Baek, In Yeop;Kim, Tae Kwon;Jin, Sang Chan;Cho, Woo Ik
Journal of The Korean Society of Clinical Toxicology
/
v.15
no.1
/
pp.1-10
/
2017
Purpose: This study was conducted to identify predictors of serious poisoning in patients with snake bite based on initial findings. Methods: We conducted a retrospective study of patients with snake bite who were treated at the emergency department between January 2010 and December 2016. The patients were divided into two groups according to the severity of symptoms based on the traditional snakebite severity grading scale. The mild poisoning group (MP) was classified as those who had a grade I snakebite severity during the hospital stay, and the severe poisoning group (SP) was classified as patients who had grade I at the time of admission, but progressed to grade II-IV during hospitalization. Initial clinical manifestations and laboratory findings of the two groups were compared. Results: Bite to hospital time intervals of SP were longer than those of MP (p=0.034), and the local effect score (LES) was higher in SP (p<0.001). Laboratory analyses revealed that creatine phosphokinase (p=0.044), creatine phosphokinase MB isoenzyme (CK-MB, p=0.011) and serum amylase (p=0.008) were significantly higher in SP. LES, CK-MB and serum amylase were significant prognostic predictors as indicated by univariate logistic regression analysis. Multivariate analysis revealed the following two significant predictors: LES (odds ratio=3.983, p<0.001) and serum amylase (odds ratio=1.020, p=0.017). Conclusion: In managing cases of snake bites, clinical manifestations and laboratory findings must be carefully evaluated. LES and serum amylase are predictive factors for severe poisoning, which is especially important to rapid determination of the intensive care of the patient.
Park, Jong-Hwa;Hyun, Seung-Jae;Kim, Ki-Jeong;Jahng, Tae-Ahn
Journal of Korean Neurosurgical Society
/
v.56
no.5
/
pp.431-435
/
2014
A fifty-year-old female non-smoker with no other specific medical history visited our institute. She complained of axial back pain with no other neurological deficit. Chest X-ray, chest computed tomography (CT) scan, CT-guided needle aspiration biopsy, whole-body positron emission tomography, spine CT and spine magnetic resonance image findings suggested NSCLC with epidermal growth factor receptor (EGFR) mutation, multiple brain metastases, and two isolated metastases to the T3 and L3 vertebral bodies. She underwent chemotherapy with gefitinib ($Iressa^{TM}$) for NSCLC and gamma knife surgery for multiple brain metastases. We performed a two-staged, total en bloc spondylectomy of the T3 and L3 vertebral bodies based on several good prognostic characteristics, such as the lack of metastases to the appendicular bone, good preoperative performance status, and being an excellent responder (Asian, never-smoker and adenocarcinoma histology) to EGFR inhibitors. Improved axial back pain after the surgery enabled her to walk with the aid of a thoracolumbosacral orthosis brace on the third postoperative day. Her Karnofsky performance status score (KPS) was 90 at the time of discharge and has been maintained to date 3 years after surgery. In selected NSCLC patients with good prognostic characteristics, we suggest that locally curative treatment such as total en bloc spondylectomy or radiosurgery should be emphasized to achieve longer term survival for the selected cases.
Seo, Gu-Jong;Ryu, Sun-Youl;Kim, Ok-Joon;Choi, Hong-Ran
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.28
no.1
/
pp.7-15
/
2002
The present study was carried out to evaluate the correlation of metastasis and prognostic factors in squamous cell carcinoma of head and neck. Examination was performed on a series of thirty-seven patients who were confirmed to squamous cell carcinoma and its lymphatic metastasis by pathologist. Correlations of metastasis and other factors such as angiogenesis, histologic grading, and p53 expression and ras oncogene were studied. The depth of tumors was around 1 to 27mm. Twenty cases were more than 10mm deep, of which seventeen cases were shown lymphatic metastasis. Total score of histologic grading including keratinization, nuclear atypia, growth pattern and intensity of inflammation was ranged from 5 to 10 points. Of these factors, nuclear atypia with intensity of inflammation, and nuclear atypia with growth pattern was correlated with nuclear atypia each. For angiogenesis, number of new-formed vessels were counted 13 to 58 each. Twenty-eight cases were shown to lymphatic metastasis. No correlation with histologic grading and lymphatic metastasis was found. The results of immunohistochemical staining for p53 and ras oncogene revealed that positive cases were 16 and 22, negative for 21 and 15 each. However, both were not correlated with histologic grading and lymphatic metastasis. These results were revealed that angiogenesis was not correlated with lymphatic metastasis of squamous cell carcinoma arising in head and neck. Nuclear atypia with intensity of inflammation and dysplasia with growth pattern were correlated with histologic grading, which suggested that more careful and adequate advice is needed for effective treatment.
