• 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.

• 대한소아치과학회지
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• 제37권3호
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• pp.368-373
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• 2010

상악 중절치는 저작시 음식물을 찢거나 자르는 기능 외에도 심미적으로 중요한 기능을 하며 상악 악궁의 형태 및 얼굴의 형태와도 관계가 있다고 알려져 있다. 그리고 발음을 하는데 있어서도 전치부는 매우 중요한 역할을 한다. 예후가 불량한 치아의 일반적인 치료는 발거 후 공간 유지장치를 하는 것이다. 그러나 혼합치열기에 있어 상악 영구 중절치의 발거는 치조골의 흡수, 불량한 심미성, 발음과 저작의 문제 등 여러 가지 합병증을 일으킬 수 있다. 이러한 이유로 상악 전치부의 치료는 보존적으로 행해져야 한다. 예후가 불량한 상악 전치부의 치료시 고려해야 할 사항으로는 환아의 나이, 성장 잠재력, 교합 관계, 구강 위생상태, 경제력 그리고 환아의 치료에 대한 협조도 등이 있다. 본 증례는 짧은 치근으로 인해 치아의 동요도가 있어 상악 좌측 중절치의 예후가 불안정함에도 불구하고 치아를 발거하지 않고 치료를 통해 상악 좌측 중절치를 정상 위치로 배열하고 보존하였다. 짧은 치근과 치아 회전으로 인한 추가적인 치근 흡수와 치아 동요도 증가 등 예후가 불안정하였지만 환아의 심리적 안정성, 나이, 심미성 등을 고려하여 보존적인 치료 후 양호한 결과를 얻었기에 이를 보고하는 바이다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권6호
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• pp.3891-3895
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• 2013

The purpose of this study was to evaluate the association of expression of ${\alpha}5{\beta}1$-integrin with clinicopathologic features and prognosis in cervical cancer. Levels of ${\alpha}5{\beta}1$-integrin in normal cervical mucosa and cervical cancer tissue were detected with immunohistochemistry. Survival analysis by the Kaplan-Meier method was performed to assess prognostic significance. ${\alpha}5{\beta}1$-integrin expression was detected in 84.6% (143/169) cervical cancer samples, significantly different from that in normal cervical mucosa (P < 0.05). Positive expression rates of ${\alpha}5{\beta}1$-integrin in patients with poor histologic differentiation, lymph node metastasis, and recurrence were elevated. Using Kaplan-Meier analysis, a comparison of survival curves of low versus high expression of ${\alpha}5{\beta}1$-integrin revealed a highly significant difference in human cervical cancer cases (P < 0.05), suggesting that overexpression of ${\alpha}5{\beta}1$-integrin is associated with a worse prognosis.The ${\alpha}5{\beta}1$-integrin promotes angiogenesis and associates with lymph node metastasis, vascular invasion and poor prognosis of cervical cancer. The current study indicated that ${\alpha}5{\beta}1$-integrin may be an independent prognostic factor for cervical cancer patients.

• Journal of Korean Neurosurgical Society
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• 제40권5호
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• pp.357-362
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• 2006

Objective : The incidence of aneurysmal subarachnoid hemorrhage has been increasing. At the same time, surgical results for elderly patients are unsatisfactory and no guidelines of treatment are available. We carried out a study comparing variable factors and surgical results between young and old age groups to find ways to improve prognosis. Methods : A retrospective study was carried out on 754 patients who were operated on between 1990 and 2004 by the same surgeon in our hospital. The patients were divided into seven groups according to age : 93 patients below 40 years of age [Group I], 419 patients aged $40{\sim}59$ [Group II], 115 patients aged $60{\sim}64$ [Group III], 82 patients aged $65{\sim}69$ [Group IV], 28 patients aged $70{\sim}74$ [Group V], 12 patients aged $75{\sim}79$ [Group VI] and 5 patients over the age of 80 [Group VII]. We then checked their medical history, Fisher's grade, Hunt-Hess grade, postoperative complications, and Glasgow Outcome Scale. Results : Age was not a statistically significant factor among patients below 70 years of age [P $value{\ge}0.05$]. But for those aged 70 and older, the age factor had a statistical value [P $value{\le}0.001$]. In addition, there was a close correlation between Hunt-Hess grade IV and V patients, and those with vasospasm, and hydrocephalus after surgery, with poor prognosis in elderly patients as well as young patients [P $value{\le}0.001$]. Conclusion : Advanced age [under the age of 70] dose not precluded adequate surgical treatment in patient with AN SAH, and we should be also alert to preventable causes of delayed neurological deterioration for improving the outcome in all elderly groups.

