• 제목/요약/키워드: all cause survival

검색결과 183건 처리시간 0.027초

성인의 선천성 심방중격결손증의 외과적 치료 (Surgical Treatment of Atrial Septal Defect in Adult - Clinical Review of 31 Cases -)

  • 장운하;오태윤;배상일
    • Journal of Chest Surgery
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    • 제31권8호
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    • pp.770-775
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    • 1998
  • 배경: 심방중격결손증은 선천성심질환중 가장 흔한 질환중의 하나이며 성인에서 진단되는 선천성 심질환 의 30%를 차지한다. 상당수의 환자들이 성인이 될때까지 별다른 증상이 없이 잘 지내기도 하고, 40∼50대에 사망 하는 경우가 많지만, 더 오래 사는 경우도 흔히 발견된다. 가장 흔한 사망원인은 주로 우심부전이나 부정맥이다. 대상 및 방법: 강북삼성병원 흉부외과에서는 1988년부터 1997년 6월까지 총33례의 심방중격결손증을 수술 하였으며, 그중 31례가 성인 심방중격결손증이었다. 동반질환은 삼첨판 폐쇄부전이 2례, 폐동맥판 협착증, 승모판 폐쇄부전 및 삼첨판 폐쇄부전, 그리고 관상동맥질환이 각각 1례였다. 결과: 모든환자에서 첩포봉합술이나 직접봉합술을 이용하여 수술하였으며, 수술후 경과는 모두 양호하였다. 수술후 심전도와 혈류역학, 및 심초음파검사상 호전을 보였다. 결론: 성인의 심방중격결손증은 60세이상의 고령일지라도 폐동맥고혈압이나 우심부전, 부정맥등을 예방 하기 위한 적극적인 외과교정술을 시행하여야 한다

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Increased Serum S-TRAIL Level in Newly Diagnosed Stage-IV Lung Adenocarcinoma but not Squamous Cell Carcinoma is Correlated with Age and Smoking

  • Kargi, Aysegul;Bisgin, Atil;Yalcin, Arzu Didem;Kargi, Ahmet Bulent;Sahin, Emel;Gumuslu, Saadet
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권8호
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    • pp.4819-4822
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    • 2013
  • Background: Lung cancer is the leading cause of cancer mortality in the world. Many factors can protect against or facilitate its development. A TNF family member TRAIL, has a complex physiological role beyond that of merely activating the apoptotic pathway in cancer cells. Vitamin D is converted to its active form locally in the lung, and is also thought to play an important role in lung health. Our goal was to investigate the possible clinical significance of serum sTRAIL and 1,25-dihydroxyvitamin D(3) levels in patients with non-small cell lung cancer (NSCLC). Materials and Methods: Totals of 18 consecutive adenocarcinoma and 22 squamous cell carcinoma patients with stage-IV non-small cell lung cancer referred to our institute were included in this study. There were 12 men and 6 women, with ages ranging from 38 to 97 (mean 60.5) years with adenocarcinoma, and 20 men and 2 women, with ages ranging from 46 to 80 (mean 65) years with squamous cell carcinoma. Serum levels of sTRAIL and 1,25-dihydroxyvitamin D(3) were measured in all samples at the time of diagnosis. Results: sTRAIL levels in NSCLC patients were higher than in the control group. Although there was no correlation between patient survival and sTRAIL levels, the highest sTRAIL levels were correlated with age and cigarette smoking in the adenocarcinoma patients. sTRAIL level in healthy individuals were correlated with serum 1,25-dihydroxyvitamin D(3). Conclusions: Serum sTRAIL concentrations were increased in NSCLC patients, and correlated with age and smoking history, but not with overall survival.

Oxaliplatin, 5-Fluorouracil and Leucovorin (FOLFOX-4) as First Line Chemotherapy in Elderly Patients with Advanced Gastric Cancer

