• 제목/요약/키워드: clinical incidence and prognosis

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자발성 뇌실질내 출혈 환자에서 혈종 증가의 위험 인자에 대한 분석 (Analysis of the Risk Factors of Hematoma Enlargement in Patients with Spontaneous Intracerebral Hemorrhage)

  • 이용묵;고현송;염진영;김성호;송시헌;김윤
    • Journal of Korean Neurosurgical Society
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    • 제30권4호
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    • pp.437-442
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    • 2001
  • Objective : The purpose of this study was to evaluate the risk factors of hematoma enlargement in patients with spontaneous intracerebral hemorrhage(ICH). Methods : A series of 214 ICH patients diagnosed by brain CT scan in our neurosurgery department from June 1995 to July 1998 were reviewed with clinical status, past medical histories, laboratory findings, CT findings and prognosis. Results : In 27 patients(12.6%), the second CT scan showed an enlarged hematoma. Age, sex, and site of hematoma were not related to hematoma enlargement. A long interval(>6 hours) between the onset and the 1st CT scan strongly reduced the incidence of hematoma enlargement. The incidence of hematoma enlargement significantly increased in patients with previous history of hypertension, cerebral infarction and ICH. This analysis also demonstrated the following independent factors predisposed to hematoma enlargement : initial high systolic blood pressure, high serum total protein, low serum albumin, low serum sodium, prolonged prothrombin time(>14 sec) and activated partial thromboplastin time(>29.5 sec), irregular hematoma shape, and combined intraventricular hemorrhage. Prognosis in the group of hematoma enlargement showed high mortality(48.1%) and poor outcome. Conclusion : Patients with previous history of hypertension, cerebral infarction and ICH, and with high systolic blood pressure, prolonged coagulation time, irregular hematoma shape and intraventricular hemorrhage in CT scan should be observed carefully. And, early surgical therapy of large hematoma and meticulous control of blood pressure may decrease the mortality and morbidity in patients with spontaneous ICH.

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위암에서 새로운 제8판 AJCC 병기 분류의 임상적, 조직 병리학적 시사점 (Clinicopathologic Implication of New AJCC 8th Staging Classification in the Stomach Cancer)

  • 김성은
    • Journal of Digestive Cancer Reports
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    • 제7권1호
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    • pp.13-17
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    • 2019
  • Stomach cancer is the fifth most common malignancy in the world. The incidence of stomach cancer is declining worldwide, however, gastric cancer still remains the third most common cause of cancer death. The tumor, node, and metastasis (TNM) staging system has been frequently used as a method for cancer staging system and the most important reference in cancer treatment. In 2016, the classification of gastric cancer TNM staging was revised in the 8th American Joint Committee on Cancer (AJCC) edition. There are several modifications in stomach cancer staging in this edition compared to the 7th edition. First, the anatomical boundary between esophagus and stomach has been revised, therefore the definition of stomach cancer and esophageal cancer has refined. Second, N3 is separated into N3a and N3b in pathological classification. Patients with N3a and N3b revealed distinct prognosis in stomach cancer, and these results brought changes in pathological staging. Several large retrospective studies were conducted to compare staging between the 7th and 8th AJCC editions including prognostic value, stage grouping homogeneity, discriminatory ability, and monotonicity of gradients globally. The main objective of this review is to evaluate the clinical and pathological implications of AJCC 8th staging classification in the stomach cancer.

Limited Clinical Significance of Splenectomy and Splenic Hilar Lymph Node Dissection for Type 4 Gastric Cancer

