• Title/Summary/Keyword: survival regression

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Outcomes of Second-Line Chemotherapy for Advanced Non-Small Cell Lung Cancer in One Institution

  • Lee, Seok Jeong;Kang, Hyun Ju;Kim, Seo Woo;Ryu, Yon Ju;Lee, Jin Hwa;Kim, Yookyung;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.1
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    • pp.13-17
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    • 2014
  • Background: This study analyzed the negative prognostic factors in patients who received second-line chemotherapy for advanced inoperable non-small cell lung cancer (NSCLC). Methods: We retrospectively reviewed the records of 137 patients with inoperable stage III-IV NSCLC who received second-line chemotherapy. The effects of clinical parameters on survival were analyzed and the hazard ratios (HR) for mortality were identified by a Cox regression analysis. Results: Sex, age older than 65 years, smoking history, cell type, T-stage, best response to first-line chemotherapy and first-line chemotherapy regimen were significant negative predictors in univariate analysis. The multivariate analysis showed that patients older than 65 years (HR, 1.530; 95% confidence interval [CI], 1.020-2.297), advanced T stage (T4 vs. T1; HR, 2.273; 95% CI, 1.010-5.114) and non-responders who showed progression with first-line chemotherapy (HR, 1.530; 95% CI, 1.063-2.203) had higher HR for death. Conclusion: The age factor, T stage and responsiveness to first-line chemotherapy were important factors in predicting the outcome of patients with advanced NSCLC who received second-line chemotherapy. The results may help to predict outcomes for these patients in the future.

Population Dynamics of Corbicula ( Corbicula) japonica Prime from Namdae Stream in Yangyang, Korea (강원도 양양 남대천에서 채집된 일본재첩, Corbicula (Corbicula) japonica Prime의 수산자원학적 연구)

  • Kwon Dae Hyeon;Kang Yong Joo;Kim Wan Ki;Lee Chae Sung
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.35 no.6
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    • pp.686-695
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    • 2002
  • Samples of Corbicula ( Corbicula) japonica Prime of Namdae Stream in Gangnung were collected from November 2000 to October 2001. Age of C. (C.) japonica was determined from the rings on the shell, The shell length of the samples ranged from 8 mm to 38 mm. The ring on the shell was formed once a year in March. Von Bertalanffy's growth parameters were estimated using a nonlinear regression method, asyinptotie shell length ($L_{\omega}$) was 48,98 mm, K was 0.20421year, theoretical age at 0 shell length $(t_0)$ was 0.3169 year, and asymptotic total weight ($W_{\omega}$) was 41.37 g. The formula of allomeky between shell length (L, mm) and total weight (W, g) of the brackish water clam was W=3.42$\times$10^{-4}L^{3}. The annual survival rate was estimated at 0.3799, instantaneous coefficient of natural mortality was 0.5007/year, and instantaneous coefficient of fishing mortality was 0.46721year. The age at first capture was estimated at 2.1593 year using shell length compositions of the brackish water clam, The current yield-per-recruit at 0.4672/year of fishing mortality was 0.6595 g. F_0.1 was estimated at 0.1865/year, Acceptable biological catch was estimated at 14.4 metric ton.

Clinical Effect of Left Ventricular Dysfunction in Patients with Mitral Stenosis after Mitral Valve Replacement

