• Title/Summary/Keyword: prognostic scores

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Serum homocysteine concentration in dogs with immunosuppressant-responsive enteropathy

  • Benvenuti, Elena;Pierini, Alessio;Gori, Eleonora;Bottero, Enrico;Pietra, Marco;Lippi, Ilaria;Meucci, Valentina;Marchetti, Veronica
    • Journal of Veterinary Science
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    • v.21 no.4
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    • pp.47.1-47.12
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    • 2020
  • 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.

Efficacy of Decompression and Fixation for Metastatic Spinal Cord Compression : Analysis of Factors Prognostic for Survival and Postoperative Ambulation

  • Park, Jin-Hoon;Rhim, Seung-Chul;Jeon, Sang-Ryong
    • Journal of Korean Neurosurgical Society
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    • v.50 no.5
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    • pp.434-440
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    • 2011
  • Objective : The goals of surgical intervention for metastatic spinal cord compression (MSCC) are prolonging survival and improving quality of life. Non-ambulatory paraplegic patients, either at presentation or after treatment, have a much shorter life expectancy than ambulatory patients. We therefore analyzed prognostic factors for survival and postoperative ambulation in patients surgically treated for MSCC. Methods : We assessed 103 patients with surgically treated MSCC who presented with lower extremity weakness between January 2001 and December 2008. Factors prognostic for overall survival (OS) and postoperative ambulation, including surgical method, age, sex, primary tumor site, metastatic spinal site, surgical levels, Tokuhashi score, and treatment with chemo- or radiation therapy, were analyzed retrospectively. Results : Median OS was significantly longer in the postoperatively ambulatory group [11.0 months; 95% confidence interval (CI), 9.29-12.71 months] than in the non-ambulatory group (5.0 months; 95% CI, 1.80-8.20 months) ($p$=0.035). When we compared median OS in patients with high (9-11) and low (0-8) Tokuhashi scores, they were significantly longer in the former (15.0 months; 95% CI, 9.29-20.71 months vs. 9.0 months; 95% CI, 7.48-10.52 months; $p$=0.003). Multivariate logistic regression analysis showed that preoperative ambulation with or without aid [odds ratio (OR) 5.35; 95% CI 1.57-18.17; $p$=0.007] and hip flexion power greater than grade III (OR 6.23; 95% CI, 1.29-7.35; $p$=0.038) were prognostic of postoperative ambulation. Conclusion : We found that postoperative ambulation and preoperative high Tokuhashi score were significantly associated with longer patient survival. In addition, preoperative hip flexion power greater than grade III was critical for postoperative ambulation.

Can Recurrence and Progression be Predicted by HYAL-1 Expression in Primary T1 Bladder Cancer?

  • Mammadov, Elnur;Aslan, Guven;Tuna, Burcin;Bozkurt, Ozan;Yorukoglu, Kutsal
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10401-10405
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    • 2015
  • Background: Molecular prognostic markers have been under investigation for the last decade and no validated marker to date has been proven to be used in daily clinical practice for urinary bladder cancers. The aim of the present study is to evaluate the significance of HYAL-1 expression in prediction of recurrence and progression in pT1 urothelial carcinomas. Materials and Methods: Eighty-nine urothelial carcinoma cases staged as T1 according to 2004 WHO classification were studied. Representative sections from every case were stained immunohistochemically for HYAL-1 and scored between 0 and +3, according to staining density, and graded as low and high for the scores 0-1 and 2-3, respectively. Results: Of the 89 pT1 bladder cancer patients, HYAL-1 expression was high in 92.1% (82 patients; 72 patients +3 and 10 patients +2) and low in 7.9% (only 7 patients; 6 patients +1 and 1 patient 0) of the cases. Of the 89 patients, 38 (42.7%) had recurrence and 22 (24.7%) showed progression. HYAL-1 staining did not show significant characteristics for tumor grade, accompanying CIS, multiplicity, tumor size, age and sex. HYAL-1 expression did not have any prognostic value in estimating recurrence or progression. Conclusions: HYAL-1 expression was found to be high, but did not have any prognostic importance in T1 bladder urothelial carcinomas.

