• Title/Summary/Keyword: disease outcome

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Surgical Results of Patients with Isthmic Spondylolisthesis with Transpedicular Screw Fixation and Posterior Lumbar Interbody Fusion Using Posterior Movable Segment (협부형 척추전방전위증에 대한 후방가동관절 이용한 골유합술 및 척추경나사못 고정술의 수술적 결과)

  • Kim, Chan;Lee, Seung Myung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup1
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    • pp.108-114
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    • 2001
  • Objective : Posterior lumbar interbody fusion(PLIF) provides the favorable outcome to degenerative lumbar disease, especially isthmic spondylolisthesis. To determine the long-term effect of PLIF using psterior movable segment, we analysed the results of follow-up radiologic changes and surgical outcome retrospectively Patients and Method : During the past 11 years(1989. 1.-1999. 9.), 148 patients with symptomatic lumbar spondylolisthesis were managed at our department and the clinical wants were throughly recieved and final outcome is determined at last follow up. PLIF using antogenous bone(posterior movable segment, iliac bone and rib) were performed in 106 case. Results : After an average follow-up period of 33 months(range ; 15-58 months), the results were excellent in 66 cases, good in 37 cases, fair in 2 cases and poor in 1 cases. And the satisfactory results were 103 cases(98.2%) in PLIF,. Conclusion : In conclusion, patients who underwent PLIF with autologous bone graft had good clinical and radiological outcomes without significant neurological complications.

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Prostate Cancer: A Hospital-Based Survival Study from Mumbai, India

  • Balasubramaniam, Ganesh;Talole, Sanjay;Mahantshetty, Umesh;Saoba, Sushama;Shrivastava, Shyam
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2595-2598
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    • 2013
  • Background: Prostate cancer is common in elderly men, especially in western countries, and incidences are rising in low-risk populations as well. In India, the age-standardized rates vary between registries. Under these circumstances we have estimated the survival of prostate cancer patients based on age, family history, diabetes, hypertension, tobacco habit, clinical extent of disease (risk group) and treatment received. Materials and Methods: The present retrospective study was carried out at the Tata Memorial Hospital (TMH), Mumbai, India. During years 1999-2002, some 850 prostate cancer cases, including 371 new cases, treated in TMH were considered as eligible entrants for the study. Five-year survival rates using actuarial and loss-adjusted (LAR) method were estimated. Results: The patient population was distributed uniformly over the three age groups. A larger proportion of the patients were diagnosed at 'metastatic stage' and hormone treatment was most common. 20% patients had history of diabetes and 40% with hypertension. The 5-year overall survival rate was 64%. Survival was 55%, 74% and 52% for '<59 years','60-69 years' and '>70 years' respectively. Non-diabetic (70%), hypertensive (74%), with family history (80%) of cancer, with localized-disease (91%) and treated with surgery, either alone or in combination, (91%) had better survival. Conclusions: The present study showed that prostate cancer patients with localized disease at diagnosis experience a better outcome. Local treatment with either surgery or radiation achieves a reasonable outcome in prostate cancer patients. A detailed study will help in understanding the prognostic indicators for survival especially with the newer treatment technologies available now.

The outcome of short-term low-dose aspirin treatment in Kawasaki disease based on inflammatory markers

  • Yoo, Jae Won;Kim, Ji Mok;Kil, Hong Ryang
    • Clinical and Experimental Pediatrics
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    • v.60 no.1
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    • pp.24-29
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    • 2017
  • Purpose: Previously, Kawasaki disease (KD) treatment with low-dose aspirin was administered for 6-8 weeks after the acute phase. However, inflammatory marker levels normalize before 6-8 weeks. In this study, we aimed to investigate the clinical outcome of short-term low-dose aspirin treatment based on inflammatory and thrombotic marker levels. Methods: We performed a retrospective review of the medical records of patients with KD who were hospitalized at Chungnam National University Hospital between September 2012 and May 2014. When fever subsided, low-dose aspirin treatment was started. Inflammatory (white blood cell count, erythrocyte sedimentation rate, and C-reactive protein) and thrombotic markers (D-dimer) were monitored at follow-ups conducted in 1- to 2-week intervals. The low-dose aspirin administration was terminated when both markers were normalized and no cardiovascular complications were observed. Results: Eighty-four patients with KD (complete KD, n=49; incomplete KD, n=35) were enrolled. The inflammatory and thrombotic marker levels were normalized within 3-4 weeks on average. At the beginning the low-dose aspirin treatment, 9 patients had coronary artery lesions but 75 did not. When the low-dose aspirin administration was terminated at the time the inflammatory marker levels were normalized, no new CALs developed during the follow-up at 6-8 weeks. Conclusion: Most of the inflammatory marker levels were normalized within 3-4 weeks after the acute phase of KD. New cardiovascular complications did not develop during the course of the short-term aspirin treatment based on the inflammatory marker levels, clinical findings, and echocardiography.