  • Kunitomo, Aina;Misawa, Kazunari;Ito, Yuichi;Ito, Seiji;Higaki, Eiji;Natsume, Seiji;Kinoshita, Takashi;Abe, Tetsuya;Komori, Koji;Shimizu, Yasuhiro
    • Journal of Gastric Cancer
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    • 제21권4호
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    • pp.392-402
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    • 2021
  • Purpose: Type 4 gastric cancer (GC) has a very poor prognosis even after curative resection, and the survival benefit of splenectomy for splenic hilar lymph node (LN; #10) dissection in type 4 GC remains equivocal. This study aimed to clarify the clinical significance of splenectomy for #10 dissection in patients with type 4 GC. Materials and Methods: The data of a total of 56 patients with type 4 GC who underwent total gastrectomy with splenectomy were retrospectively analyzed. Postoperative morbidity, state of LN metastasis, survival outcomes, and therapeutic value index (TVI) of each LN station were evaluated. TVI was calculated by multiplying the incidence of LN metastasis at each nodal station and the 5-year overall survival (OS) of patients who had metastasis to each node. Results: Overall, the postoperative morbidity rate was 28.6%, and the incidence of #10 metastasis in the patients was 28.6%. The 5-year OS rate for all patients was 29.9%, and most patients developed peritoneal recurrence. Moreover, the 5-year OS rates with and without #10 metastasis were 6.7% and 39.1% (median survival time, 20.4 vs. 46.0 months; P=0.006). The TVI of #10 was as low as 1.92. Conclusions: The clinical significance of splenectomy in the dissection of #10 for type 4 GC is limited and splenectomy for splenic hilar dissection alone should be omitted.

The Clinical, Molecular, and Mechanistic Basis of RUNX1 Mutations Identified in Hematological Malignancies

  • Yokota, Asumi;Huo, Li;Lan, Fengli;Wu, Jianqiang;Huang, Gang
    • Molecules and Cells
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    • 제43권2호
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    • pp.145-152
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    • 2020
  • RUNX1 plays an important role in the regulation of normal hematopoiesis. RUNX1 mutations are frequently found and have been intensively studied in hematological malignancies. Germline mutations in RUNX1 cause familial platelet disorder with predisposition to acute myeloid leukemia (FPD/AML). Somatic mutations of RUNX1 are observed in various types of hematological malignancies, such as AML, acute lymphoblastic leukemia (ALL), myelodysplastic syndromes (MDS), myeloproliferative neoplasm (MPN), chronic myelomonocytic leukemia (CMML), and congenital bone marrow failure (CBMF). Here, we systematically review the clinical and molecular characteristics of RUNX1 mutations, the mechanisms of pathogenesis caused by RUNX1 mutations, and potential therapeutic strategies to target RUNX1-mutated cases of hematological malignancies.

결출치아의 재식술후 효과에 관한 임상적 연구 (A CLINICAL STUDY ON REPLANTATION OF AVULSED PERMANENT TEETH)

  • 이의웅
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제26권1호
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    • pp.73-79
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    • 2000
  • A material of 48 patients with 60 avulsed and replanted permanent teeth were followed retrospectively in the period of 1996. 1 to 1998. 12 (mean observation period=1year 7months). The age of the patients at the time of replantation ranged from 9 to 63 years (mean=24 years). Clinical records of patients were reviewed to obtain valid data concerning the extent of injury and treatment provided. Pulpal and periodontal healing states were examined with periapical x-rays and clinical examination procedures (i.e. percussion test and mobility test) at their recall visit. Root ankylosis was found in fifty-two teeth(87%) and root resorption in twenty-four(40%). Only two of the replanted teeth(3%) showed partial regeneration of the periodontal ligament. Six teeth(10%) resulted in tooth loss, but the remaining fifty-four were clinically well functioning. Most of teeth have mild marginal bone loss accompanied by gingival retraction without pathological periodontal pockets. The incidence of root resorption was much higher in younger age group. However, it was not affected by the interval between avulsion and replantation, the condition of supporting tissues, the degree of root formation and the type of splinting, indicating that multiple factors involved in determining the prognosis of replanted teeth. Based on these findings, avulsed teeth in unfavorable conditions (i.e. long extra-alveolar periods, etc.) should be preserved if possible.