Clinical outcomes in patients treated with radiotherapy after surgery for cervical cancer

  • Yang, Kyungmi;Park, Won;Huh, Seung Jae;Bae, Duk-Soo;Kim, Byoung-Gie;Lee, Jeong-Won
    • Radiation Oncology Journal
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    • v.35 no.1
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    • pp.39-47
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    • 2017
  • Purpose: The purpose of this study was to analyze clinical outcomes from cervical cancer and stratify patients into risk groups for prognostic factors for early-stage disease. Materials and Methods: We retrospectively reviewed patients with stage IB or IIA cervical cancer treated with adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) following primary surgery at Samsung Medical Center from 2001 to 2011. Adjuvant RT was added for patients with intermediate-risk factors, and adjuvant CCRT was performed on high-risk patients after surgery. Results: We reviewed 247 patients-149 in the high-risk group and 98 in intermediate-risk group. The median follow-up was 62 months. Loco-regional failure (LRF) alone occurred in 7 patients (2.8%), distant metastasis alone in 37 patients (15.0%) and LRF with DM in 4 patients (1.6%). The 5-year disease-free survival (DFS) and overall survival (OS) rates for both groups were 79.7% and 87.6%, respectively. In the high-risk group, the 5-year DFS and OS probabilities were 72.5% and 81.9%, respectively. Histologic type, pathologic tumor size, and the number of pelvic lymph node (PLN) metastasis were significant prognostic factors for DFS and OS. We suggest a scoring system (0-3) using these prognostic factors to predict poor prognosis in high-risk patients. Using this system, patients with higher scores have higher recurrence and lower survival rates. Conclusion: In the high-risk cervical-cancer group who received primary surgery and adjuvant CCRT, non-squamous type, large tumor size and the number of PLN metastasis were significant prognostic factors, and the number of these factors was associated with survival rates.

Prognostic Factors and Scoring Systems for Non-Small Cell Lung Cancer Patients Harboring Brain Metastases Treated with Gamma Knife Radiosurgery

  • Eom, Jung-Seop;Cho, Eun-Jung;Baek, Dong-Hoon;Lee, Kyung-Nam;Shin, Kyung-Hwa;Kim, Mi-Hyun;Lee, Kwang-Ha;Kim, Ki-Uk;Park, Hye-Kyung;Kim, Yun-Sung;Park, Soon-Kew;Cha, Seong-Heon;Lee, Min-Ki
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.1
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    • pp.15-23
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    • 2012
  • Background: The survival of non-small cell lung cancer (NSCLC) patients with brain metastases is reported to be 3~6 months even with aggressive treatment. Some patients have very short survival after aggressive treatment and reliable prognostic scoring systems for patients with cancer have a strong correlation with outcome, often supporting decision making and treatment recommendations. Methods: A total of one hundred twenty two NSCLC patients with brain metastases who received gamma knife radiosurgery (GKRS) were analyzed. Survival analysis was calculated in all patients for thirteen available prognostic factors and four prognostic scoring systems: score index for radiosurgery (SIR), recursive partitioning analysis (RPA), graded prognostic assessment (GPA), and basic score for brain metastases (BSBM). Results: Age, Karnofsky performance status, largest brain lesion volume, systemic chemotherapy, primary tumor control, and medication of epidermal growth factor receptor tyrosine kinase inhibitor were statistically independent prognostic factors for survival. A multivariate model of SIR and RPA identified significant differences between each group of scores. We found that three-tiered indices such as SIR and RPA are more useful than four-tiered scoring systems (GPA and BSBM). Conclusion: There is little value of RPA class III (most unfavorable group) for the same results of 6-month and 1-year survival rate. Thus, SIR is the most useful index to sort out patients with poorer prognosis. Further prospective trials should be performed to develop a new molecular- and gene-based prognostic index model.

