Kim, In-Ah;Choi, Ihl-Bhong;Kang, Ki-Mun;Shinn, Kyung-Sub;Kim, Hack-Ki
Radiation Oncology Journal
/
v.14
no.2
/
pp.137-147
/
1996
Purpose : This report is the result f retrospective analysis for children who received prophylactic cranial irradiation combined with intrathecal chemotherapy. Materials and Methods : Ninety children with ALL who had got bone marrow remission after induction chemotherapy received PCI. All but 3 children were treated with a dose of 1800 cGy as a standard regimen. While the PCI was given, all patients received intrathecal chemotherapy. Results : Nine of 90 patients experienced CNS relapse during the duration of follow-up ranged from 36 to 96 months (median 60 months). Three children experienced BM relapse prior to CNS relapse. Therefore, CNS relapse rate as the first adverse event was $6.7\%$. Median time interval of CNS relapse was 16 months from the first day of hematologic complete remission. Eighty-nine percent of patients who had CNS relapse were associated with hematologic relapse. and $78\%$ of CNS relpase occurred during maintenance chemotherapy (on-therapy relapse). The CNS RFS at 2 and 5 years are $68\%$ and $42\%$, respectively with median of 43 months. The Prognostic factors affecting CNS RFS are initial WBC count (cut-off point of 50,000/ul), FAB subtype and CALGB risk criteria. The DFS at 2 and 5 years are 61 and $39\%$, respectively with median of 34 months. The prognostic factors affecting DFS are initial WBC count (cut-off point of 50,000/ul), FAB subtype, POG and CALGB risk criteria. Conclusions : In our study, $6.7\%$ of CNS relapse rate as a first adverse event was comparable with other studies. Various risk criteria was based on age at diagnosis and initial WBC count such as POG and CALGB criteria, had prognostic significance for CNS RFS and DFS. Prospective randomized trial according to prognostic subgroup based on risk criteria and systematic study about neuropsychologic function for long term survivors, are essential to determine the most effective and least toxic form of CNS prophylaxis.
The Purpose of this study was to investigate the predictors of relapse in orthodontic treatment of skeletal Class III malocclusion in growing patients. A total of 55 patients were studied and all subjects were divided into two groups according to their stability in the post-treatment stage. Of the sample, 33 patients were included in the stable group and the remaining 22 were assigned to the relapse group. Cephalometric data of the pre-treatment stage was taken and compared between the stable and relapse group. The following results were obtained through t-test: 1. This study presented statistical evidence to show that the major skeletal determinant of prognosis in Class III orthodontic treatment was not anteroposterior discrepancy .but vertical discrepancy, especially within the AB-maxillo mandibular triangle. Vertical angular measurements that showed statistically significant differences were AB-MP and ODI(P<0.01) and the vortical ratio measurements were MP-P/AL and PP-P/AL(P<0.05). 2. Relapse tendency increased with the steep occlusal Plane, especially the steep lower occlusal plane. As to occlusal plane, there were statistically significant differences in OP(L)-PP, OP-PP, AB-OP(L) and Wits appraisal(P<0.05). This study claimed that anteroposterior discrepancy was not necessarily the proper criteria to predict relapse. Vertical discrepancy had a significant effect on post-treatment stability.
Kim, Cheol Min;Kim, Sung Gon;NamKoong, Kee;Cho, Dong Hwan;Lee, Byung Ook;Choi, Ihn Geun;Kim, Min Jeong
Korean Journal of Biological Psychiatry
/
v.14
no.4
/
pp.249-255
/
2007
Objectives : The aim of this prospective study is to investigate predictors estimating relapse in Korean alcohol-dependent patients using variables like alcohol history, drinking craving, treatment motivation and insight. Methods : Alcohol dependent patients(N=48) who completed questionnaires about sociodemographic variables and drinking history, Timeline Follow-Back(TLFB), Obsessive-Compulsive Drinking Scale(OCSD), Alcohol Urge Questionnaire(AUQ), Pennsylvania Alcohol Craving Scale(PACS), University of Rhode Island Change Assessment(URICA), Hanil Alcohol Insight Scale(HAIS) were followed-up for 24weeks. Subjects who drank heavily(5 standard drinking or more/day) or were not followed up anymore were classified as the relapse group. We used logistic regression analysis with backward elimination of SPSS PC+11.5 to investigate relapse estimate predictors. Results : Average drinking amount per drinking day for last 1 year and HAIS score were predictors of relapse in alcohol-dependent patients. Conclusions : Our findings suggest that therapist should give more attention to alcohol-dependent patients who had more drinks per drinking day for last 1 year and had lower insight level.
