Purpose: Centromere protein H (CENP-H) and Ki67 are overexpressed in some malignancies, but whether they are predictors of survival after primary resection for hypopharyngeal squamous cell carcinoma (HSCC) remains unknown. Methods: We assessed immunohistochemical expression of CENP-H and Ki67 in 112 HSCC specimens collected between March 2003 and March 2005 for analysis by clinical characteristics. The Kaplan-Meier method was used to analyze relapse-free survival and logistic multivariate regression to determine risk factors of relapse-free survival. Cholecystokinin octapeptide assays and flow cytometry were used to examine cell proliferation and apoptosis after siRNA inhibition of CENP-H in HSCC cells. Results: Overall, 50 (44.6%) HSCC specimens showed upregulated CENP-H expression and 69 (61.6%) upregulated Ki67. An increased CENP-H protein level was associated with advanced cancer stage and alcohol history (P=0.012 and P=0.048, respectively) but an increased Ki67 protein level only with advanced cancer stage (P=0.021). Increased CENP-H or Ki67 were associated with short relapse-free survival (P<0.001 or P=0.009, respectively) and were independent predictors of relapse-free survival (P=0.001 and P=0.018, respectively). siRNA knockdown of CENP-H mRNA inhibited cell proliferation and promoted cancer cell apoptosis in vitro. Conclusions: Upregulated CENP-H and Ki67 levels are significantly associated with short relapse-free survival in HSCC. These factors may be predictors of a relapsing phenotype in HSSC cases.
This study was intended to evaluate a post-operative relapse tendency in mandibular prognathism patients with open-bite. 18 patients with or without open-bite have undergone sagittal split ramus osteotomy and were investigated radiologically with cephalogram. The results were as following 1. The preoperative anterior facial height, mandibular plane angle and mandibular gonial angle were larger in open-bite patients than in nonopen-bite patients.(p>0.05) 2. There was significant correlation between surgical change of SNA, mandibular plane length and long-term relapse.(p<0.01). 3. There was relatively stable postoperative anterior facial height in open bite patients. 4. There was no significant correlation between the surgical change of mandibular plane angle, amount of mandibular setback and long-term relapse.(p>0.01) 5. This study showed that horizontal relapse was more significant than vertical relapse.
Jung, Gyu Sik;Kim, Taek Kyun;Lee, Jeong Woo;Yang, Jung Dug;Chung, Ho Yun;Cho, Byung Chae;Choi, Kang Young
Archives of Plastic Surgery
/
v.44
no.1
/
pp.19-25
/
2017
Background Numerous condylar repositioning methods have been reported. However, most of them are 2-dimensional or are complex procedures that require a longer operation time and a highly trained surgeon. This study aims to introduce a new technique using a condylar repositioning plate and a centric relation splint to achieve a centric relationship. Methods We evaluated 387 patients who had undergone surgery for skeletal jaw deformities. During the operation, a centric relation splint, intermediate splint, final centric occlusion splint, and condylar repositioning plate along with an L-type mini-plate for LeFort I osteotomy or a bicortical screw for bilateral sagittal split ramus osteotomy were utilized for rigid fixation. The evaluation included: a physical examination to detect preoperative and postoperative temporomandibular joint dysfunction, 3-dimensional computed tomography and oblique transcranial temporomandibular joint radiography to measure 3-dimensional condylar head movement, and posteroanterior and lateral cephalometric radiography to measure the preoperative and postoperative movement of the bony segment and relapse rate. Results A 0.3% relapse rate was observed in the coronal plane, and a 2.8% relapse rate in the sagittal plane, which is indistinguishable from the dental relapse rate in orthodontic treatment. The condylar repositioning plate could not fully prevent movement of the condylar head, but the relapse rate was minimal, implying that the movement of the condylar head was within tolerable limits. Conclusions Our condylar repositioning method using a centric relation splint and miniplate in orthognathic surgery was found to be simple and effective for patients suffering from skeletal jaw deformities.
This study investigated the effect of spouse attitude of psychiatric patients on relapse. The research was based on the concept that spouses' attitudes toward mental illness influences relapse, mediated by marital relationship and social adaptation. Data were collected from 102 of the psychiatrically disordered who were married, and analyzed through Structural Equation Modelling to validate causal paths and mediator effects of the variables. The marital relationship was shown to act as a mediator between spouse attitude and social adaptation, while social adaptation showed a complete mediation effect between marital relationship and relapse. Thus, spouse attitude towards mental illness was shown to have a statistically meaningful effect on relapse indirectly and through sequential mediation effect of marital relationship and social adaptation. This study proposes the facilitation of counseling and training programs to improve the marital relationships of psychiatric patients. The emphasis is on the educational program for the spouses to improve their knowledge of mental illness.