Kim, Eun Seok;Lee, Sang Hoon;Nam, Sang Soo;Kim, Yong Suk
Journal of Acupuncture Research
/
v.31
no.1
/
pp.149-158
/
2014
Objectives : The aim of this study is to investigate the influence of anxiety and depression on motor recovery of acute Bell's palsy to estimate how much psychological factors affect the clinical prognosis. Methods : A total of 20 inpatients with acute unilateral Bell's palsy within 1 week of onset participated in this study. The severity of participants' facial palsy was measured by Yanagihara(Y-system) score, FDI and House-Brackmann scale at the time of 1 week and 3 weeks from the onset. The motor recovery of acute Bell's palsy is defined as ${\Delta}Y$-system during 2 weeks. Beck anxiety scale(BAI) and the center for epidermiologic studies depression scale(CES-D) were adopted to assess anxiety and depression, respectively. Correlation analysis and linear regression analysis were conducted between ${\Delta}Y$-system and prognostic factors including anxiety and depression. Results : Significant associations were found between ${\Delta}Y$-system and depression(CES-D) but no significant associations were found between ${\Delta}Y$-system and other prognostic factors, hypertension, diabetes, postauricular pain, disgeusia, age, degree of initial palsy and anxiety(BAI). And a regression equation with 0.295 for coefficient of determination was obtained. Through this analysis, the ${\Delta}Y$-system can be predicted using regression equation which cover 29.5 % of depression index(CES-D). Conclusion : Depression is a significant clinical prognostic factor on motor recovery of acute Bell's palsy. So, Bell's palsy treatment should be combined with psychological care and support.
Background: Homocysteine (HCY) was evaluated in healthy and chronic enteropathic dogs, however no studies on dogs with immunosuppressant-responsive enteropathy are available. Objectives: The aim was to evaluate serum HCY concentrations and its prognostic role in dogs with immunosuppressant-responsive enteropathy compared to healthy dogs. Methods: Serum HCY concentration was statistically compared between 24 healthy dogs and 29 dogs with immunosuppressant-responsive enteropathy. Correlation analyses between serum total protein, albumin (ALB), C-reactive protein (CRP), folate and cobalamin, and serum HCY concentration were performed in immunosuppressant-responsive enteropathic dogs. Results: The associations between serum HCY concentration and clinical, histological, endoscopic scores and follow-up were evaluated. Mean serum HCY concentration was higher in immunosuppressant-responsive enteropathic dogs compared to control dogs (30.22 ± 8.67 µmol/L vs. 5.26 ± 2.78 µmol/L; p < 0.0001). No association between serum HCY concentration and total protein, ALB, CRP, folate concentration as well as, clinical score, histological and endoscopic scores was found. A negative correlation between serum HCY concentration and cobalamin was noted (p = 0.0025, r = -0.54). No significant difference in HCY was found between responsive and non-responsive dogs or between survivors and non-survivors. Conclusions: Although, serum HCY concentration was higher in immunosuppressant-responsive enteropathy, its prognostic value remains unclear. However, further prospective, large-scale studies are warranted to better investigate the possible prognostic role of HCY in immunosuppressant-responsive enteropathic dogs.