Pyo Hong Ryull;Suh Chang Ok;Kim Gwi Eon;Rho Jae Kyung
Radiation Oncology Journal
/
v.13
no.2
/
pp.129-142
/
1995
Purpose: Traditionally the patients with early stage non-Hodgkin's lymphoma of the head and neck was treated with radiotherapy. But the results were not satisfactory due to distant relapse. Although combined treatment with radiotherapy and chemotherapy was tried with some improved results and chemotherapy alone was also tried in recent years, the choice of treatment for the patients with early stage non-Hodgkin's lymphoma of the head and neck has not been defined Therefore, in order to determine the optimum treatment method, we analysed retrospectively the outcomes of the patients with Ann Arbor stage I and II non-Hodgkin's lymphoma localized to the head and neck who were treated at Severance Hospital. Materials and Methods: 159 patients with stage I and II non-Hodgkin's lymphoma localized to the head and neck were treated at our hospital from January, 1979 to December, 1992. Of these patients, 114 patients whose primary sites were Waldeyer's ring or nodal region, and received prescribed radiation dose and/or more than 2 cycles of chemotherapy. were selected to analyze the outcomes according to the treatment methods ( radiotherapy alone, chemotherapy alone. and combined treatment with radiotherapy and chemotherapy ). Results: Five year overall actuarial survival of the patients whose Primary site was Waldeyer's ring was $62.5\%.$ and that of the Patients whose primary site was nodal region was $53.8\%$ There was no statistically significant difference between survivals of both groups. Initial response rate to radiotherapy. chemotherapy, and combined treatment was $92\%,\;83\%,\;94\%$ respectively, and 5 year relapse free survival was $49.9\%,\;52.4\%,\;58.5\%$ respectively ( statistically not significant ). In the patients with stage I. 3 year relapse free survival of chemotherapy alone group was $75\%$ and superior to other treatment groups. In the Patients with stage II, combined treatment group revealed the best result with $60.1\%$ of 3 year relapse free survival. The effect of sequential schedule of each treatment method in the Patients who were treated by combined modality was analyzed and the sequence of primary chemotherapy + radiotherapy + maintenance chemotherapy showed the best result ( 3 year relapse free survival was $79.1\%).$ There was no significant survival difference between BACOP regimen and CHOP regimen. Response to treatment was only one significant (p(0.005) prognostic factor on univariate analysis and age and mass size was marginally significant ( p(0.1). On multivariate analysis, age (p=0.026) and mass size (p=0.013) were significant prognostic factor for the relapse free survival. Conclusion: In summary, the patients who have non-Hodgkin's lymphoma of the head and neck with stage I and mass size smaller than 10 cm, can be treated by chemotherapy alone, but remainder should be treated by combined treatment method and the best combination schedule was the sequence of initial chemotherapy followed by radiotherapy and maintenance chemotherapy.