Objectives: This study aimed to investigate smoking relapse and the related factors within 1 year after discharge from the smoking cessation clinics (SCCs) of public health centers (PHCs). Methods: Data were collected with a structured questionnaire from 395 people who success fully stopped smoking at 4 SCCs in Busan between May and June 2009, and this data were analyzed by Kaplan-Meier survival curves and the Cox proportional hazard model. Results: The rate of smoking relapse within 1 year after discharge from SCCs was 39.2% and this decreased rapidly over 6 months after discharge. The factors related to smoking relapse within 1 year after discharge from SCCs were being female (HR, 2.11; 95% CI, 1.17 to 3.82), a trial of smoking cessation with any assistants (HR, 1.95; 95% CI, 1.19 to 3.19), more than 7 ppm of exhaled CO2 on the SCCs' registration (HR, 1.81; 95% CI, 1.24 to 2.64), use of pharmacotherapy after discharge from SCCs (HR, 2.00; 95% CI, 1.36 to 2.93), alcohol drinking more than once a week after discharge from SCCs (HR, 3.32; 95% CI, 2.15 to 6.78), and a perceived barrier (HR, 1.21; 95% CI, 1.14 to 1.30) after discharge from the SCCs. Conclusions: According to the results, at least 6 months follow-up after discharge from SCCs of public health centers is recommended to reduce the rate smoking relapse. It is also recommended to strengthen the education on how to overcome barriers such as drinking in the course of smoking cessation clinics.
Purpose: The purpose of this study is to identify factors associated with smoking relapse within six months after quit attempts among workers in small and medium-sized enterprises in South Korea. Methods: The analysis was conducted for a total of 194 people who attempted to quit smoking by applying for a smoking cessation support service at the Regional Tobacco Control Center. The data used in the study were extracted from the Smoking Cessation Service Integrated Information System. Kaplan-Meier estimator and Cox proportional hazards regression model were used to identify variables associated with smoking relapse within six months' time period. Results: Smoking relapse rate within six months was 66.0%, and variables associated with relapse included the cases such as carbon monoxide (CO) at the time of registration (HR: 2.15, 95% CI: 1.10~4.22 for CO ≥20 ppm or more vs.CO <10 ppm), the average number of cigarettes smoked per day (HR: 1.04, 95% CI: 1.00~1.07), and the number of counseling(HR: 0.60, 95% CI: 0.54~0.67). Conclusion: Smoking characteristics and counseling showed one of the strongest correlations with relapse within six months. This implies that it is necessary to understand the smoking characteristics and patterns of workers and to provide continuous smoking cessation counseling tailored to individual characteristics for effective smoking relapse prevention.
Despite recent groundbreaking advances in multiple myeloma (MM) treatment, most MM patients ultimately experience relapse, and the relapse biology is not entirely understood. To define altered gene expression in MM relapse, gene expression profiles were examined and compared among 16 MM patients grouped by 12 months progression-free survival (PFS) after autologous stem cell transplantation. To maximize the difference between prognostic groups, patients at each end of the PFS spectrum (the four with the shortest PFS and four with the longest PFS) were chosen for additional analyses. We discovered that integrin-${\alpha}8$ (ITGA8) is highly expressed in MM patients with early relapse. The integrin family is well known to be involved in MM progression; however, the role of integrin-${\alpha}8$ is largely unknown. We functionally overexpressed integrin-${\alpha}8$ in MM cell lines, and surprisingly, stemness features including $HIF1{\alpha}$, VEGF, OCT4, and Nanog, as well as epithelial mesenchymal transition (EMT)-related phenotypes, including N-cadherin, Slug, Snail and CXCR4, were induced. These, consequently, enhanced migration and invasion abilities, which are crucial to MM pathogenesis. Moreover, the gain of integrin-${\alpha}8$ expression mediated drug resistance against melphalan and bortezomib, which are the main therapeutic agents in MM. The cBioPortal genomic database revealed that ITGA8 have significant tendency to co-occur with PDGFRA and PDGFRB and their mRNA expression were up-regulated in ITGA8 overexpressed MM cells. In summary, integrin-${\alpha}8$, which was up-regulated in MM of early relapse, mediates EMT-like phenotype, enhancing migration and invasion; therefore, it could serve as a potential marker of MM relapse and be a new therapeutic target.
