• Title/Summary/Keyword: cumulative survival rate

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Long-term Survival Outcomes of Laparoscopic Gastrectomy for Advanced Gastric Cancer: Five-year Results of a Phase II Prospective Clinical Trial

  • Ahn, Sang-Hoon;Kang, So Hyun;Lee, Yoontaek;Min, Sa-Hong;Park, Young Suk;Park, Do Joong;Kim, Hyung-Ho
    • Journal of Gastric Cancer
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    • v.19 no.1
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    • pp.102-110
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    • 2019
  • Purpose: Despite an increased acceptance of laparoscopic gastrectomy (LG) in early gastric cancer (EGC), there is insufficient evidence for its oncological safety in advanced gastric cancer (AGC). This is a prospective phase II clinical trial to evaluate the feasibility of LG with D2 lymph node dissection (LND) in AGC. Materials and Methods: The primary endpoint was set as 3-year disease-free survival (DFS). The eligibility criteria were as follows: 20-80 years of age, cT2N0-cT4aN3, American Society of Anesthesiologists score of 3 or less, and no other malignancy. Patients were enrolled in this single-arm study between November 2008 and May 2012. Exclusion criteria included cT4b or M1, or having final pathologic results as EGC. All patients underwent D2 lymphadenectomy. Three-year DFS rates were estimated by the Kaplan-Meier method. Results: A total of 157 patients were enrolled. The overall local complication rate was 10.2%. Conversion to open surgery occurred in 11 patients (7.0%). The mean follow-up period was $55.0{\pm}20.4months$ (1-81 months). The cumulative 3-year DFS rates were 76.3% for all stages, and 100%, 89.3%, 100%, 88.0%, 71.4%, and 35.3% for stage IB, IIA, IIB, IIIA, IIIB, and IIIC, respectively. Recurrence was observed in 37 patients (23.6%), including hematogenous (n=6), peritoneal (n=13), locoregional (n=1), distant node (n=8), and mixed recurrence (n=9). Conclusions: In addition to being technically feasible for treatment of AGC in terms of morbidity, LG with D2 LND for locally advanced gastric cancer showed acceptable 3-year DFS outcomes.

Analysis of the Shell Height Frequencies on the Fresh-Water Cockle, Corbicula elatior, by Means of Probability Graph (확률도에 의한 재첩(Corbicula elatior) 각고빈도의 분석)

  • PARK Sing Won;LEE Sung Hun
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.1 no.1
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    • pp.31-43
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    • 1968
  • 1. Shell height frequencies of the fresh-water cockle, Corbicula elatior, sampled in the period of 1960 to 1963, are analyzed to assess the age composition and average growth pattern. Cumulative frequencies in a sample are traced on a probability scale, and the points of inflection on a probability graph are assumed to dissect age groups. 2. Seasonal growth of Corbicula elatior in the Naktong River ill as follows: Young cockles settle down on river-bed by June and grow rapidly during the summer season, reaching 14mm in shell height by October. From October to April the growth is very slow. The rapid growth in the second year starts around in May. 3. Survival rate per year for Corbicula elatior in the Naktong River is estimated to be $5\~10\%$ by age composition.

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Role of Postoperative Conventional Radiation Therapy in the Management of Supratentorial Malignant Glioma - with respect to survival outcome and prognostic factors - (천막상부 악성 신경교종에서 수술 후 방사선 치료의 역할 - 생존율과 예후인자 분석 -)

