• Title/Summary/Keyword: progression

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Patterns of failure and prognostic factors in resected extrahepatic bile duct cancer: implication for adjuvant radiotherapy

  • Koo, Tae Ryool;Eom, Keun-Yong;Kim, In Ah;Cho, Jai Young;Yoon, Yoo-Seok;Hwang, Dae Wook;Han, Ho-Seong;Kim, Jae-Sung
    • Radiation Oncology Journal
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    • v.32 no.2
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    • pp.63-69
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    • 2014
  • Purpose: To find the applicability of adjuvant radiotherapy for extrahepatic bile duct cancer (EBDC), we analyzed the pattern of failure and evaluate prognostic factors of locoregional failure after curative resection without adjuvant treatment. Materials and Methods: In 97 patients with resected EBDC, the location of tumor was classified as proximal (n = 26) and distal (n = 71), using the junction of the cystic duct and common hepatic duct as the dividing point. Locoregional failure sites were categorized as follows: the hepatoduodenal ligament and tumor bed, the celiac artery and superior mesenteric artery, and other sites. Results: The median follow-up time was 29 months for surviving patients. Three-year locoregional progression-free survival, progression-free survival, and overall survival rates were 50%, 42%, and 52%, respectively. Regarding initial failures, 79% and 81% were locoregional failures in proximal and distal EBDC patients, respectively. The most common site was the hepatoduodenal ligament and tumor bed. In the multivariate analysis, perineural invasion was associated with poor locoregional progression-free survival (p = 0.023) and progression-free survival (p = 0.012); and elevated postoperative CA19-9 (${\geq}37U/mL$) did with poor locoregional progression-free survival (p = 0.002), progression-free survival (p < 0.001) and overall survival (p < 0.001). Conclusion: Both proximal and distal EBDC showed remarkable proportion of locoregional failure. Perineural invasion and elevated postoperative CA19-9 were risk factors of locoregional failure. In these patients with high risk of locoregional failure, adjuvant radiotherapy could be considered to improve locoregional control.

Exploring 6th Graders Learning Progression for Lunar Phase Change: Focusing on Astronomical Systems Thinking (달의 위상 변화에 대한 초등학교 6학년 학생들의 학습 발달과정 탐색: 천문학적 시스템 사고를 중심으로)

  • Oh, Hyunseok;Lee, Kiyoung
    • Journal of the Korean earth science society
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    • v.39 no.1
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    • pp.103-116
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    • 2018
  • The purpose of this study was to explore $6^{th}$ graders learning progression for lunar phase change focusing astronomical systems thinking. By analyzing the results of previous studies, we developed the constructed-response items, set up the hypothetical learning progressions, and developed the item analysis framework based on the hypothetical learning progressions. Before and after the instruction on the lunar phase change, we collected test data using the constructed-response items. The results of the assessment were used to validate the hypothetical learning progression. Through this, we were able to explore the learning progression of the earth-moon system in a bottom-up. As a result of the study, elementary students seemed to have difficulty in the transformation between the earth-based perspective and the space-based perspective. In addition, based on the elementary school students' learning progression on lunar phase change, we concluded that the concept of the lunar phase change was a bit difficult for elementary students to learn in elementary science curriculum.

Survival Outcomes of Recurrent Epithelial Ovarian Cancer: Experience from a Thailand Northern Tertiary Care Center