  • Haghighi, Shirin;Kasbkar, Hadi;Esmaeilpour, Keihan;Yasaei, Mehrdad
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권7호
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    • pp.3277-3280
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    • 2016
  • Background: Gastric cancer is considered the fourth most common cancer and second most common cause of cancer-related mortalities worldwide. Gastric cancer develops more frequently among elderly. The oxaliplatin/5FU/leucovorin (FOLFOX) regimen has shown a notable activity against gastric cancer. Aim: To evaluate the responses and complications of FOLFOX-4 regimen as first line chemotherapy in elderly patients with advanced gastric cancer. Materials and Methods: From October 2014 to November 2015, a total of 21 patients with metastatic or local AGC (advanced gastric cancer) were analyzed. All patients were administered a FOLFOX-4 regimen consisting of a 2h infusion of oxaliplatin $85mg/m^2$ (day 1), continuous infusion of $1000mg/m^2$ 5-Fu in 24h., and leucovorin $200mg/m^2$ in 2h infusion as a first-line chemotherapy. Results: A total of 18 patients were assessable for efficacy and toxicity. One of 18 patients achieved a complete response, and 12 had partial responses, giving an overall response rate of 72.6%. Three (16%) patients demonstrated stable disease and 2 (12%) progression. The median progression free survival was 7.3 months, and the median overall survival was 11.9 months. One patient had grade 3 neuropathy. No other grade 3 or 4 NCI-CTC were seen. Conclusions: The FOLFOX-4 regimen used in our study was both active and acceptable for AGC in elderly patients as neoadjuvant and main therapy.

인체 임파양세포에서 $G_2$기 염색체의 방사선 감수성 (Radiation Induced $G_2$ Chromatid Break and Repair Kinetics in Human Lymphoblastoid Cells)

  • 성진실
    • Radiation Oncology Journal
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    • 제11권2호
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    • pp.193-203
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    • 1993
  • In understanding radiosensitivity a new concept of inherent radiosensitivity based on individuality and heterogeneity within a population has recently been explored. There has been some discussion of possible mechanism underlying differences in radiosensitivity between cells. Ataxia telangiectasia (AT), a rare autosomal recessive genetic disorder, is characterized by hypersensitivity to ionizing radiation and other DNA damaging agents at the cellular level. There have been a lot of efforts to describe the cause of this hypersensitivity to radiation. At the cellular level, chromosome repair kinetics study would be an appropriate approach. The purpose of this study was to better understand radiosensitivity En an approach to investigate kinetics of induction and repair of $G_2$ chromatic bleaks using normal, AT heterozygous (ATH), and AT homozygous lymphoblastoid cell lines. In an attempt to estimate initial damage, $9-{\beta}-D-arabinosyl-2-fluoroadenine,$ an inhibitor of DNA synthesis and repair, was used in this study. It was found from this study that radiation induces higher chromatid breaks in AT than in normal and ATH cells. There was no significant differences of initial chromatid breaks between normal and ATH cells. Repair kinetics was the same for all. So the higher level of breaks in AT $G_2$ cells is thought to be a reflection of the increased initial damage. The amount of initial damage correlated well with survival fraction at 2 Gy of cell survival curve following radiation. Therefore, the difference of radiosensitivity in terms of $G_2$ chromosomal sensitivity is thought to result from the difference of initial damage.

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Comparison of Radial Artery and Saphenous Vein Composite Y Grafts during Off-pump Coronary Artery Bypass

  • Wi, Jin-Hong;Joo, Hyun-Chel;Youn, Young-Nam;Song, Suk-Won;Kim, Tae Hoon;Yoo, Kyung-Jong
    • Journal of Chest Surgery
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    • 제46권4호
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    • pp.265-273
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    • 2013
  • Background: The safety and efficacy of arterial composite grafts for total arterial revascularization have been demonstrated. The saphenous vein (SV) is a widely used graft because of its accessibility, sufficient length, and ease of manipulation. Our aim was to compare mid-term outcomes of saphenous vein Y-grafts with radial artery Y-grafts joined by anastomosis to the left internal thoracic artery. Materials and Methods: Records of off-pump coronary artery bypass grafting with composite Y-grafts based on the left internal thoracic artery technique in 552 patients were analyzed retrospectively. After propensity score matching, 79 radial arterial (RA) composite grafts (RA group) and 79 saphenous vein composite grafts (SV group) were compared. The duration of mean follow-up was $24.6{\pm}14.6$ months (range, 1 to 55 months). Results: There were no differences in surgical mortality, all-cause mortality, or morbidity among the groups. Rates of 4-year survival were 91.7% and 96.3% in the RA and SV groups, respectively (p=0.519). The coronary reintervention-free survival rate and freedom from major adverse cardiovascular or cerebrovascular events were similar in the two groups (p=0.685, p=0.564). Conclusion: Construction of composite Y-grafts using the radial artery or saphenous vein showed similar mid-term results. Long-term follow-up and randomized trials will be needed to confirm our present conclusions.