  • Nam Taek Keun;Chung Woong Ki;Ahn Sung Ja;Nah Byung Sik
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.389-398
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    • 1998
  • Purpose : To evaluate the role of conventional postoperative adjuvant radiotherapy in the management of supratentorial malignant glioma and to determine favorable prognostic factors affecting survival. Materials and Methods : From Sep. 1985 to Mar. 1997, the number of eligible patients who received postoperative radiotherapy completely was 69. They ranged in age from 7 to 66 years (median, 47). Forty-two (61$\%$) patients were glioblastoma multiforme and the other 27 (39$\%$) were anaplastic astrocytoma. Twenty patients (29$\%$) had Karnofsky score equal or more than 80 preoperatively. Forty-three patients (62$\%$) had symptom duration equal or less than 3 months. Twenty-four patients (35$\%$) had gross total resection and forty patients(58$\%$) had partial resection, the remaining five patients (7$\%$) had biopsy only. Radiotherapy dose ranged from 50.4 Gy to 61.2 Gy (median, 55.8; mode, 59.4) with fraction size of 1 8 Gy-2.0 Gy for 33-83 days(median, 48) except three patients delivered 33, 36, 39 Gr, respectively with fraction size of 3.0 Gy due to poor postoperative performance status. Follow-up rate was 93$\%$ and median follow-up period was 14 months. Results : Overall survival rate at 2 and 3 years and median survival were 38$\%$, 20$\%$, and 16 months for entire patients; 67$\%$, 44$\%$, and 34 months for anaplastic astrocytoma; 18$\%$, 4$\%$, and 14 months for glioblastoma multiforme, respectively (p=0.0001). According to the extent of surgery, 3-year overall survival for gross total resection, partial resection, and biopsy only was 38$\%$, 11$\%$, and 0$\%$, respectively (p=0.02) The 3-year overall survival rates for patients age 40>, 40-59, and 60< were 52$\%$, 8$\%$, and 0$\%$, respectively (p=0.0007). For the variate of performance score 80< vs 80>, the 3-year survival rates were 53$\%$ and 9$\%$, respectively (p=0.008). On multivariate analysis including covariates of three surgical and age subgroups as above, pathology, extent of surgery and age were significant prognostic factors affecting overall survival. On another multivariate analysis with covariates of two surgical (total resection vs others) and two a9e (50> vs 50<) subgroups, then, pathology, extent of surgery and performance status were significant factors instead of age and 3-year cumulative survival rate for the five patients with these three favorable factors was 100$\%$ without serious sequela. Conclusion : We confirmed the role of postoperative conventional radiotherapy in the management of supratentorial malignant glioma by improving survival as compared with historical data of surgery only. Patients with anaplastic astrocytoma, good performance score, gross total resection and/or young age survived longest. Maximum surgical resection with acceptable preservation of neurologic function should be attempted in glioblastoma patients, especially in younger patients. But the survival of most globlastoma patients without favorable factors is still poor, so other active adjuvant treatment modalities should be tried or added rather than conventional radiation treatment alone in this subgroup.

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Role of Postoperative Radiation Therapy in the Management of Cervical Cancer (자궁경부암에서 수술 후 방사선치료의 역할)

  • Chun, Ha-Chung;Lee, Myung-Za
    • Radiation Oncology Journal
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    • v.22 no.4
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    • pp.265-270
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    • 2004
  • Purpose: To evaluate the effectiveness of postoperative radiation therapy in cervical cancer patients and define the prognostic factors to affect survival rates. Materials and Methods: Eighty one patients with cervical cancer who were treated with postoperative radiation therapy following surgery at our institution between May 1992 and April 2000 were retrospectivelv analyzed. Forty two patients had stage IB disease, 17 had stage IIA disease, and remaining 22 had stage IIB disease, respectively. Histological examination revealed 76 squamous cell carcinoma and 5 adenocarclnoma. Sixty one patients were noted to have stromal invasion greater than 8 mm and 20 patients were noted to have stromal invasion 7 mm or less. Sixteen patients had parametrial invasion and 65 patients did not. Positive vaginal resection margin was documented in only eight patients and positive lymphovascular invasion was in twelve patients. All of the patients were treated with external beam radiation therapy alone. Majority of the patients were treated with 4 field brick technique to encompass whole pelvis. Total of 5,500 cGy was delivered to the primary surgical tumor bed. Minimum follow up period was four years. Results: Actuarial disease free survival rates for entire group of the patients were 95% and 89% at 2 and 5 years, respectively Five year disease free survival rates for patients with stage IB, IIA, and IIB disease were 97%, 87% and 70%, respectivelv. Local recurrences were documented in 5 patients. Cumulative local failure rate at 3 years was 6% Five year disease free survival rates for patients with stromal invasion greater than 8 mm and 7 mm or less were 88% and 92%, respectively (p>0.05). Five year disease free survival rate for patients with parametrial invasion was significantly lower than those with no invasion (72% vs 92%, p<0.05). Also there was significantly lower survival in patients with positive vaginal resection margin, compared with patients with negative resection margin (64% vs 94%, p<0.05). However, lymphovascular invasion was not a statistically significant prognostic factor Parametrial invasion and positive surgical resection margins were noted to be significant prognostic factors. Conclusions: Postoperative radiation therapy appears to be beneficial in controlling local disease in cervical cancer patients with high pathologic risk factors. Parametrial invasion and positive resection margins were noted to be significant prognostic factors to affect survival and more effective treatment should be investigated in these patients.