Cihan, Sener;Kucukoner, Mehmet;Ozdemir, Nuriye;Dane, Faysal;Sendur, Mehmet Ali Nahit;Yazilitas, Dogan;Urakci, Zuhat;Durnali, Ayse;Yuksel, Sinemis;Aksoy, Sercan;Colak, Dilsen;Seker, Mehmet Metin;Taskoylu, Burcu Yapar;Oguz, Arzu;Isikdogan, Abdurrahman;Zengin, Nurullah
Asian Pacific Journal of Cancer Prevention
/
v.15
no.13
/
pp.5337-5341
/
2014
Background: The standard therapy for stage I rectum cancer is surgical resection. Currently, there is no strong evidence to suggest that any type of adjuvant therapy is beneficial. The risks of local relapse and distant metastasis are higher in rectal tumors. Therefore, while there is no clearly defined absolute indication for adjuvant therapy in lymph node negative colon cancers, rectum tumors that are T3N0 and higher require adjuvant treatment. Due to the more aggressive nature of rectal cancers, we explored the clinical and pathologic factors that could predict the risk of relapse in Stage I (T1-T2) disease and whether there was any progression-free survival benefit to adjuvant therapy. Materials and Methods: This multicenter study was carried out by the Anatolian Society of Medical Oncology. A total of 178 patients with rectal cancers who underwent curative surgery between January 1994 and August 2012 in 13 centers were included in the study. Patient demographics, including survival data and tumor characteristics were obtained from medical charts. Results: The median age was 58 years (range 26-85 years). Most tumors were well or moderately differentiated. For adjuvant treatment, 13 patients (7.3%) received radiotherapy alone, 12 patients (6.7%) received chemotherapy alone and 15 patients (8.4%) were given chemoradiotherapy. Median follow up was 29 months (3-225 months). Some 42 patients (23.6%) had relapse during follow up; 30 with local recurrence (71.4%) whereas 12 (28.6%) were distant metastases. Among the patients, 5-year DFS was 64% and OS was 82%. Mucinous histology and receiving adjuvant therapy were found to have statistically insignificant correlations with relapse and survival. Conclusions: In our retrospective analysis, approximately one quarter of patients exhibited either local or systemic relapse. The rates of relapse were slightly higher in the patients who had no adjuvant therapy. There may thus be a role for adjuvant therapy in high-risk stage I rectal tumors.
Park, Hye-Sook;Ha, Eun-Hee;Wie, Cha-Hyung;Kang, Ji-Yong
Journal of Preventive Medicine and Public Health
/
v.29
no.1
s.52
/
pp.67-78
/
1996
The purpose of this study was examine the general characteristics of relapsed pulmonary tuberculous patients (i.e. age, sex, weight, occupation, previous forms of treatment, drug sensitivity, and the frequency of relapse) in order to improve future treatments of tuberculosis as well as to perpetuate health education. The data was obtained from the medical records of 186 relapsed pulmonary tuberculosis patients who were registered for treatment at various public health offices in Seoul during the year of 1994. The major findings obtained from the study were as follows; 1) The male to female ratio of relapsed pulmonary tuberculous patients was about 7:3, more specifically 23.7% of the men and 30.9% of the women were between 20 and 29 years of age. 2) Comparing initial less aggravated states to relapsed states, patients with minimal X-ray findings later proved moderately advanced X-ray findings. Furthermore, patients with negative sputum AFB findings later proved positive sputum AFB findings. 3) Of the 186 patients studied, 91.9% suffered, relapse and 8.1% suffered 2 or more relapses. Of the patients who suffered at least 1 relapse, 54.8% received short-term treatment, 26.9% received long-term treatment, and 18.3% received treatment of an unknown during their initial tuberculosis treatment periods. 4) fifty five point four percent of the patients had no reaction to the drug treatment(not available), 25.9% of the patients had sensitive reaction to the drug treatment, 18.7% of the patients had resistant reaction to the- drug treatment. Drug resistance was higher in patients that exhibited positive X-ray findings as well as in patients that exhibited positive sputum AFB findings. furthermore, patients receiving treatment of an unknown nature(35.5%) exhibited higher drug resistance than those receiving short-term treatment(13.6%) and long-term treatment(17.0%). 5) Of the 160 patients who suffered relapses, 8.8% suffered a relapse within 1 year after treatment and 91.2% suffered a relapse at least 1 year after treatment. Furthermore, our study showed that women, under 30, who received short-term treatment and encounterd complications during their primary treatment suffered relapses faster than any other groups studied. In addition, minimal X-ray findings and sputum AFB findings were not correlated to the time relapse occured. Therefore, the seater efforts are needed to prevent relapsed pulmonary tuberculosis.