Malignant glioblastoma multiforme (GBM) is the most malignant brain tumor and despite recent advances in diagnostics and treatment prognosis remains poor. In this retrospective study, we assessed the clinical and radiological parameters, as well as fluorescence in situ hybridization (FISH) of 1p19q deletion, in a series of cases. A total of 816 patients with GBM who received surgery and radiation between January 2010 and May 2014 were included in this study. Kaplan-Meier survival analysis and Cox regression analysis were used to find the factors independently influencing patient progression free survival (PFS) and overall survival (OS). Age at diagnosis, preoperative Karnofsky Performance Scale (KPS) score, KPS score change at 2 weeks after operation, neurological deficit symptoms, tumor resection extent, maximal tumor diameter, involvement of eloquent cortex or deep structure, involvement of brain lobe, Ki-67 and MMP9 expression level and adjuvant chemotherapy were statistically significant factors (p<0.05) for both PFS and OS in the univariate analysis. Cox proportional hazards modeling revealed that age ${\leq}50$ years, preoperative KPS score ${\geq}80$, KPS score change after operation ${\geq}0$, involvement of single frontal lobe, deep structure involvement, low Ki-67 and MMP9 expression and adjuvant chemotherapy were independent favorable factors (p<0.05) for patient clinical outcomes.
Purpose: Sepsis is the most common cause of neonatal death accounting for 30-50% of mortality annually in developing countries. This study was to determine the prognostic factors of neonatal sepsis mortality. Methods: A retrospective cohort was conducted in Dr. R. Sosodoro Djatikoesoemo Governor Hospital from April 2021 to September 2021 on 121 neonates in the neonatal intensive care unit (NICU) diagnosed with sepsis. The inclusion criteria were neonates aged 0-28 days, admitted to the NICU, and diagnosed with sepsis. The exclusion criteria were incomplete data and the presence of congenital abnormalities. A χ2 test was performed on the sex, gestational age, mode of delivery, birth weight, APGAR score, birthplace, and blood culture. A normality test was performed on leukocytes, lymphocytes, neutrophils, platelets, C-reactive protein (CRP), and length of stay. Then performed a Mann-Whitney test. Results: Birth weight (P=0.038), gestational age (P=0.009), and blood culture (P=0.014) showed a significant relationship with the neonatal sepsis outcome while Mann-Whitney test showed significant differences in the platelets (P=0.018), CRP (P=0.002), and length of stay (P<0.001). Multivariate analysis showed that 3 prognostic factors associated with neonatal sepsis mortality were prematurity (odds ratio [OR], 3.906; 95% confidence interval [CI], 1.344-11.356; P=0.012), low birth weight (LBW, OR, 2.833; 95% CI, 1.030-7.790; P=0.044), and gram-negative bacteria (OR, 4.821; 95% CI, 1.018-22.842; P=0.047). Conclusions: Prematurity, LBW, and gram-negative bacteria were associated with the prognostic factors of neonatal sepsis.
Park, Jong-Hoon;Lee, Soo-Yong;Jeon, Dae-Geun;Cho, Wan-Hyung;Song, Won-Seok;Kim, Jin-Wook;Koh, Han-Sang
The Journal of the Korean bone and joint tumor society
/
v.11
no.2
/
pp.160-167
/
2005
Purpose : Distal femur and proximal tibia are the common sites affected by giant cell tumor of bone. There are a variety of treatment modality including wide excision and intralesional curettage. We evaluated the local recurrence rates and the post-operative functional scores of giant cell tumors around knee joint and investigated the identification of possible prognostic factors for recurrence. Materials and Methods: We reviewed 41 patients pathologically confirmed as giant cell tumors around knee joint that have undergone intralesional curettage using high-speed burr and methylmethacrylate. We evaluated the recurrence rate and post-surgical functional score and possible prognostic factors for recurrence, such as, gender, age, tumor location, size, subchondral invasion, intra-articular invasion and the Campanacci Grades. Mean follow up period was 50 (12-122) months. Results: The recurrence rate was 17% and mean recurrence onset was 10 months postoperatively. According to Musculoskeletal Tumor Society (MSTS) functional evaluation system, the average score was 27.8(93%) and 78% had excellent function. According to our study, suspected prognostic factors revealed not significant for recurrence. Conclusion: We found no significant recurrence related factors. Intralesional excision with high-sped burring and PMMA provides a low recurrence rate, similar to others in the literature, and good functional scores.
