Background: New tumour biomarkers are being intensely investigated for malignant mesothelioma (MM). Fibulin-3 is produced in MM but its role remains uncertain. The aim of this study was to evaluate the validity of measuring serum fibulin-3 in the diagnosis and prognosis of MM. Materials and Methods: This prospective study was performed on 43 patients and 40 healthy controls who were admitted to our hospital between January 2012 and January 2014. Data from MM patients, including demographic and clinical features, routine laboratory data, levels of serum fibulin-3, and treatment outcomes were defined as potential prognostic factors. The receiver operating characteristic (ROC) curve for fibulin-3 was used to detect the cut-off value with highest sensitivity and specificity. Univariate survival analysis was performed using the Kaplan-Meier method in patients with MM. Afterwards, the possible factors identified with univariate analyses were entered into the cox regression analysis. Results: Our results revealed that patients with MM had significantly higher serum levels of fibulin-3 than controls. The results showed that the best cut-off point was 36.6 ng/ml with an AUC (area under the curve)=0.976, sensitivity=93.0% and specificity=90.0. In our study, the initial significant poor prognostic factors were advanced stage, high white blood cell count, high platelet count, high C-reactive protein (p<0.05 for each variable). Later, according to multivariate analysis the results showed only advanced stage as significant parameter (p=0.040). Conclusions: We determined that real use for serum fibulin-3 was not for prognosis but for diagnosis in MM. Also advanced stage was associated with poor MM prognosis.
Purpose: Anastomotic leakage (AL) is associated with high morbidity and mortality, high reoperation rates, and increased hospital length of stay. Here we investigated the risk factors for AL after anterior resection for rectal cancer with a double stapling technique. Patients and Methods: Data for 460 patients who underwent primary anterior resection with a double stapling technique for rectal carcinoma at a single institution from 2003 to 2007 were prospectively collected. All patients experienced a total mesorectal excision (TME) operation. Clinical AL was defined as the presence of leakage signs and confirmed by diagnostic work-up according to ICD-9 codes 997.4, 567.22 (abdominopelvic abscess), and 569.81 (fistula of the intestine). Univariate and logistic regression analyses of 20 variables were undertaken to determine risk factors for AL. Survival was analysed using the Cox regression method. Results: AL was noted in 35 (7.6%) of 460 patients with rectal cancer. :Median age of the patients was 65 (50-74) and 161 (35%) were male. The diagnosis of AL was made between the 6th and 12th postoperative day (POD; mean 8th POD). After univariate and multivariate analysis, age (p=0.004), gender (p=0.007), tumor site (p<0.001), preoperative body mass index (EMI) (p<0.001), the reduction of TSGF on 5th POD less than 10U/ml (p=0.044) and the pH value of pelvic dranage less than or equal to 6.978 on 3rd POD (p<0.001) were selected as 6 independent risk factors for AL. It was shown that significant differences in survival of the patients were AL-related (p<0.001), high ASA score related (p=0.036), high-level EMI related (p=0.007) and advanced TNM stage related
Park, Seung-Kyu;Kwon, Eun-Soo;Ha, Hyun-Cheol;Hwang, Su-Hee
Tuberculosis and Respiratory Diseases
/
v.46
no.1
/
pp.25-35
/
1999
Background : The treatment for multi-drug resistant tuberculosis(MDRTB) is encountered to be important clinically, but there are still a few reports about it all over the world. So, we evaluated the outcomes of only chemotherapy for the pulmonary MDRTB retrospectively. Method: We reviewed the clinical courses of 63 patients with pulmonary disease due to M.tuberculosis resistant to rifampin and isoniazid who were under follow-up between March 1996 and June 1996 after hospitalization at our hospital between January 1993 and January 1996. We performed cohort retrospective study for all these patient's records. Their regimens were selected individually and preferably included four medications that they had not been given previously and to which the strain was fully susceptible. Results: The 63 patients(mean age, 43.2 years) had previously received a median 5.1drugs. Fifty two(82.5%) patients responded to chemotherapy(as indicated by negative sputum cultures for at least three consecutive months) ; eleven patients(17.5 %) had no response, as shown by continually positive cultures. In a univariate analysis, an unfavorable response was significantly associated with greater number of resistant drugs before the current courses of therapy(relative risk 21.5 ; 95 percent confidence interval, 1.2-3.0; p<0.05). The mean period of follow-up was seventeen months. There was no relapse suooequently among the patients with responses. There was no death related to tuberculosis. Conclusion: In this report from National Masan Tuberculosis Hospital in Korea, multi-drug resistant pulmonary tuberculosis responded relatively well to carefully selected regimens.