One of the strenuous problems in orthodontic procedures is postretention stability and retention against relapse. Many investigative trial had been done to disclose the factors associated with relapse and effective prescription to stave off, however, the nature of these jeopardies remained obscure. The objective was to investigate the long-term stability and quantitative changes of dental arches subsequently after Class I nonextraction treatment. Study models,cephalometric headfilms of 26 samples which were taken before, after teatment and postretention were employed to measure the interdental width of corresponding buccal teeth,overbite,overjet and the inclination of incisors and molars. Statistical analysis was carried to compare each measurements across the time period, and followings were brought around. 1. The quantitative amount of relapse in overbite presented positive correlation with the amount of changes through the treatment. 2. Stability of intercanine width was so far secure in the case the expansion had been done through. 3. The amount of changes in intercanine width of the lower regardless of expansion or contraction manifested less than the upper, however, the relapse ratio got high. 4. The upper and lower incisors were likely to be labioversive, and remained stable after retention. 5. The first molars of the upper and lower were conceivably tipped back immediately after treatment and returned to the original angulation. The expansion of intermolar width stayed stable across the time scheme after treatment It was suggested that the maintenance of intercanine width of lower was pertinent to perform the postretention stabilityv and the expansion of dental arch shoed be confined within physiologic boundaries of the patients.
Portinari, Mattia;Baldini, Gabriele;Guidoboni, Massimo;Borghi, Alessandro;Panareo, Stefano;Bonazza, Simona;Dionigi, Gianlorenzo;Carcoforo, Paolo
Annals of Surgical Treatment and Research
/
v.95
no.5
/
pp.286-296
/
2018
Purpose: Sentinel lymph node (SLN) biopsy (SLNB) is widely accepted for staging of melanoma patients. It has been shown that clinico-pathological features such as Breslow thickness, ulceration, age, and sex are better predictors of relapse and survival than SLN status alone. The aims of this study were to evaluate the long-term (10-year) prognostic impact of SLNB and to determine predictive factors associated with SLN metastasis, relapse, and melanoma specific mortality (MSM). Methods: This was a prospective observational study on 289 consecutive patients with primary cutaneous melanoma who underwent SLNB from January 2000 to December 2007, and followed until January 2014, at an Italian academic hospital. Results: SLN was positive in 64 patients (22.1%). The median follow-up was 116 months (79-147 months). Tenyear disease-free survival and melanoma specific survival were poor in patients with positive SLN (58.7% and 66.4%, respectively). Only the increasing Breslow thickness resulted independently associated to an increased risk of SLN metastasis. Cox regression analysis showed that a Breslow thickness >2 mm was an independent predictor of relapse, and male sex and Breslow thickness >2 mm was a predictor of MSM. At 10 years, SLN metastasis was not significantly associated to either relapse or MSM. Conclusion: After the fifth year of follow-up, SLN metastasis is not an independent predictive factor of relapse or mortality which are mainly influenced by the characteristics of the primary tumor and of the patient. Patients with a Breslow thickness >2 mm regardless of the SLN status should be considered at high risk for 10-year relapse and mortality.
Pediatric nephrotic syndrome is a well-known illness for its high relapsing rate. If we can predict the relapsing rate and the responses to the steroid therapy of individual patients with nephrotic syndrome, the predictability will be helpful in building a therapeutic plan. Here is my review of research articles on the risk factors for the prediction of relapsing nephrotic syndrome.
Multiple sclerosis is an autoimmune demyelinating disorder of the nervous system. The ocular manifestation includes optic neuritis, internuclear opthalmoplegia and nystagmus. Upbeat nystagmus is a rare manifestation of multiple sclerosis. We report a patient with relapsing multiple sclerosis who presented with upbeat nystagmus from a circumscribed lesion in the caudal medulla.
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