Background: The prognostic value of human epidermal growth factor receptor-2 (HER-2/neu) for survival of patients with colorectal cancer (CRC) is still ambiguous. We therefore performed a meta-analysis to evaluate its prognostic significance. Materials and Methods: We searched the MEDLINE and EMBASE databases for published literature investigating associations between HER-2/neu status and overall survival of patients with CRC. A meta-analysis was performed using a DerSimonian-Laird model and publication bias was investigated by Begg's and Egger's tests. Subgroup analysis was also conducted according to the study design type, study quality score, cut-off value for HER-2/neu overexpression, publication region, patient number and publication year. Results: A total of 17 eligible studies involving 2,347 patients were identified for this meta-analysis. The combined hazard ratio (HR) was 1.31 (95% confidence interval (CI): 0.96-1.79), suggesting that HER-2/neu overexpression was not significantly associated with overall survival of patients with CRC. However, subgroup analysis revealed that HER-2/neu overexpression had an unfavorable impact on survival when the analysis was restricted to subgroups of study quality score ${\leq}5 $(HR=1.56, 95%CI: 1.17-2.10), Asian patients (HR=1.74, 95%CI: 1.22-2.49), patient number ${\leq}106$ (HR=1.57, 95%CI: 1.01-2.44), publication year before 2003 (HR=1.59, 95%CI: 1.02-2.49), and prospectively designed study (HR=3.62, 95%CI: 1.42-9.24). The effect disappeared in subgroups of study quality scores > 5 (HR=0.69, 95%CI: 0.33-1.44), non Asian patients (HR=1.14, 95%CI: 0.77-1.70), patients' number > 106 (HR=1.07, 95%CI: 0.67-1.72), publication year after 2003 (HR=1.13, 95%CI: 0.76-1.69), and retrospectively designed study (HR=1.22, 95%CI: 0.89-1.67). Conclusions: Our meta-analysis suggests that HER-2/neu overexpression might not be a significantly prognostic indicator for patients with CRC. Further studies are required to confirm these results.
Lee, Jin Ho;Jang, Ji Young;Shim, Hong jin;Lee, Jae Gil
Journal of Trauma and Injury
/
v.25
no.4
/
pp.166-171
/
2012
Purpose: In patients with traumatic hemoperitoneum or pelvic bone fracture who underwent angiography and embolization, we want to find the prognostic factors related with mortality. Methods: Patients(333 patients) who visited our hospital with traumatic injury from March 2008 to April 2012 were included in this study. Only 37 patients with traumatic hemoperitoneum or pelvic bone fracture underwent angiography and embolization. A retrospective review was conducted, and Glasgow coma scale (GCS), Revised trauma score (RTS), Injury severity score (ISS), initial laboratory finding and time interval, the amount of transfusion from the arrival at the ER to the start of embolization, and the vital signs before and after procedure were checked. Stastical analysis was conducted using the Chi square and Mann-Whitney U test. Results: In univariate analysis, the amount of transfusion, the base deficit before procedure, the systolic blood pressure before and after the procedure, the GCS, the RTS and the ISS were significantly associated with prognosis. In the multivariate analysis, the ISS and the base deficit had significant association with prognosis. Of the 37 patients who underwent angiography and embolization, 31 patients needed not additional procedure (Group A) while the other 6 patients needed an additional procedure (Group B). After procedure, a statistically significant higher blood pressure was observed in Group A than in Group B. As to the difference in blood pressure before and after the procedure, a statistically significant decrease in systolic blood pressure was observed in Group B, but an increase was observed in Group A. Conclusion: In traumatic hemoperitoneum or pelvic bone fracture patients who underwent angiography and embolization, GCS, ISS, RTS, transfusion amount before the procedure, initial base deficit and systolic blood pressure were factors related to mortality. When patients who underwent angiography and embolization only were compared with patients who underwent re-embolization or additional procedure after the first embolization, an increase in systolic blood pressure after embolization was a prognostic factor for successful control of bleeding.
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