  • Jansaka, Natpat;Suprasert, Prapaporn
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10837-10840
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    • 2015
  • To assess survival outcomes in a retrospective study, recurrent epithelial ovarian cancer patients were divided into three groups according to the platinum free interval as follows: platinum refractory that included the patients with tumor progression during treatment; platinum resistant and platinum sensitive that included the patients with tumor progression less than or more than six months, respectively. Clinical data for tumor progression in epithelial ovarian cancer patients treated at Chiang Mai University Hospital between January, 2006 and December, 2010 were reviewed. Thirty-nine patients were in the platinum refractory group while 27 were in the platinum resistant group and 75 in the platinum sensitive group. The mean age, the parity, the administration of neoadjuvant chemotherapy and the serous type did not significantly different across groups while the mean total number of chemotherapy regimens, the early stage patients, the patients with complete surgery and the surviving patients were significant more frequent in the platinum sensitive group. Regarding subsequent treatment after tumor recurrence, 87.2% underwent chemotherapy. With the median follow up time at 29 months, the median overall survival rates were 20 months, 14 months and 42 months in platinum refractory, platinum resistant and platinum sensitive groups, respectively (p<0.001). In addition, when the platinum sensitive patients developed the next episode of tumor progression, the median progression free interval time was only three to four months. In conclusion, the outcomes for platinum refractory the and platinum resistant groups was poorer than the platinum sensitive group. However, subsequent progression in the platinum sensitive group was also associated with a poor outcome.

Slowing the Progression of Chronic Kidney Disease in Children and Adolescents (소아 청소년 만성 콩팥병의 진행 억제)

  • Ha, Il-Soo;Choi, Yong
    • Childhood Kidney Diseases
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    • v.14 no.1
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    • pp.1-9
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    • 2010
  • Slowing the progression of chronic kidney disease is much more important in children and adolescents with a relatively longer remaining life span. A practical way to assess the rate of progression of chronic kidney disease is to measure the change of GFR estimated by formulae. To slow the progression, hypertension and proteinuria have to be controlled strictly, and hypoplastic anemia must be treated with erythropoietin. If not contraindicated, ACE inhibitor or angiotensin receptor blocker is recommended with monitoring of the side effects. Trials to slow the progression should be commenced as soon as the chronic kidney disease is confirmed and needs to be continued until renal transplantation as long as residual renal function remains. An online system, the Korean Pediatric Chronic Kidney Disease Registry (http://pedcrf.or.kr/), provides tools that are useful in evaluation and management of the children and adolescents with chronic kidney diseases.

Statins Have No Role in Preventing the Progression of Aortic Valve Sclerosis

  • Seo, Jeong-Hun;Chun, Kwang-Jin;Lee, Bong-Ki;Cho, Byung-Ryul;Ryu, Dong Ryeol
    • Journal of Cardiovascular Imaging
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    • v.26 no.4
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    • pp.229-237
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    • 2018
  • BACKGROUND: Statins are thought to have little effect on the progression of aortic stenosis, but the data on their role in patients with aortic valve sclerosis (AVS) are limited and inconsistent. METHODS: We retrospectively analyzed 541 consecutive patients (214 men, age: $70{\pm}11$ years) with AVS. Each patient underwent two or more electrocardiography examinations at least 6 months apart at Kangwon National University Hospital from August 2010 to August 2015. AVS is defined as irregular thickening of the leaflets, focal increases in echogenicity and minimal elevation of the peak aortic valve velocity (> 1.5 and < 2 m/s). The progression rate of AVS was expressed as the increase in peak velocity per year (m/s/yr). RESULTS: The mean follow-up duration was $24.9{\pm}13.3$ months in the statin-treated group and $24.1{\pm}12.4$ months in the non-statin-treated group (p = 0.460). There were no differences between the statin-treated and non-statin-treated groups in mean age, gender or smoking status. Relative to the non-statin-treated group, a higher number of patients in the statin-treated group had hypertension, diabetes, ischemic heart disease, and stroke. The progression rate of AVS did not differ between the statin-treated and non-statin-treated groups ($0.012{\pm}0.340m/s/yr$ vs. $0.014{\pm}0.245m/s/yr$, p = 0.956). Multivariate analysis showed initial peak aortic jet velocity was significantly associated with AVS progression (${\beta}=0.153$, p = 0.009). CONCLUSIONS: Our study demonstrated that statins had no effect on the progression of AVS. However, well-designed studies are needed to define the prognosis and management of AVS.