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Glufosinate 중독 환자의 신경학적 예후 인자로서 APACHE II Score의 유용성 (Utility of the APACHE II Score as a Neurologic Prognostic Factor for Glufosinate Intoxicated Patients)

  • 유대한;이정원;최재형;정동길;이동욱;이영주;조영신;박준범;정혜진;문형준
    • 대한임상독성학회지
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    • 제14권2호
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    • pp.107-114
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    • 2016
  • Purpose: The incidence of glufosinate poisoning is gradually increasing, and it can be fatal if severe poisoning occurs. However, factors useful for predicting the post-discharge neurological prognosis of patients who have ingested glufosinate have yet to be identified. Our objective was to evaluate the utility of the acute physiology and chronic health evaluation (APACHE) II score measured in the emergency department for predicting the neurological prognosis. Methods: From April 2012 to August 2014, we conducted a retrospective study of patients who had ingested glufosinate. The outcome of the patients at discharge was defined by the Cerebral Performance Category Score (CPC). The patients were divided into a good prognosis group (CPC 1, 2) and a poor prognosis group (CPC 3, 4, 5), after which the APACHE II scores were compared. The Hosmer-Lemeshow test and the area under the receiver operating characteristic (ROC) curve from patients determined calibration and discrimination. Results: A total of 76 patients were enrolled (good prognosis group: 67 vs poor prognosis group: 9). The cut-off value for the APACHE II score was 12 and the area under the curve value was 0.891. The Hosmer and Lemeshow C statistic x2 was 7.414 (p=0.387), indicating good calibration for APACHE II. Conclusion: The APACHE II score is useful at predicting the neurological prognosis of patients who have ingested glufosinate.

Clinical Features and Prognosis of Corneal Ulcers in Dogs with Chronic Kidney Disease

  • Choi, Heeyeon;Kim, Se Eun;Kim, Taehyun;Jang, Jaeyoung;Hwang, Sun Young;Seo, Kangmoon
    • 한국임상수의학회지
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    • 제38권3호
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    • pp.115-119
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    • 2021
  • This study was designed to investigate the characteristics of corneal ulcers in dogs with chronic kidney disease (CKD). Medical records of dogs that had been diagnosed with corneal ulcers and chronic kidney disease at Haemaru Referral Animal Hospital between April 1, 2011 and March 31, 2016 were investigated. A control group was randomly selected during the same time period. This group included patients with corneal ulcers but no evidence of systemic disease. The mean healing time of superficial corneal ulcers in the CKD group was 21.0 ± 15.0 days. This was a significantly longer healing time than was observed in the control group (11.0 ± 6.6 days, p = 0.019). The incidence rates of uveitis and keratoconjunctivitis sicca in the CKD group were significantly higher than in the control group (p = 0.000 and p = 0.026, respectively). Additionally, non-healing ulcers had significantly elevated white blood cell counts, while those with healing ulcers had WBC counts within the normal range in CKD group (p = 0.000). This study revealed that corneal ulcers in CKD patients would be delayed epithelial healing process and accompanied by ocular disease which affected to corneal healing compared to non-CKD patients.

Clinical Grading System, Surgical Outcomes and Prognostic Analysis of Cranial Base Chordomas

  • Wang, Benlin;Tian, Fengxuan;Tong, Xiaoguang
    • Journal of Korean Neurosurgical Society
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    • 제65권3호
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    • pp.469-478
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    • 2022
  • Objective : Cranial base chordomas are rare, but their treatment is challenging. Tumor recurrence is still common despite improvements in microsurgical techniques and postoperative radiotherapy. We retrospectively analyzed the course of treatment, overall survival, and recurrence/progression of chordomas over the past 10 years. Methods : We retrospectively reviewed 50 patients who underwent surgery at Tianjin Huanhu Hospital between 2010 and 2020 and were pathologically diagnosed with chordomas. Tumor resection was performed within the maximum safe range in all patients; the extent of resection was evaluated by imaging; and the incidence of complications, recurrence or progression, and overall survival were assessed. Results : Fifty patients were divided into the low-risk group (LRG) and high-risk group (HRG) based on the cranial chordoma grading system (CCGS). The Karnofsky Performance Scale scores and gross total resection rate of the LRG were significantly higher than those of the HRG (p<0.05). The incidence of complications and mortality in the LRG were lower than those of HRG. The analysis of cumulative survival and cumulative recurrence free survival/progression free survival (RFS/PFS) showed no statistical differences in the extent of resection for survival, recurrence, or progression. Univariate and multivariate analyses showed that Ki-67 was significantly associated with tumor recurrence and was an independent hazard factor (p=0.02). Conclusion : The CCGS can help neurosurgeons anticipate surgical outcomes. Pathological results are important in evaluating the possibility of tumor recurrence, and postoperative radiotherapy improves overall survival and RFS/PFS.