Effect of Polymer, Calcium, Perlite and Chitosan in Organic Amendment on Growth in Kentucky Bluegrass (유기질개량재에서 폴리머, 칼슘, 펄라이트 및 키토산 성분이 켄터키 블루그래스의 생장에 미치는 효과)

  • Kim, Kyoung-Nam
    • Weed & Turfgrass Science
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    • v.3 no.1
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    • pp.19-28
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    • 2014
  • Research was initiated in greenhouse to investigate effects of polymer, calcium, perlite and chitosan on the growth of Kentucky bluegrass (KB). A total of 24 treatment combinations were used in the study. Treatments were made of water-swelling polymer (WSP), calcium, perlite, and chitosan in soil organic amendment (SOA). Significant differences were observed in germination rate, turfgrass coverage, turfgrass density and top growth among treatments. Germination rate, density and plant height varied with time after seeding. A proper mix of WSP is considered to be lower than 3% for turfgrass coverage and density. Regarding survival capability and top growth, however, it was good under 6%. Overall KB growth was more influenced by calcium and perlite than chitosan. Calcium and perlite were the most effective elements for early survival capacity and turfgrass density, respectively. But no effect was found by chitosan. Top growth increased with three elements, being perlite > calcium > chitosan. The chitosan was effective in early germination, but there was no effect on top growth until 3 weeks, when compared with others. A further study is needed for investigating the effect of these materials on the growth characteristics in mixtures of sand and SOA before a field application.

Clinical and radiographic evaluation of $Neoplan^{(R)}$ implant with a sandblasted and acid-etched surface and external connection (SLA 표면 처리 및 외측 연결형의 국산 임플랜트에 대한 임상적, 방사선학적 평가)

  • An, Hee-Suk;Moon, Hong-Suk;Shim, Jun-Sung;Cho, Kyu-Sung;Lee, Keun-Woo
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.2
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    • pp.125-136
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    • 2008
  • Statement of problem: Since the concept of osseointegration in dental implants was introduced by $Br{{\aa}}nemark$ et al, high long-term success rates have been achieved. Though the use of dental implants have increased dramatically, there are few studies on domestic implants with clinical and objective long-term data. Purpose: The aim of this retrospective study was to provide long-term data on the $Neoplan^{(R)}$ implant, which features a sandblasted and acid-etched surface and external connection. Material and methods: 96 $Neoplan^{(R)}$ implants placed in 25 patients in Yonsei University Hospital were examined to determine the effect of the factors on marginal bone loss, through clinical and radiographic results during 18 to 57 month period. Results: 1. Out of a total of 96 implants placed in 25 patients, two fixtures were lost, resulting in 97.9% of cumulative survival rate. 2. Throughout the study period, the survival rates were 96.8% in the maxilla and 98.5% in the mandible. The survival rates were 97.6% in the posterior regions and 100% in the anterior regions. 3. The mean bone loss for the first year after prosthesis placement and the mean annual bone loss after the first year for men were significantly higher than that of women (P<0.05). 4. The group of partial edentulism with no posterior teeth distal to the implant prosthesis showed significantly more bone loss compared to the group of partial edentulism with presence of posterior teeth distal to the implant prosthesis in terms of mean bone loss for the first year and after the first year (P<0.05). 5. The mean annual bone loss after the first year was more pronounced in posterior regions compared to anterior regions (P<0.05). 6. No significant difference in marginal bone loss was found in the following factors: jaws, type of prostheses, type of opposing dentition, and submerged /non-submerged implants (P<0.05). Conclusion: On the basis of these results, the factors influencing marginal bone loss were gender, type of edentulism, and location in the arch, while the factors such as arch, type of prostheses, type of opposing dentition, submerged / non- submerged implants had no significant effect on bone loss. In the present study, the cumulative survival rate of the $Neoplan^{(R)}$ implant with a sandblasted and acid-etched surface was 97.9% up to a maximum 57-month period. Further long-term investigations for this type of implant system and evaluation of other various domestic implant systems are needed in future studies.