Purpose : To assess the efficacy of craniospinal radiotherapy in patients with acute lymphoblastic leukemia (ALL) experiencing the CNS relapse. Materials and Methods: Thirty ALL patients with relapse in the central nervous system (CNS) were treated with radiotherapy and intrathecal chemotherapy. Age ranged 2 to 46. The number of males and females were all 15. Twenty-two cases were previously treated with presymptomatic radiotherapy to the whole brain. The extent of radiotherapy was the whole brain (18-24 Gy) and the whole spine (12 Gy) in 21 cases but the whole brain only in the 9 cases with poor performance. Results : The complete remission rate in the CNS was $100{\%}$. Among the 12 cases ($40{\%}$) who had secondary relapse, 9 cases had the bone marrow relapse alone, 2 cases had the CNS and bone marrow relapse, 1 cases had the CNS relapse alone. Higher CNS remission rate was observed when the initial remission duration was longer than 24 months or radiation was delivered to the whole brain and the whole spine. Survival rate at 2 year was $31.6{\%}$. Remission duration in the 10 living patients ragned from 9 to 87 months (median; 58 months).
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.43
no.3
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pp.152-159
/
2017
Objectives: The aim of this study was to investigate the effects of advancement magnitude and changes in mandibular plane angle on the stability of mandibular advancement. Materials and Methods: This retrospective cohort study evaluated the postoperative stability of mandibular advancement in class II skeletal subjects who underwent bilateral sagittal split osteotomy. Radiographs taken preoperatively, immediately postoperatively and 1 year postoperatively were traced and analyzed using linear and angular measurements. To determine horizontal and vertical relapse, an X-Y coordinate system was established in which the X-axis was constructed by rotating S-N downward by $7^{\circ}$ (approximation of the Frankfort horizontal plane) and the Y-axis was defined as a line perpendicular to the X-axis and passing through the point Sella. For certain reference points including point A, point B, pogonion and menton, the perpendicular distance between each point and both axes was determined and cephalometric variables were recorded as X and Y coordinates. Results: Twenty-five subjects were studied. A significant correlation between the amount of mandibular advancement and relapse in the B point (vertical and horizontal) and the pogonion point was observed (vertical and horizontal, P<0.001). Evaluation of data demonstrated a positive correlation between the mandibular plane angle (SN/ML) change and vertical relapse in the B point (P<0.05). A simple regression model demonstrated that 74% of horizontal relapse and 42.3% of vertical relapse in the B point was related to the amount of mandibular advancement. The receiver operating characteristic test showed that 8.5 mm mandibular advancement is related to a relapse rate of 1 mm or more in the pogonion, vertically or horizontally. Conclusion: The magnitude of mandibular advancement is a stronger surgical predictor for horizontal rather than vertical relapse at the B point. Changes in mandibular plane angle (SN/ML) during surgery affect vertical, but not horizontal relapse at the B point.
Journal of agricultural medicine and community health
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v.36
no.2
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pp.87-100
/
2011
Objectives: This study aimed to identify factors associated with smoking relapse. Methods: The study sample was recruited among subjects who were enrolled in the smoking cessation clinic of a public health center and had succeeded in quitting smoking for at least six months. A total of 159 male subjects were followed via mail survey one year later. The independent variables in the analyses were socio-demographic characteristics, smoking history and behavior, receipt of smoking cessation aids, health behaviors and components of the health belief model (HBM). The dependent variable was smoking relapse assessed one year after quitting. Ordered logit regressions were used to identify factors associated with smoking relapse. Results: The relapse rate of the ex-smokers in our sample was 25.8%, and the occasional smoking rate was 17.0%. Univariate analyses revealed that only factors related to the HBM, such as perceived susceptibility to diseases (p<0.01), perceived severity of diseases (p<0.01), perceived health benefits of not smoking (p<0.01), perceived barriers to quitting smoking due to increasing stress and difficulty in social life (p<0.01), and self-efficacy (p<0.01) were associated with the likelihood of relapse for ex-smokers. Ordered logit analyses yielded two significant factors affecting the likelihood of relapse, the perceived barriers to quitting smoking and self-efficacy. Conclusions: Our results indicate that higher levels of barriers to quitting smoking and lower levels of self-efficacy were significantly related to risk of smoking relapse. These findings may be useful for identifying those at highest risk for relapse and choosing the optimal strategies for prevention of relapse for ex-smokers.
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