  • Park, Kwon Jae;Woo, Jong Soo;Park, Jong Yoon;Jung, Jae Hwa
    • Journal of Chest Surgery
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    • v.49 no.5
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    • pp.350-355
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    • 2016
  • Background: Mitral stenosis (MS) remains one of the important heart diseases. There are many factors that influence the clinical outcomes, and little is known about how left ventricular (LV) dysfunction clinically affects the prognosis of the patient with MS after mitral valve replacement (MVR). We reviewed our clinical experiences of MVR in patients with MS who had LV dysfunction. Methods: Between January 1991 and January 2013, 110 patients with MS who underwent MVR were analyzed and divided into two groups according to ejection fraction (EF). Group 1 ($EF{\leq}45%$) included 13 patients and group 2 (EF>45%) included 97 patients. Results: Thromboembolism occurred in 8 patients after MVR (group 1: n=3, 23.1%; group 2: n=5, 5.2%) and its incidence was significantly higher in group 1 than in group 2 (p=0.014). There were 3 deaths each in groups 1 and 2 during follow-up. The overall rate of cardiac-related death in group 1 was significantly higher than in group 2 (group 1: n=3, 23.1%; group 2: n=3, 3.1%; p=0.007). The cumulative survival rate at 1 and 15 years was 83.9% and 69.9% in group 1 and 97.9% and 96.3% in group 2 (p=0.004). The Cox regression analysis revealed that survival was significantly associated with postoperative stroke (p=0.011, odds ratio=10.304). Conclusion: This study identified postoperative stroke as an adverse prognostic factor in patients with MS after MVR, and a s more prevalent in patients with LV dysfunction. Postoperative stroke should be reduced to improve clinical outcomes for patients. Preventive care should be made in multiple ways, such as management of LV dysfunction, atrial fibrillation, and anticoagulation.

Duration of Abstinence after Discharge from Alcoholism Inpatient Treatment - Comparing Voluntarily vs. Involuntarily Admitted Patients - (알코올중독자의 입원동의 여부에 따른 퇴원후 단주기간에 관한 연구)

  • Rhee, Chaie-Won
    • Korean Journal of Social Welfare Studies
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    • no.39
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    • pp.57-81
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    • 2008
  • Motivation has been identified as an important factor predicting long-term outcomes of alcohol abuse treatment. Whether a patient agreed on his/her inpatient treatment at time of hospitalization could be an indicator of their motivation for treatment. This study focused on this aspect of treatment motivation and examined whether this factor predicts post-discharge abstinence. A sample of 145 individuals who were hospitalized for alcohol abuse treatment participated in the baseline data collection, of which only 66 successfully completed the 8 month follow-up telephone interview. The findings of survival analysis suggest that voluntarily admitted individuals had significantly longer duration of post-discharge abstinence compared to their counterparts. A Cox proportional hazards regression model revealed that voluntary admission and family support were significant predictors for post-discharge relapse of drinking, after controlling for the effects of marital status, living alone, and working status. Implications for social work practice are discussed.

Association between Cumulative Fluid Balance and Outcomes in Acute Respiratory Distress Syndrome Patients Treated with Extracorporeal Membrane Oxygenation

  • Lee, Jun Hee;Won, Jong Yun;Kim, Ji Eon;Kim, Hee Jung;Jung, Jae Seung;Son, Ho Sung
    • Journal of Chest Surgery
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    • v.54 no.1
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    • pp.36-44
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    • 2021
  • Background: Extracorporeal membrane oxygenation (ECMO) has become increasingly accepted as a life-saving procedure for patients with severe acute respiratory distress syndrome (ARDS). This study investigated the relationship between cumulative fluid balance (CFB) and outcomes in adult ARDS patients treated with ECMO. Methods: We retrospectively analyzed the data of adult ARDS patients who received ECMO between December 2009 and December 2019 at Korea University Anam Hospital. CFB was calculated during the first 7 days after ECMO initiation. The primary endpoint was 28-day mortality. Results: The 74 patients were divided into survivor (n=33) and non-survivor (n=41) groups based on 28-day survival. Non-survivors showed a significantly higher CFB at 1-7 days (p<0.05). Cox multivariable proportional hazard regression revealed a relationship between CFB on day 3 and 28-day mortality (hazard ratio, 3.366; 95% confidence interval, 1.528-7.417; p=0.003). Conclusion: In adult ARDS patients treated with ECMO, a higher positive CFB on day 3 was associated with increased 28-day mortality. Based on our findings, we suggest a restrictive fluid strategy in ARDS patients treated with ECMO. CFB may be a useful predictor of survival in ARDS patients treated with ECMO.