Technical complications of cement-retained implant-supported single crowns and splinted crowns with zirconia frameworks (지르코니아 프레임워크를 이용한 시멘트 유지형 임플란트-지지 단일 크라운과 연결 크라운의 보철적 합병증)

  • You, Sang-Choon;Bae, Jung-Yoon
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.1
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    • pp.26-31
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    • 2017
  • Purpose: This study was to assess clinically the success rates and technical complications of cement-retained implant-supported single crowns and splinted crowns with zirconia frameworks. Materials and methods: 75 (single crowns: 51, splinted crowns: 24) cement-retained implant-supported single crowns and splinted crowns with zirconia frameworks which were restored in 67 patients were investigated for the evaluation of the success rates and technical complications. All restorations were cemented with temporary cement. Age, gender, restoration position, opposing teeth, restoration type were assessed as possible factors affecting technical complications. Results: During the mean observation period of 22.2 months, cumulative success rates of all restorations were 66.9 (73.2 - 60.6)%. Retention loss was found in 16 restorations (single crowns: 14, splinted crowns: 2), abutment screw loosening and veneer porcelain fracture were found in each 2 single crowns, respectively. According to a Kaplan-Meier survival analysis of single crowns and splinted crowns, the cumulative success rates were 58.9 (66.6 - 51.2)%, 87.5 (96.1 - 78.9)%, respectively. There was a statistically significant difference. The other possible factors did not have a significant effect on the technical complications. Conclusion: Retention loss was the most frequent technical complication. Abutment screw loosening and veneer porcelain fracture were found rarely in single crowns only. Age, gender, restoration position, and antagonist did not have significant effect on the technical complications. Splinted crowns had a higher success rate than single crowns.

Effects of Dietary Scutellaria baicalensis Extract on Growth, Feed Utilization and Challenge Test of Olive Flounder (Paralichthys olivaceus)

  • Cho, S.H.;Jeon, G.H.;Kim, H.S.;Kim, D.S.;Kim, C.
    • Asian-Australasian Journal of Animal Sciences
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    • v.26 no.1
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    • pp.90-96
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    • 2013
  • Effects of dietary Scutellaria baicalensis extract (SBE) on growth, feed utilization and challenge test of olive flounder (Paralichthys olivaceus) were determined. Six hundred thirty fish averaging 5.0 g were distributed into 18, 180-L tanks. Six experimental diets were prepared in triplicate: SBE-0, SBE-0.5, SBE-1, SBE-2, SBE-3 and SBE-5 diets containing SBE at the concentrations of 0, 0.5, 1, 2, 3 and 5%, respectively. Fish were hand-fed to apparent satiation twice a day for 8 wks. At the end of 8-wk feeding trial, ten fish from each tank were infected by Edwardsiella tarda for challenge test. Survival and weight gain of fish were not affected by dietary concentrations of SBE. However, specific growth rate of fish fed the SBE-2 diet was higher than that of fish fed the SBE-0, SBE-1, SBE-3 and SBE-5 diets. Neither feed efficiency nor serum chemical composition of fish was affected by dietary concentrations of SBE. The cumulative mortality of fish fed the SBE-0 diet was 100% at 96 h after E. tarda infection, but 77 to 87% for fish fed the other diets. Dietary inclusion of 2% SBE appears to be recommendable to improve specific growth rate of fish and SBE had the potential to mitigate mortality of fish at E. tarda infection.