Effect of oral antioxidants on the progression of canine senile cataracts: a retrospective study

  • Park, Sanghyun;Kang, Seonmi;Yoo, Sukjong;Park, Youngwoo;Seo, Kangmoon
    • Journal of Veterinary Science
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    • v.23 no.3
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    • pp.43.1-43.14
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    • 2022
  • Background: Cataracts are the leading cause of impaired vision or blindness in dogs. There are many antioxidants that can prevent cataract progression, but whether they are clinically effective in dogs has not been established. Objectives: To analyze the delaying or preventing effect of oral antioxidants on canine senile cataracts through retrospective analysis. Methods: Medical records of dogs from January 1, 2015 to July 10, 2020 were reviewed. Dogs that were 8 yr of age or older with senile cataracts were included in this study. The dogs were divided into two treatment groups (dogs administered with Ocu-GLO supplement and dogs administered with Meni-One Eye R/C supplement) and a control group (dogs that were not administered any supplement). Dogs with incipient and immature cataracts were included in this study. Altogether, 112 dogs (156 eyes) with incipient cataracts and 60 dogs (77 eyes) with immature cataracts were included. The period of time that cataracts progressed from incipient to immature, and from immature to mature was recorded for each dog. Results: There was no significant delaying effect on the progression of incipient cataracts. However, both Ocu-GLO (hazard ratio = 0.265, p = 0.026) and Meni-One (hazard ratio = 0.246, p = 0.005) significantly delayed the progression of immature cataracts compared to the control group. Conclusions: Although there was no significant delaying effect of oral antioxidants on incipient cataract progression, antioxidants could be used to delay the progression of senile immature cataract.

A Correlation of Interleukin-6 of Pancreatic Cancer Patients and Cancer Progression: Case Series (췌장암 환자의 IL-6 수치와 암 진행의 상관 관계에 대한 3례 증례보고)

  • Han-eum Joo;Young-min Cho;Jun-yeol Kim;Jung-hyang Park;Soo-jin Kim;Hae-chang Yoon;Jung-hyo Cho
    • The Journal of Internal Korean Medicine
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    • v.45 no.3
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    • pp.508-518
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    • 2024
  • Objectives: To report a correlation of IL-6 of pancreatic cancer and cancer progression in three pancreatic cancer patients. Method: Three pancreatic cancer patients were monitored for changes in IL-6 levels, tumor markers (CEA, CA19-9), and clinical outcomes over their treatment period. Results: Patient 1's IL-6 levels rose with liver metastasis and tumor progression, coinciding with increases in tumor markers. Patient 2's IL-6 levels remained elevated during chemotherapy, correlating with tumor growth. Patient 3's IL-6 levels spiked prior to cancer progression. Conclusion: Elevated IL-6 levels were observed in advancing pancreatic cancer patients, suggesting IL-6 as a potential biomarker for monitoring cancer progression in pancreatic cancer. Regular IL-6 monitoring could improve prognostic evaluations and treatment strategies.

Risk factors for progressing to critical illness in patients with hospital-acquired COVID-19