Objective Quantitation of EGFR Protein Levels using Quantitative Dot Blot Method for the Prognosis of Gastric Cancer Patients

  • Xin, Lei;Tang, Fangrong;Song, Bo;Yang, Maozhou;Zhang, Jiandi
    • Journal of Gastric Cancer
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    • v.21 no.4
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    • pp.335-351
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    • 2021
  • Purpose: An underlying factor for the failure of several clinical trials of anti-epidermal growth factor receptor (EGFR) therapies is the lack of an effective method to identify patients who overexpress EGFR protein. The quantitative dot blot method (QDB) was used to measure EGFR protein levels objectively, absolutely, and quantitatively. Its feasibility was evaluated for the prognosis of overall survival (OS) of patients with gastric cancer. Materials and Methods: Slices of 2×5 ㎛ from formalin-fixed paraffin-embedded gastric cancer specimens were used to extract total tissue lysates for QDB measurement. Absolutely quantitated EGFR protein levels were used for the Kaplan-Meier OS analysis. Results: EGFR protein levels ranged from 0 to 772.6 pmol/g (n=246) for all gastric cancer patients. A poor correlation was observed between quantitated EGFR levels and immunohistochemistry scores with ρ=0.024 and P=0.717 in Spearman's correlation analysis. EGFR was identified as an independent negative prognostic biomarker for gastric cancer patients only through absolute quantitation, with a hazard ratio of 1.92 (95% confidence interval, 1.05-3.53; P=0.034) in multivariate Cox regression OS analysis. A cutoff of 208 pmol/g was proposed to stratify patients with a 3-year survival probability of 44% for patients with EGFR levels above the cutoff versus 68% for those below the cutoff based on Kaplan-Meier OS analysis (log rank test, P=0.002). Conclusions: A QDB-based assay was developed for gastric cancer specimens to measure EGFR protein levels absolutely, quantitatively, and objectively. This assay should facilitate clinical trials aimed at evaluation of anti-EGFR therapies retrospectively and prospectively for gastric cancer.

Intensive care unit management of uncomplicated type B aortic dissection in relation to treatment period: a retrospective observational study

  • Lee, Chul Ho;Jang, Jae Seok;Cho, Jun Woo
    • Journal of Yeungnam Medical Science
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    • v.39 no.4
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    • pp.294-299
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    • 2022
  • Background: Medical therapy is the standard treatment for uncomplicated acute type B aortic dissection (ATBAD), but there is little evidence of the need for intensive care unit (ICU) management. Therefore, we aimed to investigate the effects of ICU treatment on uncomplicated ATBAD. Methods: We retrospectively studied patients with uncomplicated ATBAD who were medically treated between January 2010 and July 2020. Patients were divided into short-term ICU stay (SIS) and long-term ICU stay (LIS) groups, according to a 48-hour cutoff of ICU stay duration. The incidence of pneumonia and delirium, rate of aortic events, hospital mortality, and survival rate were compared. Results: Fifty-five patients were treated for uncomplicated ATBAD (n=29 for SIS and n=26 for LIS). The incidence of pneumonia (3.6% vs. 7.7%) and delirium (14.3% vs. 34.6%) was higher in the LIS group than in the SIS group, but the differences were not statistically significant. The survival rates at 1, 3, and 5 years were not different between the two groups (SIS: 96.4%, 92.2%, and 75.5% vs. LIS: 96.2%, 88.0%, and 54.2%, respectively; p=0.102). Multivariate Cox regression analysis for aortic events showed that using a calcium channel blocker lowered the risk of aortic events. Conclusion: Long-term ICU treatment is unlikely to be necessary for the treatment of uncomplicated ATBAD. Active use of antihypertensive agents, such as calcium channel blockers, may be needed during the follow-up period.