The quality of life in patient with atopic dermatitis (청장년기 아토피피부염 환자의 살의 질에 관한 연구)

  • Kim, Min-Hee;Kim, Ja-Hye;Shin, Sang-Ho;Roh, Youn-Ho;Yu, Hyun-Jung;Kim, Hoon;Kim, Kyu-Kon;Yoon, Hwa-Jung;Ko, Woo-Shin
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.19 no.2
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    • pp.223-232
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    • 2006
  • Background : Many doctors are under a bias toward clinical severity in patients with atopic dermatitis. But the various studios show that atopic dermatitis may produce a range of impacts on the qualify of lift . Nevertheless there is much to be desired about the association between the quality of lift and atopic dermatitis in the department of Dermatology in Korean medicine. Objective : This study was conducted to investigate the impact of the atopic dermatitis on quality of life and explore prognostic factors that influence outcomes. Methods : 70 patients were recruited in this study rho write out more than 90% of Skindex-29 questionnaires. The function of total scores and three domain scores and SCORAD index was investigated and the correlation of each domain scores also . Result : The total scores, showed significant correlation with three domain scores in atopic dermatitis. The correlation of each three domain scores were significant. SCORAD index showed significant correlation with three domain scores and total scores. Conclusion : In this study atopic dermatitis efface of the quality of life in physical, social, and psychological factors. So we considered to the quality of life as well as clinical severity in patient with atopic dermatitis.

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The Prognostic Value of the Seventh Day APACHE III Score in Medical Intensive Care Unit (내과계 중환자들의 예후 판정에 었어서 제 7병일 APACHE III 점수의 임상적 유용성)

  • Kim, Mi-Ok;Yun, Soo-Mi;Park, Eun-Joo;Sohn, Jang-Won;Yang, Seok-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.2
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    • pp.236-244
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    • 2001
  • Background : Most current research using prognostic scoring systems in critically ill patients have focused on prediction using the first intensive care unit (ICU) day data or daily updated data. Usually the mean ICU length of stay in Korea is longer than in the western world. Consequently, a more cost-effective and practical prognostic parameter is required. The principal aim of this study was to assess the prognostic value of the seventh day(7th day : the average mean ICU length of stay) APACHE III score in a medical intensive care unit. Methods : 241 medical ICU patients from July 1997 to April 1998 were enrolled. The 1st and 7th scores were measured by using the APACHE III scoring system and compared between survivors and non-survivors. Logistic regression analysis was performed to determine the relationship between the $1^{st}$ and $7^{th}$ APACHE III scores and the mortality risk. Results : 1 )The mean length of stay in the ICU was $10.3{\pm}13.8$ days. 2)The mean $1^{st}$ and $7^{th}$ day APACHE III scores were $59.7{\pm}30.9$ and $37.9{\pm}27.7$. 3) The mean $1^{st}$ day APACHE III score was significantly lower in survivors than in non- survivors($49.9{\pm}23.8$ vs $86.3{\pm}32.3$, P<0.0001). 4)The mean $7^{th}$ day APACHE III score was significantly lower in survivors than in non- survivors($30.1{\pm}18.5$ vs $80.1{\pm}30.4$, P<0.0001). 5)The odds ratios among the $1^{st}$ and $7^{th}$ day APACHE III scores and the mortality rate were 1.0507 and 1.0779 respectively. Conclusion : These results suggest that the seventh day APACHE III score is as useful in predicting the outcome as is such like the first day APACHE III score. Therefore, in comparison to the daily APACHE III score, measuring the $1^{st}$ and $7^{th}$ day APACHE III scores are also useful for predicting the prognosis of critically ill patients in terms of cost-effectiveness. It is suggested that the $7^{th}$ day APACHE III score is useful for predicting the clinical outcome.

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Prognostic Factors for Arthroscopic Subacromial Decompression (관절경적 견봉하 감압술에 영향을 미치는 예후 인자)