  • Kyung-Eui Lee;Jinwoo Lee;Sang-Min Lee;Hong Yeul Lee
    • The Korean journal of internal medicine
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    • v.39 no.3
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    • pp.477-487
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    • 2024
  • Background/Aims: Risk factors for progression to critical illness in hospital-acquired coronavirus disease 2019 (COVID-19) remain unknown. Here, we assessed the incidence and risk factors for progression to critical illness and determined their effects on clinical outcomes in patients with hospital-acquired COVID-19. Methods: This retrospective cohort study analyzed patients admitted to the tertiary hospital between January 2020 and June 2022 with confirmed hospital-acquired COVID-19. The primary outcome was the progression to critical illness of hospital-acquired COVID-19. Patients were stratified into high-, intermediate-, or low-risk groups by the number of risk factors for progression to critical illness. Results: In total, 204 patients were included and 37 (18.1%) progressed to critical illness. In the multivariable logistic analysis, patients with preexisting respiratory disease (OR, 3.90; 95% CI, 1.04-15.18), preexisting cardiovascular disease (OR, 3.49; 95% CI, 1.11-11.27), immunocompromised status (OR, 3.18; 95% CI, 1.11-9.16), higher sequential organ failure assessment (SOFA) score (OR, 1.56; 95% CI, 1.28-1.96), and higher clinical frailty scale (OR, 2.49; 95% CI, 1.62-4.13) showed significantly increased risk of progression to critical illness. As the risk of the groups increased, patients were significantly more likely to progress to critical illness and had higher 28-day mortality. Conclusions: Among patients with hospital-acquired COVID-19, preexisting respiratory disease, preexisting cardiovascular disease, immunocompromised status, and higher clinical frailty scale and SOFA scores at baseline were risk factors for progression to critical illness. Patients with these risk factors must be prioritized and appropriately isolated or treated in a timely manner, especially in pandemic settings.

A Framework for Progression in the Professional Development and Learning of Secondary Science Teachers' Teaching Practice (중등 과학교사의 수업 실행 전문성의 발달과 학습 틀)

  • Choi, Young;Lee, Musang;Song, Myungseub
    • Journal of Science Education
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    • v.34 no.1
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    • pp.124-139
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    • 2010
  • The purpose of this study was to develop and apply a framework for progression in the professional development and learning of secondary science teachers' teaching practice. The progression in the professional development was modified Pilhee Woo's framework(2010), and in the learning was developed by the researchers. The former included 6 elements and 36 aspects. The progression of each aspect was composed of five level criteria. The content validity is 96.4% and the reliability is .96. The latter was composed of another five level criteria. The content validity is 96.0% and the reliability is .95. Internet-online test and the questionnaire were administered to 203 secondary science teachers who were selected by convenience sampling. The mean level of the progression in the professional development and learning were 2.21 and 2.95. ANOVA, t-test and correlation analysis were conducted to compare differences by the characteristics of teachers. The level of the progression in the professional development and learning was significant difference according to almost all of teachers' characteristics. The level of the progression in the professional development was significantly correlated with the level of the progression in the learning.

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Exploring Learning Progression of Logical Thinking in Acid and Base Chemical Reactions (산과 염기 화학반응에서 논리 사고 학습발달단계 탐색)

  • Park, Chulyong;Kim, Sungki;Choi, Hee;Paik, Seoung-Hey
    • Journal of the Korean Chemical Society
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    • v.63 no.5
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    • pp.376-386
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    • 2019
  • The purpose of this study was to explore the learning progression of logical thinking in acid and base chemical reactions and to evaluate its validity. For this purpose, we collected 387 participants in 9 schools of elementary, middle and high schools nationwide. The questionnaire developed in this study was composed of nine items. The questionnaire presented the acid and base reactants and products, and the students pictured their thoughts on how these substances change, and answered the reasons of their thoughts. Situation contexts of the questionnaire were divided into two groups: one kind of solute dissolved in a solvent, and two kinds of solute dissolved in a solvent. In this study, six levels of learning progression were assumed by combining material conservation logic, combination logic, proportion logic, and particle number conservation logic. By analyzing the data, Infit and Outfit values of Person reliability, Item reliability, MNSQ and ZSTD were obtained from the Rasch model. As a result of the analysis of data, it was found that lower levels of learning progression prevailed up to the younger grade students till $8^{th}$ grade. The higher levels of learning progression(Level 2~Level 5) prevailed up to the older grade students. However, higher levels of learning progression dropped sharply in Grade 12. The 5 level of learning progression was very low in all grades, and $9^{th}$ grade had highest percentage of students belonging to the 5 level. Interpretation of these unusual results suggests a future research related to explanation differences of textbooks.