Barthel's Index: A Better Predictor for COVID-19 Mortality Than Comorbidities

  • da Costa, Joao Cordeiro;Manso, Maria Conceicao;Gregorio Susana;Leite, Marcia;Pinto, Joao Moreira
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.4
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    • pp.349-357
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    • 2022
  • Background: The most consistently identified mortality determinants for the new coronavirus 2019 (COVID-19) infection are aging, male sex, cardiovascular/respiratory diseases, and cancer. They were determined from heterogeneous cohorts that included patients with different disease severity and previous conditions. The main goal of this study was to determine if activities of daily living (ADL) dependence measured by Barthel's index could be a predictor for COVID-19 mortality. Methods: A prospective cohort study was performed with a consecutive sample of 340 COVID-19 patients representing patients from all over the northern region of Portugal from October 2020 to March 2021. Mortality risk factors were determined after controlling for demographics, ADL dependence, admission time, comorbidities, clinical manifestations, and delay-time for diagnosis. Central tendency measures were used to analyze continuous variables and absolute numbers (proportions) for categorical variables. For univariable analysis, we used t test, chi-square test, or Fisher exact test as appropriate (α=0.05). Multivariable analysis was performed using logistic regression. IBM SPSS version 27 statistical software was used for data analysis. Results: The cohort included 340 patients (55.3% females) with a mean age of 80.6±11.0 years. The mortality rate was 19.7%. Univariate analysis revealed that aging, ADL dependence, pneumonia, and dementia were associated with mortality and that dyslipidemia and obesity were associated with survival. In multivariable analysis, dyslipidemia (odds ratio [OR], 0.35; 95% confidence interval [CI], 0.17-0.71) was independently associated with survival. Age ≥86 years (pooled OR, 2.239; 95% CI, 1.100-4.559), pneumonia (pooled OR, 3.00; 95% CI, 1.362-6.606), and ADL dependence (pooled OR, 6.296; 95% CI, 1.795-22.088) were significantly related to mortality (receiver operating characteristic area under the curve, 82.1%; p<0.001). Conclusion: ADL dependence, aging, and pneumonia are three main predictors for COVID-19 mortality in an elderly population.

Prognostic Impact of Postoperative Complications in High-Risk Operable Non-small Cell Lung Cancer

  • Lee, Seungwook;Roknuggaman, Md;Son, Jung A;Hyun, Seungji;Jung, Joonho;Haam, Seokjin;Yu, Woo Sik
    • Journal of Chest Surgery
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    • v.55 no.1
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    • pp.20-29
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    • 2022
  • Background: Patients with high-risk (HR) operable non-small cell lung cancer (NSCLC) may have unique prognostic factors. This study aimed to evaluate surgical outcomes in HR patients and to investigate prognostic factors in HR patients versus standard-risk (SR) patients. Methods: In total, 471 consecutive patients who underwent curative lung resection for NSCLC between January 2012 and December 2017 were identified and reviewed retrospectively. Patients were classified into HR (n=77) and SR (n=394) groups according to the American College of Surgeons Oncology Group criteria (Z4099 trial). Postoperative complications were defined as those of grade 2 or higher by the Clavien-Dindo classification. Results: The HR group comprised more men and older patients, had poorer lung function, and had more comorbidities than the SR group. The patients in the HR group also experienced more postoperative complications (p≤0.001). More HR patients died without disease recurrence. The postoperative complication rate was the only significant prognostic factor in multivariable Cox regression analysis for HR patients but not SR patients. HR patients without postoperative complications had a survival rate similar to that of SR patients. Conclusion: The overall postoperative survival of HR patients with NSCLC was more strongly affected by postoperative complications than by any other prognostic factor. Care should be taken to minimize postoperative complications, especially in HR patients.

A Study on the Factors Affecting the Likelihood of the Asset Poor's Poverty Exit and Entry (자산빈곤이행 가능성에 영향을 미치는 요인에 관한 연구)

  • Kang, Sung-min;Yoo, Tae-kyun
    • Korean Journal of Social Welfare Studies
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    • v.40 no.1
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    • pp.115-138
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    • 2009
  • The primary focus of this study is to examine the characteristics of the asset poor and to empirically investigate those factors affecting the likelihood of the asset poor's poverty exit and entry. The 2nd wave through 8th wave data from KLIPS were used for analysis. The asset poverty lined of 50% of the household net asset was set up so that households below 50% are classified as the asset poor. The characteristics of the asset poor were examined in a static manner by analyzing only the 8th wave KLIPS data. To investigate those factors affecting the likelihood of asset poor's poverty transferal with a dynamic perspective, the authors employed two survival analysis methods, the life table analysis and the Time-dependent Cox regression analysis. Based on the findings, some recommendations were made for future policy efforts to support the asset poor and for the current poverty policies as well. In specific, if the 'Individual Development Account' is to be initiated in the future, it would be essential to build a systematic model to utilize accumulated asset by enhancing job competencies and ability to gain a decent job.