Negative Pressure Wound Therapy Applied to a Meshed Split-Thickness Skin Graft

  • Lee, Dong-Hun;Kim, Yu-Jin
    • Archives of Reconstructive Microsurgery
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    • 제25권2호
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    • pp.29-36
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    • 2016
  • Purpose: Skin grafting is used for the transfer of cutaneous tissue from one site of the body to another. To improve graft survival, close contact between the graft and the wound bed is essential for vessels to grow across the gap. Here, we introduce an easy and efficient dressing method to improve graft survival. Materials and Methods: A retrospective chart review was performed to identify patients who underwent split thickness skin graft and negative pressure wound therapy (NPWT) or conventional treatment between January 2007 and April 2015. Overall, 25 consecutive patients were included in the NPWT group and 49 were included in the conventional dressing group to compare the outcome of the procedure. The data were obtained from medical records, including age, sex, cause of the skin defect, size of graft, time for healing, wound preparation time, and complications. Results: Of the NPWT group, the average wound size was $147.04{\pm}146.74cm^2$ (range, $9{\sim}900cm^2$). With the exception of one patient, all wounds healed without the need for further procedure. The average duration of time required for the NPWT group, which was defined as removal of stitches (or staples) and no need for additional active dressing, was $6.4{\pm}1.97days$ (range, 5~15 days). The average time for the conventional dressing group was $10.78{\pm}2.38days$ (range, 5~15 days). Conclusion: NPWT can be used to cover regions in which wound healing does not occur fully or when neither tie-over nor compressive dressings are applicable. This treatment also reduced wound healing time and allowed earlier patient mobilization and hospital discharge.

Salivary biomarkers in oral squamous cell carcinoma

  • Nguyen, Truc Thi Hoang;Sodnom-Ish, Buyanbileg;Choi, Sung Weon;Jung, Hyo-Il;Cho, Jaewook;Hwang, Inseong;Kim, Soung Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제46권5호
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    • pp.301-312
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    • 2020
  • In disease diagnostics and health surveillance, the use of saliva has potential because its collection is convenient and noninvasive. Over the past two decades, the development of salivary utilization for the early detection of cancer, especially oral cavity and oropharynx cancer has gained the interest of the researcher and clinician. Until recently, the oral cavity and oropharynx cancers are still having a five-year survival rate of 62%, one of the lowest in all major human cancers. More than 90% of oral cancers are oral squamous cell carcinoma (OSCC). Despite the ease of accessing the oral cavity in clinical examination, most OSCC lesions are not diagnosed in the early stage, which is suggested to be the main cause of the low survival rate. Many studies have been performed and reported more than 100 potential saliva biomarkers for OSCC. However, there are still obstacles in figuring out the reliable OSCC salivary biomarkers and the clinical application of the early diagnosis protocol. The current review article discusses the emerging issues and is hoped to raise awareness of this topic in both researchers and clinicians. We also suggested the potential salivary biomarkers that are reliable, specific, and sensitive for the early detection of OSCC.

Differential Signature of Obesity in the Relationship with Acute Kidney Injury and Mortality after Coronary Artery Bypass Grafting

  • Moon, Hongran;Lee, Yeonhee;Kim, Sejoong;Kim, Dong Ki;Chin, Ho Jun;Joo, Kwon Wook;Kim, Yon Su;Na, Ki Young;Han, Seung Seok
    • Journal of Korean Medical Science
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    • 제33권48호
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    • pp.312.1-312.10
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    • 2018
  • Background: Obesity is related to several comorbidities and mortality, but its relationship with acute kidney injury (AKI) and long-term mortality remain undetermined in patients undergoing coronary artery bypass grafting. Methods: Data from 3,018 patients (age ${\geq}18$ years) who underwent coronary artery bypass graft surgery from two tertiary referral centers were retrospectively reviewed between 2004 and 2015. Obesity was defined using the body mass index, according to the World Health Organization's recommendation. The odds and hazard ratios in post-surgical, AKI, and all-cause mortality were calculated after adjustment for multiple covariates. Patients were followed for $90{\pm}40.9$ months (maximum: 13 years). Results: Among the cohort, 37.4%, 2.4%, 21.1%, 35.1%, and 4.0% of patients were classified as normal weight, underweight, overweight-at-risk, obese I, and obese II, respectively. Post-surgical AKI developed in 799 patients (26.5%). Patients in the obese groups (overweight-at-risk to obese II) had a higher risk of AKI than did those in the normal-weight group. During the follow-up period, 787 patients (26.1%) died. Underweight patients had a higher risk of mortality than did normal-weight patients, whereas overweight-at-risk, obese I, and obese II patients showed better survival rates. Conclusion: After coronary artery bypass graft surgery, obese patients encountered a high risk of AKI, and underweight patients exhibited a low chance of survival. Awareness of both obese and underweight statuses should be raised in these patients.