HPV-Associated p16INK4A Expression and Response to Therapy and Survival in Selected Head and Neck Cancers

  • Kanyilmaz, Gul;Ekinci, Ozgur;Muge, Akmansu;Celik, Sevinc;Ozturk, Furkan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.1
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    • pp.253-258
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    • 2015
  • Background: Development of squamous cell cancer of head and neck (SCCHN) is associated with human papillomavirus (HPV) infection, which in turn is closely related with expression of $p16^{INK4A}$. Loss of $p16^{INK4A}$ expression by deletion, mutation, or hypermethylation is common in SCCHN. We here evaluated $p16^{INK4A}$ as a prognostic marker of treatment response and survival in our SCCHN patients with laryngeal, hypopharyngeal or nasopharyngeal cancers. Materials and Methods: 131 patients diagnosed with SCCHN between January 2,2006 and July 17, 2010 were examined for $p16^{INK4A}$. The median age was 60 years (15-82 years). Fifty one patients were stage I-II and 80 were stage III-IV. Immunohistochemical expression of $p16^{INK4A}$ was analyzed in pretreatment paraffin-embedded tumor blocks. The influence of $p16^{INK4A}$ status on disease-free survival, and overall survival after treatment was evaluated. Results: $p16^{INK4A}$ positivity was found in 58 patients (44%). Tumor-positivity for$ p16^{INK4A}$ was correlated with improved disease free survival (70.1 months vs 59 months) and improved overall survival (2, 3 and 5-year values; 77% vs 72%, 70% vs 63% and, 63% vs 55%; respectively). On multivariate analysis, stage was determined as independent prognostic factor for disease-free survival. Conclusions: Stage was the major prognostic factor on treatment response and survival in our patients. $p16^{INK4A}$ status predicts better outcome in laryngeal, hypopharyngeal or nasopharyngeal cancer cases treated with surgery plus adjuvant radiochemotherapy as well as with definitive radiation therapy and/or chemotherapy.

Hemolytic uremic syndrome (용혈성 요독 증후군)

  • Park, Hye Won
    • Clinical and Experimental Pediatrics
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    • v.50 no.10
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    • pp.931-937
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    • 2007
  • The hemolytic uremic syndrome (HUS) is a rare disease of microangiopathic hemolytic anemia, low platelet count and renal impairment. HUS usually occurs in young children after hemorrhagic colitis by shigatoxin-producing enterohemorrhagic E. coli (D+HUS). HUS is the most common cause of acute renal failure in infants and young children, and is a substantial cause of acute mortality and morbidity; however, renal function recovers in most of them. About 10% of children with HUS do not reveal preceding diarrheal illness, and is referred to as D- HUS or atypical HUS. Atypical HUS comprises a heterogeneous group of thrombomicroangiopathy (TMA) triggered by non-enteric infection, virus, drug, malignancies, transplantation, and other underlying medical condition. Emerging data indicate dysregulation of alternative complement pathway in atypical HUS, and genetic analyses have identified mutations of several regulatory genes; i.e. the fluid phase complement regulator Factor H (CFH), the integral membrane regulator membrane cofactor protein (MCP; CD46) and the serine protease Factor I (IF). The uncontrolled activation of the complement alternative pathway results in the excessive consumption of C3. Plasma exchange or plasma infusion is recommended for treatment of, and has dropped the mortality rate. However, overall prognosis is poor, and many patients succumb to end-stage renal disease. Clinical presentations, response to plasma therapy, and outcome after renal transplantation are influenced by the genotype of the complement regulators. Thrombotic thrombocytopenic purpura (TTP), another type of TMA, occurs mainly in adults as an acquired disease accompanied by fever, neurologic deficits and renal abnormalities. However, less frequent cases of congenital or hereditary TTP associated with ADAMTS-13 (a disintegrin and metalloprotease, with thrombospondin 1-like domains 13) gene mutations have been reported, also. Recent advances in molecular genetics better allow various HUS to be distinguished on the basis of their pathogenesis. The genetic analysis of HUS is important in defining the underlying etiology, predicting the genotype-related outcome and optimizing the management of the patients.

