisture and a transducer's approaching direction. It is thought that when the measurement in a size of kidney is especially important clinically, the intake and intake time in moisture need to be considered and that measuring with the posterior approach in prone position is a good method aiming to increase reproducibility in measuring length of the kidney.

• Journal of Chest Surgery
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• v.38 no.1 s.246
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• pp.56-62
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• 2005

Because of high morbidity and mortality, traumatic diaphragm injury remains a diagnostic challenge. In this study, we evaluate that some factors and scores can be used as predictors. Material and Method: From May 1995 to June 2003, 23 patients with traumatic diaphragm injury were enrolled. We examined the clinical features of patients. RTS, TRISS, ISS and APACHE II scores for each patient are calculated for analyzing the relationship of mortality and ICU duration. Result: The study identified 15 men $(65.2{\%})$ and 8women $(34.8{\%})$. There are right sided diaphragmatic injury in 11 patients $(47.8{\%})$, left sided in 11 $(47.8{\%})$, and both sided in 1 ($0.4{\%}$). Plain X-ray, CT, upper GI contrast study and esophagogastroscopy were used as diagnostic tools. Age, hemodynamic status, early diagnosis are not associated with outcome. As prognostic factor, RTS and ISS are associated with mortality and there was negative relationship between RTS and ICU duration (r=0.737, p=0.026). Conclusion: An early diagnosis of traumatic diaphragm injury can frequently be missed in the acute trauma setting. So high index of suspicion and a careful examination are important in multiple trauma patients. An RTS can probably be used effectively as a predictor for the severity and prognosis in patients with traumatic diaphragm injury.