Lymphangiogenic and Angiogenic Microvessel Density in Chinese Patients with Gastric Carcinoma: Correlation with Clinicopathologic Parameters and Prognosis

  • Cao, Fang;Hu, Yong-Wei;Li, Ping;Liu, Ying;Wang, Kuo;Ma, Lei;Li, Peng-Fei;Ni, Can-Rong;Ding, Hou-Zhong
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권8호
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    • pp.4549-4552
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    • 2013
  • The incidence of gastric cancer worldwide, and in particular in developing countries, has shown a marked increase. Poor prognosis of gastric cancer patients occurs due to the rapid metastasis of the disease via the lymphatic and blood vessels. The aim of this study was to investigate the expression and the clinical significance of D2-40 and CD34 in human gastric cancer. D2-40 and CD34 expression wasdetected in 1,072 cases of Chinese patients with gastric carcinoma using immunohistochemistry. The lymphatic vessel density (LVD) and microvessel density (MVD) were calculated and analyzed and the correlation with the clinicopathological factors and prognosis was determined. The LVD and MVD of the gastric cancer cases were significantly higher compared to those of normal tissues (P < 0.05). The expression of D2-40-LVD and CD34-MVD in the malignancies were positively related to the age, tumor size, invasion depth, lymphatic metastasis and pathological tumor-node-metastasis (pTNM) (P < 0.05); However, no statistically significant difference was identified between them with the patient gender (P > 0.05). Up-regulation of D2-40 and CD34 expression was significantly correlated with the poor survival rate in univariate and multivariate analyses. The LVD marked by D2-40 and the MVD marked by CD34 were positively correlated to the clinicopathological factors of the malignancies and may play important role in the development and progression of gastric cancer.

Properties of Synchronous Versus Metachronous Bilateral Breast Carcinoma with Long Time Follow Up

  • Eliyatkin, Nuket;Zengel, Baha;Yagci, Ayse;Comut, Erdem;Postaci, Hakan;Uslu, Adam;Aktas, Safiye
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권12호
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    • pp.4921-4926
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    • 2015
  • Background: Breast cancer is the most common cancer type among women with increasing incidence rates, improved prognosis and survival. According to the localization of the tumor, breast cancer is designated as unilateral (UBC) or bilateral (BBC). BBC can be classified as synchronous (SBBC) or metachronous (MBBC) based on the time interval between the diagnosis of the first and the secondary tumors. According to the guideline of WHO 2012, BBC is generally defined as SBBC when contralateral breast carcinoma is diagnosed within 3 months. The aim of this study was to compare the characteristics and patterns of metastasis of BBC patients with UBC. Materials and Methods: A cohort of 768 patients with breast cancer treated at the Turkish Ministry of Health-Izmir Bozyaka Research and Training Hospital between 1976 and 2012 were studied. Survival analysis was performed comparing UBC and BBC patients. In addition, evaluations were performed in patients with SBBC and MBBC sub-groups. We used a 3-months interval to distinguish metachronous from synchronous. Results: When clinical and histopathological parameters were statistically evaluated, ER status, event-free and overall survival were found to be significant between UBC and BBC patients. In comparison of SBBC and MBBC patients, age, histological type of tumor, event-free and overall survival were found to be significant. Conclusions: BBC cases were found to show worse prognosis than UBC cases. Among BBC, SBBC had the worst prognosis based on overall survival rates.