• Journal of Korean Neurosurgical Society
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• 제30권12호
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• pp.1375-1380
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• 2001

Objective : The authors analyzed the incidence, the cause and the prognosis of hydrocephalus following aneurysmal subarachnoid hemorrhage to evaluate the risk factors of hydrocephalus and to provide the proper treatment method for hydrocephalus following aneurysmal subarachnoid hemorrhage. Methods : The 505 cases of subarachnoid hemorrhage followed by aneurysmal surgery from January 1990 to May 1999, were divided into shunt group and shunt-free group and we were reviewed for the clinical status, Fisher's grade, brain CT findings and prognosis. Results : The incidence of acute hydrocephalus was 37.2% of patients and 18.9% to developed chronic hydrocephalus. Shunt surgery due to chronic hydrocephalus was required in 6.5% of patients. We found following variables were significantly related to shunt-dependent hydrocephalus : high Hunt-Hess and Fisher grade, initial CT findings of intraventricular hemorrahge, posterior circulation aneurysm, preoperative rebleeding, delayed ischemic deficits, and initial high ventricular size index. There were no statistically significant relationships between shunt-dependent hydrocephalus and patient age or sex, timing of operation. The previous hypertension was not related to shunt dependent hydrocephalus. Prognosis in shunt group showed poor result. Conclusion : The risk factors of hydrocephalus following aneurysmal subarachnoid hemorrhage are high Hunt-Hess grade, high Fisher's grade, aneurysms of posterior circulations, preoperative aneurysmal rebleeding, delayed ischemic deficits, initial CT findings of intraventricular hemorrahge and initially increased ventricular size. The patients with these factors should the carefully observed and managed accordingly due to poor prognosis related to hydrocephalus requiring shunt operation.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.1985-1988
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• 2013

Aim: To study any correlation of LKB1 expression with prognosis in hepatocellular carcinoma (HCC) cases. Methods: A total of 70 HCC patients and 20 primary intrahepatic stone patients in the first affiliated hospital of Wenzhou Medical College were enrolled in this study. LKB1 expression was detected by immunohistochemistry. Patients were followed-up and prognostic factors were evaluated. Result: LKB1 expression was decreased in the HCC samples. Loss of LKB1 expression in HCC was significantly related to histologic grade (P=0.010), vascular invasion (P=0.025) and TMN stage (P=0.011). Patients showing negative LKB1 expression had a significantly shorter disease-free and overall survival than those with positive expression (P = 0.001, P=0.000, respectively). Multivariate Cox regression analysis indicated that LKB1 expression level was an independent factor of survival (P = 0.033). Conclusion: HCC patients with decreased expression LKB1 have a poor prognosis. The loss of LKB1 expression is correlated with a lower survival rate.

• Asian Pacific Journal of Cancer Prevention
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• 제15권17호
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• pp.7219-7222
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• 2014

Background: Early gastric cancer (EGC) is well accepted as having a favorable prognosis, but some patients experience an ominous outcome after curative resection. This study was aimed at evaluating predictive factors associated with prognosis of D2 gastrectomies in patients with early gastric cancer. Materials and Methods: A total of 518 patients with early gastric cancer who underwent D2 gastrectomies were reviewed in this study. The clinicopathological features and surgical outcomes were analyzed. The survival rate was estimated using the Kaplan-Meier method and compared by log rank test. Prognostic factors were analyzed using a multivariate Cox proportional hazards model. Results: The 5-year survival rate was 90.3%. Tumor infiltration, lymph node metastasis and lymphovascular invasion were significant prognostic factors for survival. Gender, age, tumor size, tumor location, macroscopic type and histological type were not significant prognostic factors. Multivariate analysis indicated that lymph node metastasis was an independent poor prognosis factor. Conclusions: Early gastric cancers with lymph node metastasis have a relatively poor prognosis after standard surgery. Even after curative resection, patients with EGC with positive lymph nodes should be closely followed and be considered as candidates for comprehensive therapies.