Development of a Health Education Modification Program Regarding Liver Flukes and Cholangiocarcinoma in High Risk Areas of Nakhon Ratchasima Province Using Self-Efficacy and Motivation Theory

  • Kaewpitoon, Soraya J;Rujirakul, Ratana;Wakkuwattapong, Parichart;Benjaoran, Fuangfa;Norkaew, Jun;Kujapun, Jirawoot;Ponphimai, Sukanya;Chavenkun, Wasugree;Kompor, Porntip;Padchasuwan, Natnapa;Kaewpitoon, Natthawut
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2947-2951
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    • 2016
  • A quasi-experimental study was conducted to develop a health education modification program based on self-efficacy and motivation regarding liver flukes and cholangiocarcinoma development in Keang Sanam Nang district, Nakhon Ratchasima province, Thailand. A total of 36 individuals were invited to participate in the program and were screened for population at risk of liver fluke infection and cholangiocarcinoma using SUT-OV-001 and SUT-CCA-001. Development of health education modification program regarding liver fluke and cholangiocarcinoma prevention included 3 steps: (1) preparation, (2) health education program, and (3) follow-up and evaluation. The study was implemented for 10 weeks. Pre-and-post-test knowledge was measured with questionnaires, Kuder-Richardson-20: KR-20 = 0.718,and Cronbach's Alpha Coefficient = 0.724 and 0.716 for percection and outcome expectation questionnaires. Paired and independent t-tests were applied for data analysis. The majority of the participants were female (55.6%), aged between ${\leq}50$ and 60 years old (36.1%), married (86.1%), education level of primary school (63.9%), agricultural occupation (80.6%), and income <4,000 Baht (44.4%). The results revealed that after the health education program, the experimental group had a mean score of knowledge, perception, and outcome expectation regarding liver fluke and cholangiocarcinoma prevention significantly higher than before participation and in the control group. In conclusion, this successful health education modification program for liver fluke and cholangiocarcinoma, therefore may useful for further work behavior modification in other epidemic areas.

Clinical Research Trends in Respiratory Diseases Related to Particulate Matter (미세먼지 관련 호흡기질환 임상연구 동향)

  • Lyu, Yee Ran;Kim, JinHoo;Yang, Won-kyung;Kim, Seung-hyeong;Park, Yang-Chun
    • The Journal of Internal Korean Medicine
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    • v.40 no.3
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    • pp.443-457
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    • 2019
  • Objectives: This study aimed to review the clinical research trends in respiratory diseases related to particulate matter (PM) to help design clinical studies on herbal medicine that protects against PM. Methods: We searched three international databases (Pubmed, EMBASE, and CENTRAL) to investigate clinical studies on respiratory diseases related to PM and to analyze their study design, respiratory-related disease, inclusion/exclusion criteria, study period, outcome measure, study results, measurement method of PM and range of PM. Results: A total of 18 studies were finally selected, including 13 observational studies and 5 randomized controlled trials. The selected studies showed an increasing trend from 1985 to 2018 and were conducted mostly in North America, followed by Europe and Asia. Subject disease and age were decided in variety by each study objective, although asthma accounted for the majority. For the outcome assessment, pulmonary function test was mostly used for lung function. Quality of life questionnaires and biomarkers in blood and sputum were also used. Conclusion: A well-designed clinical study on herbal medicine that protects against PM is needed, and this study is expected to be used as base data.

Graves' Disease Patients with Large Goiters Respond Best to Radioactive Iodine Doses of at Least 15 mCi: a Sonographic Volumetric Study

  • Jeong, Yun Ah;Yoon, Jee Hee;Kim, Hee Kyung;Kang, Ho-Cheol
    • International journal of thyroidology
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    • v.11 no.2
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    • pp.137-142
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    • 2018
  • Background and Objectives: Radioactive iodine therapy (RAI) is an important treatment modality of Graves' disease (GD), but there is still not a consensus on the optimal dosage regimen. We studied the treatment success rate of different RAI doses, and examined which clinical markers were useful for determining the optimal RAI dosage for successful therapy in Korean patients. Materials and Methods: We retrospectively studied 123 patients with GD treated with RAI between 2004 and 2014 at Chonnam National University Hwasun Hospital. The responder group was defined as patients who developed hypothyroidism requiring levothyroxine replacement following RAI, regardless of the RAI dosage. Results: A total of 54 patients (43.9%) became hypothyroid after the first dose, and 31 needed two to four additional doses to achieve hypothyroidism. In the responder group as a whole (85 patients), the mean total dose of RAI was $15.5{\pm}7.0mCi$ and the mean thyroid volume (TV) was $35.4{\pm}23.4mL$. When divided into low dose (<15 mCi, n=46) and high dose (${\geq}15mCi$, n=39) responder groups, TV was significantly lower in the low-dose responder group ($25.7{\pm}11.4$ vs. $48.4{\pm}31.3$, p<0.001). The optimal cut-off TV for the low-dose responder group was <32.37 mL (sensitivity 80.9%, specificity 76.7%). Conclusion: TV had significant effects on the outcome of RAI in GD patients. The optimal fixed RAI dose for Korean GD patients with a large goiter (${\geq}33mL$) should be at least 15 mCi to achieve the best outcome.