Oxidative Stress and Apoptosis in Goldfish (Carassius auratus) Caused by Exposure to Different Concentrations of Micro-polystyrene

  • Li, Zhongze;Song, Jin Ah;Choi, Cheol Young
    • Ocean and Polar Research
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    • 제43권3호
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    • pp.141-148
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    • 2021
  • Microplastic contamination in waterbodies is a growing source of concern for researchers and other stakeholders. We investigated oxidative stress and toxicity in goldfish (Carassius auratus) in response to exposure to 1-㎛ diameter micro-polystyrene (MP) at concentrations of 0, 10, 100, and 1000 beads/mL (MP 0, MP 10, MP 100, and MP 1000 groups) for 7 d (at day 0, 1, 3, 5, and 7). We analyzed the survival rates; superoxide dismutase (SOD) and catalase (CAT) mRNA expression levels in the liver; SOD and CAT activity in the plasma; caspase-3 mRNA expression in the liver; and the levels of hydrogen peroxide (H2O2) in plasma. Terminal transferase dUTP nick end labeling (TUNEL) assays were also conducted to determine apoptosis levels in the liver. All fish in the MP 1000 group died by day 7 and the MP 100 group had a lower survival rate than the MP 10 and MP 0 groups. The mRNA expression as well as SOD, CAT, and caspase-3 activity levels were increased significantly with increases in MP concentration and exposure time. Finally, according to the TUNEL assay, more apoptosis was observed in the MP 1000 group at day 5 than in other groups. In summary, MP concentrations above 100 beads/mL caused death and oxidative stress to goldfish. We conclude that MP can cause oxidative stress and apoptosis in goldfish, which leads to death.

Characteristics and Clinical Outcomes of Cancer Patients who Developed Constrictive Physiology After Pericardiocentesis

  • Hyukjin Park;Hyun Ju Yoon;Nuri Lee;Jong Yoon Kim;Hyung Yoon Kim;Jae Yeong Cho;Kye Hun Kim;Youngkeun Ahn;Myung Ho Jeong;Jeong Gwan Cho
    • Korean Circulation Journal
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    • 제52권1호
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    • pp.74-83
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    • 2022
  • Background and objectives: This study aimed to identify the characteristics and clinical outcomes of cancer patients who developed constrictive physiology (CP) after percutaneous pericardiocentesis. Methods: One-hundred thirty-three cancer patients who underwent pericardiocentesis were divided into 2 groups according to follow-up echocardiography (CP vs. non-CP). The clinical history, imaging findings, and laboratory results, and overall survival were compared. Results: CP developed in 49 (36.8%) patients after pericardiocentesis. The CP group had a more frequent history of radiation therapy. Pericardial enhancement and malignant masses abutting the pericardium were more frequently observed in the CP group. Fever and ST segment elevation were more frequent in the CP group, with higher C-reactive protein levels (6.6±4.3mg/dL vs. 3.3±2.5mg/dL, p<0.001). Pericardial fluid leukocytes counts were significantly higher, and positive cytology was more frequent in the CP group. In baseline echocardiography before pericardiocentesis, medial e' velocity was significantly higher in the CP group (8.6±2.1cm/s vs. 6.5±2.3cm/s, p<0.001), and respirophasic ventricular septal shift, prominent expiratory hepatic venous flow reversal, pericardial adhesion, and loculated pericardial fluid were also more frequent. The risk of all-cause death was significantly high in the CP group (hazard ratio, 1.53; 95% confidence interval,1.10-2.13; p=0.005). Conclusions: CP frequently develops after pericardiocentesis, and it is associated with poor survival in cancer patients. Several clinical signs, imaging, and laboratory findings suggestive of pericardial inflammation and/or direct malignant pericardial invasion are frequently observed and could be used as predictors of CP development.