• Asian Pacific Journal of Cancer Prevention
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• 제14권7호
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• pp.4107-4113
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• 2013

Objective: Matrix metalloproteinase-9(MMP-9) plays an important role in tumor cell invasion. Although it has been studied frequently in ovarian cancer, its prognostic impact is still equivocal. The aim of this study was to more precisely estimate its prognostic significance. Method:We searched Pubmed, Embase, OVID, Sciencedirect and CBM databases to identify eligible studies. Hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (95% CIs) were pooled across studies using fixed-effects or random-effects models. We also performed subgroup analysis. Results: 30 studies (n=2552 patients) focusing on prognosis or expression of MM-9 were included. Increased expression of MMP-9 was associated with poor prognosis in ovarian cancer patients (HR=1.68, 95%CI 1.09-2.59, p=0.02). Besides, MMP-9 expression in ovarian cancer was significantly higher than non-malignant tumors (OR=11.46, 95%CI 8.47-15.50, P<0.00001). Moreover, increased expression of MMP-9 was significantly associated with FIGO stage (OR=4.85, 95%CI 2.60-9.04, P<0.00001), grade of differentiation (OR=3.34, 95%CI 2.46-4.54, P<0.00001), lymph node metastasis (OR=5.75, 95%CI 3.71-8.92, P<0.00001) and there was no association with histological type of ovarian cancer. Conclusions: Increased expression of MMP-9 was associated with poor prognosis in ovarian cancer patients. Down-regulation of MMP-9 is an attractive therapeutic approach which might improve outcome of ovarian cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제16권1호
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• pp.327-332
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• 2015

Background: Gastric cancer is one of the frequently seen cancers in the world and it is the second most common reason for death due to cancer. The prognostic role of expression of p53 detected by immunohistochemistry in gastric cancer remains controversial. This meta-analysis aimed to explore any association between overexpression and survival outcomes. Materials and Methods: We systematically searched for studies investigating the relationships between expression of p53 detected by immunohistochemistry and prognosis of gastric cancer patients. Study quality was assessed using the Newcastle-Ottawa Scale. After careful review, survival data were extracted from eligible studies. A meta-analysis was performed to generate combined hazard ratios for overall survival and disease-free survival. Results: A total of 4.330 patients from 21 studies were included in the analysis. Our results showed tissue p53 overexpression in patients with gastric cancer to be associated with poor prognosis in terms of overall survival (HR, 1.610; 95% CI, 1.394 -5.235; p:<0.001). Pooled hazard ratio for disease free survival showed that p53 positivity or negativity were not statitistically significant (HR, 1.219; 95%CI, 0.782-1.899; p:0.382). Conclusions: The present meta-analysis indicated overexpression of p53 detected by immunohistochemistry to be associated with a poor prognosis in patients with gastric cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제15권8호
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• pp.3741-3745
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• 2014

Background: Emerging evidence implicates the platelet-derived growth factor-D (PDGF-D) in many types of human solid tumors. We investigated whether PDGF-D plays an important role in endometrial cancer (EC) in relation to clinicopathologic phenotype, angiogenesis, and patient prognosis. Materials and Methods: We analyzed PDGF-D protein expression by Western blotting in twenty-seven human endometrial cancer tissues, and matched normal endometrial controls collected at the third Affiliated hospital of Sun Yat-sen University during 2012-2013 (n=27). Immunohistochemical staining was performed using a human PDGF-D antibody on the endometrial cancer patients collected in the same facility during January 2001 and October 2013 (n=152). Patients were followed from the time of primary surgery in 2001-2013 until death or last follow-up. We correlated the PDGF-D expression levels with clinicopathologic parameters and prognosis in human endometrial cancer patients. Results: Compared with matched normal endometrial cases, PDGF-D was up-regulated in endometrial cancer. Expression of PDGF-D protein, found in 78% of the cases, was associated with nonendometrioid histologic type (p=0.028), FIGO stage III/IV (p=0.039), >50% solid tumor growth (p=0.048), pelvic LN metastasis (p=0.035) and ER and PR negativity (p=0.04 and 0.002). PDGF-D expression was also significantly associated with expression of VEGF-A (p=0.021). In multivariate analysis, PDGF-D expression proved to be an independent prognostic factor in addition to histologic grade and FIGO stage. Patients with high expression levels of PDGF-D had a significantly poorer overall survival rate compared with patients with no expression. Conclusions: PDGF-D expression is frequently up-regulated in endometrial cancer, and is associated with aggressive features and poor prognosis.