Long-Term Results of Double Mitral and Aortic Valve Replacement (승모판과 대동맥판 중복치환환자의 장기임상성적)

  • 김종환
    • Journal of Chest Surgery
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    • v.24 no.6
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    • pp.541-546
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    • 1991
  • The Ionescu-Shiley bovine pericardial xenograft valve was the most common cardiac substitute valve at Seoul National University Hospital. Since the follow-up extended for longer than 10 years, a total of and consecutive 107 patients with double mitral and aortic valve replacement using this valve from May 1979 to June 1984 were studied for the long-term clinical results. Their ages were 34.0$\pm$11.9 years at surgery, and eight patients died within 30 days of surgery with operative mortality rate of 7.5%. Ninety-nine early survivors were followed up for a total of 488.1 patient-years[Mean$\pm$SD, 4.9$\pm$2.7 years], and nine died with the linearlized late mortality rate of 1.84% /patient-year[pt-yr]. They experienced major complications: thromboembolism, 0.615% /pt-yr bleeding, 0.205% /pt-yr; endocarditis, l. 639%/pt-yr; overall valve failure, 6.146% /pt-yr; and primary tissue failure, 1.639%/ pt-yr. The actuarial survival rates were 91.4$\pm$2.9% and 89.6$\pm$3.4% at postoperative 5 and 10 years, and the probability of freedom from thromboembolism was 95.8$\pm$2.5% at 10 years. The primary tissue failure began to occur from postoperative 6 years and the probabilities of freedom from structural valve failure were 80.2$\pm$7.9% and 62.3$\pm$12.7% at 8 and 10 years after surgery respectively. Although there was increasing number of patients with valve tissue failure after 6 years, the evidence of expected premature and accelerated valve degeneration among young population was not clear on the age-related analysis. And, no definite cumulative patient groups beyond the various age limits could be suggested for or against the use of this valve.

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Treatment of Atrial Fibrillation in Elderly Patients with the Cox Maze Procedure Concurrently with Other Cardiac Operations

  • Kuh, Ja Hong;Song, Joon Young;Kim, Tae Youn;Kim, Jong Hun;Choi, Jong Bum
    • Journal of Chest Surgery
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    • v.50 no.3
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    • pp.171-176
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    • 2017
  • Background: In elderly patients who have atrial fibrillation (AF), surgical ablation of the arrhythmia during cardiac surgery may be challenging. Despite the reported advantages of ablating AF with the Cox maze procedure (CMP), the addition of the CMP may complicate other cardiac operations. We evaluated the effect of the CMP in elderly patients concurrent with other cardiac operations. Methods: From October 2007 to December 2015, we enrolled 27 patients aged >70 years who had AF and who underwent the CMP concurrently with other cardiac operations. The mean preoperative additive European System for Cardiac Operative Risk Evaluation score was $8{\pm}11$ (high risk). Results: Only 1 hospital death occurred (4%). The Kaplan-Meier method showed a high 5-year cumulative survival rate (92%). At mean follow‐up of 51 months, 23 patients (89%) had sinus rhythm conversion. The postoperative left atrial dimensions did not significantly differ between the 8 patients who had reduction plasty for giant left atrium ($53.4{\pm}7.5cm$) and the 19 patients who did not have reduction plasty ($48.7{\pm}5.7cm$). Conclusion: In patients aged >70 years, concurrent CMP may be associated with a high rate of sinus rhythm conversion without increased surgical risk, despite the added complexity of the main cardiac procedure.