Impact of beta blockers on survival outcomes in ovarian cancer: a nationwide population-based cohort study

  • Baek, Min-Hyun;Kim, Dae-Yeon;Kim, Seon Ok;Kim, Ye-Jee;Park, Young-Han
    • Journal of Gynecologic Oncology
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    • v.29 no.6
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    • pp.82.1-82.13
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    • 2018
  • Objective: The impact of beta blockers (BBs) on survival outcomes in ovarian cancer was investigated. Methods: By using Korean National Health Insurance Service Data, Cox proportional hazards regression was performed to analyze hazard ratios (HRs) with 95% confidence intervals (CIs) adjusting for confounding factors. Results: Among 866 eligible patients, 206 (23.8%) were BB users and 660 (76.2%) were non-users. Among the 206 BB users, 151 (73.3%) were non-selective beta blocker (NSBB) users and 105 (51.0%) were selective beta blocker (SBB) users. BB use in patients aged ${\geq}60$ years, longer duration use (${\geq}1$ year), in patients with Charlson Comorbidity Index (CCI) ${\geq}3$, and in cardiovascular disease including hypertension was associated with better survival outcome. These findings were observed in both NSBB and SBB. When duration of medication was analyzed based on number of days, NSBB (${\geq}180$ days) was associated with improved overall survival (OS) with a relatively shorter period of use compared to SBB (${\geq}720$ days). In multivariate Cox proportional hazards model, longer duration of BB medication (${\geq}1$ year) was an independent favorable prognostic factor for both OS and disease-specific survival in ovarian cancer patients. Conclusion: In our nationwide population-based cohort study, BB use was associated with better survival outcomes in ovarian cancer in cases of long term duration of use, in older patients, and in cardiovascular and/or other underlying disease (CCI ${\geq}3$).

Effects of Banhahubak-tang on Gastroesophageal Reflux Disease : A Systematic Review and Meta-Analysis (위식도역류질환에 대한 반하후박탕의 효과 : 체계적 문헌고찰과 메타분석)

  • Kang, Sieun;Kim, Kyoungmin;Jin, Myungho
    • Journal of Society of Preventive Korean Medicine
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    • v.26 no.2
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    • pp.11-24
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    • 2022
  • Objectives : This study was designed to investigate the effect of Banhahubak-tang on gastroesophageal reflux disease(GERD) through a systematic review and meta-analysis of randomized controlled trials(RCTs). Methods : RCTs using Banhahubak-tang on GERD was searched in databases such as EMBASE, PubMed, MEDLINE, CENTRAL, CNKI, KISS, RISS, ScienceON, and OASIS. RCTs published up to October 8th, 2021 were included. Meta-analysis was performed by synthesizing outcome data, including Total Effectiveness Rate (TER), Reflux Symptom Index(RSI), Reflux Finding Score(RFS), and Incidence of Adverse Reactions. RevMan 5.4 software was used for data analysis. The Cochrane collaboration bias risk assessment scale was used to evaluate the methodological quality of the included studies. Results : Ten RCTs met the inclusion criteria. The total effective rate was the most commonly used outcome measure. The meta-analysis revealed that the TER in the experimental group was higher than that of the control group(N=2, RR:1.22, 95% CI:1.09 to 1.36, P=0.0004, I2=0%)(N=6, RR:1.22, 95% CI:1.14 to 1.32, P<0.00001, I2=0%)(N=8, RR:1.22, 95% CI: 1.14 to 1.30, P<0.00001, I2=0%). On the other hand, RSI(N=2, MD : -4.29, 95% CI: -4.71 to -3.86, I2=94%), RFS(N=2, MD : -3.28, 95% CI: -3.71 to -2.85, I2=96%), and Incidence of Adverse Reactions(N=5, RR: 0.32, 95% CI: 0.17 to 0.61, I2=0%) in the experimental group were lower than that of the control group. Conclusion : Treatment with Banhahubak-tang was found to be effective on GERD. However the results might be biased because of the poor quality and small sample size of the included RCTs.