  • Kim Sung-Jae;Shin Sang-Jin;Park Moon-Soo
    • Clinics in Shoulder and Elbow
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    • v.2 no.2
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    • pp.93-98
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    • 1999
  • Purpose: The purpose of this study was to analyze the prognostic factors for arthroscopic subacromial decompres­sion and rotator cuff debridement in impingement syndrome. Materials and Methods : Arthroscopic subacromial decompression with or without rotator cuff debridement was performed in 46 cases of 44 consecutive patients with either stage n or stage ill impingement syndrome. The patients were classified by Neer's stage and size of tear according to the criteria of Cofield. The results were assessed with UCLA rating scale. We used repeated measures ANOVA and Chi-square test to assess correlation between the results and six variables including stage, rotator cuff tear size, age at the operation, duration of symptom, throwing sports activity, and trauma history. The follow-up period averaged 53 months(range, 27 to 92 months). Results: Lower stage by Neer's stage was correlated with higher postoperative scores and with significant difference between preoperative and postoperative scores of UCLA rating scale. However, other factors did not show significant influence upon the results. The patients with complete rotator cuff who showed satisfactory results after procedures were older and had shorter symptom duration, small cuff size. Conclusions : In patients with impingement syndrome treated by arthroscopic debridement and subacromial decompression, superior results were obtained when belonged to a lower Neer stage and when the rotator cuff was only partially tom. In cases with complete rotator cuff tear, higher success rates were obtained with smaller tear sizes. Age at operation, duration of symptoms, throwing athlete, traumatic tear did not affect the results.

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Effects of Calcific lesion on Shockwave Therapy of the Tennis Elbow (체외충격파를 이용한 테니스 엘보우의 치료에서 석회화 병변의 영향)

  • Lee Seok-Beom;Kwon Duck-Joo;Song Young-Joon;Lee Kee-Byung
    • Clinics in Shoulder and Elbow
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    • v.7 no.1
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    • pp.35-40
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    • 2004
  • Purpose: The aim of this study was to investigate effects of calcific lesion on shockwave therapy of the tennis elbow. Materials and Methods: twenty-four patients with refractory tennis elbow were treated with shock waves. The patients were evaluated by assessment of pain using visual analog scale (VAS) and simple elbow test (SET). Comparision of clinical outcomes for the patients with and without calcification in the extensor tendon and/or cortical irregularity of lateral condyle was tried to determine if this could be a possible prognostic factor in clinical settings. Overall clinical outcomes were evaluated by Roles and Maudsley score at 12 months after ESWT. Results: Significant improvement of symptoms were observed in 20 (83 %) patients at 12 months follow up according to Roles and Maudesley scores. The patients with calcification and/or cortical irregularity improved significantly better, when compared to the patients without calcification and/or cortical irregularity at follow up. Conclusion: This study suggests that shock waves therapy could be considered as effective and noninvasive treatment modality for refractory tennis elbow. Also calcific deposit in extensor tendon and/or cortical irregularity of the lateral epicondyle was seem to be good prognostic factor for shock wave therapy for tennis elbow

Quality of Life in Patients with Skin Disease (한국어판 Skindex-29를 통해 본 피부과 환자의 삶의 질)

  • Kim Min-Hi;Kim Ja-Hye;Yoon Hwa-Jung;Ko Woo-Shin
    • The Journal of Korean Medicine
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    • v.26 no.3 s.63
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    • pp.43-54
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    • 2005
  • Backgrounds : Many people think that ski disease has littel influence on the quality of life in patient, but various studios show that skin disease may produce a range of impacts on QOL. Nevertheless, there is much to be learned about the association between the duality of life and skin disease in the area of Oriental dermatology. Objectives : This study was conducted fe investigate the impact of the various skin diseases on QOL and explore prognostic factors that influence outcomes. Methods : 103 patients were recruited who filled out more than $90\%$ of the skindex-29 questionnaire. The function of sum scores and three domain scores with each skin disease were investigated, as well as the correlation of each domain scores. Results : The disease with the lowest qualify of life was atopic dermatitis. followed by eczematous dermatitis, seborrheic dermatitis and acne vulgaris in order. The sum scales showed significant correlation with three domain scores in atopic dermatitis, urticaria, allergodermia, acne vulgaris, psoriasis and seborrheic dermatitis, The correlation of all three domain scores was significant in atopic dermatitis, urticaria, allergodermia, and psoriasis. Conclusions : Tn this study, skin disease affects the quality of life in physical, social, and psychological factors- Thus, we must consider the quality of life as well as clinical severity inpatients with skin disease.

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