The Journal of the Korean bone and joint tumor society
/
v.15
no.1
/
pp.7-12
/
2009
Purpose: This study was aimed to assess TLE1 as a target molecule of synovial sarcoma. Method: We obtained tissue samples and clinical data from 36 patients who were diagnosed and treated for synovial sarcoma in our hospital. Immunohistochemical staining was performed to detect the expression of TLE1 in synovial sarcoma and normal tissues such as fat, skeletal muscle, peripheral nerve, vascular endothelium, and epithelium. Univariate survival analysis was performed to find whether overexpression of TLE1 is correlated to poor prognosis. Results: TLE1 was expressed in 35 (97%) cases (grade 1 was 5 cases, grade 2 was 28 cases, grade 3 was 2 cases.). Normal tissues from mesenchymal origin did not express TLE1. However, epithelial and endothelial cells showed weak expression (grade 1) of TLE1. The level of TLE1 expression did not have any prognostic significance according to univariate survival analysis. Conclusion: TLE1 may be a new molecular target of synovial sarcoma that differentiates synovial sarcoma from normal mesenchymal cells.
Kim, Nam Young;Kim, Kyoung Hun;Park, Sung Ho;Lee, Guk Haeng;Lee, Byeong Cheol;Lee, Myung-Chul;Choi, Ik Joon
Korean Journal of Head & Neck Oncology
/
v.32
no.2
/
pp.1-4
/
2016
Background and Objectives: National cancer center institute reports that male patients of papillary thyroid carcinoma (PTC) are annually increasing. This study aimed to analyze the features of the male patients with PTC. Materials and Method: We retrospectively reviewed and analyzed clinical records of 170 patients who were treated for PTC in male patients between 2000 and 2010. Clinical features, size, pathologic type, extrathyroidal extension, recurrence, multiplicity, extent of surgery, and lymph node metastasis were retrospectively evaluated.Univariate and multivariate analyses of various clinical factors were performed. Results: Total 4145 patients received surgery for papillary thyroid carcinoma. The number of male patients was 170 (4.1%) among them. Of170 male patients, only 16(9.4%) patients underwent the recurrence of PTC. The size of tumor, central neck node metastasis, lateral neck node metastasis, extrathyroidal extension and RAI ablation therapy were associated with recurrence(p< 0.05) in univariate analysis. However, only the extrathyroidal extension [p=0.03, Odds ratio=3.58(95% CI. 1.09~14.24)] was related to the recurrence in multivariate analysis. Conclusion: Re-estimation of clinical features in male PTC patients should be concerned. The recurrence of PTC in male patients was 16(9.4%) and nearly same as the other studies. The extrathyroidal extension was revealed as an associated factor for the recurrence. Evaluation of regional or distant metastasis should be considered in patients with the extrathyroidal extension in male PTC patients during long-term follow-up.
Rhee, Jong Joo;Ahn, Jae Sung;Jeon, Sang Ryong;Kim, Jeong Hoon;Ra, Young Shin;Kim, Chang Jin;Lee, Jung Kyo;Kwun, Byung Duk
Journal of Korean Neurosurgical Society
/
v.30
no.sup2
/
pp.221-227
/
2001
Objective : The therapeutic impact of tumor resection in glioblastomas is poorly defined and still questionable. Therefore, we conducted the current study to verify the role of tumor resection in the treatment of these highly malignant tumors. Methods : A retrospective study was performed(1990-1999) to compare the treatment results of surgical resection plus radiotherapy(130 patients) with those of stereotactic biopsy plus radiotherapy(19 patients) in glioblastomas. Only adult patients with supratentorial, de novo glioblastoma located in one lobe were included. Survival time/rate was analysed with Kaplan-Meier method, and prognostic variables were obtained from the univariate log-rank test and the multivariate Cox's proportional hazards model. Results : The resection group and the biopsy group did not differ in terms of age, gender, duration of symptoms, presenting symptoms, tumor location, tumor side, tumor size, and the frequency of midline shift. Patients in the biopsy group more often were found to have worse preoperative Karnofsky performance status(KPS)(p=0.001). On univariate analysis, age, KPS, and tumor side were associated with survival(p=0.0053, 0.0001, and 0.0331 respectively). Median survival time and 1-year survival rate were also statistically improved by tumor resection ; resection group - 13 months and 61.2%, and biopsy group - 8 months and 19.7%, respectively(p=0.0001). In patients with midline shift of the tumor, resection was highly effective comparing to biopsy(p=0.0001), but in patients without midline shift, external beam radiation alone was as effective as tumor resection(p=0.0605). Other prognostic variables did not affect survival. On multivariate analysis after variable selection, survival was independently associated with KPS(p=0.001), but not the surgical resection(p=0.2837). Even in biopsy group with midline shift of the tumor, survival rate was not different from that seen after tumor resection(p=0.3505). Conclusions : Radiotherapy alone was as effective as tumor resection plus radiotherapy in patients without midline shift of the tumor. Although there was not statistically significant, tumor resection looked like effective in patients with midline shift. For supratentorial, lobar glioblastoma patients without mass effect of the tumor, biopsy with radiotherapy is one of rational treatment strategies. We consider that tumor resection should be performed in patients with pretreatment midline shift.
Jeong, Ho Tae;Kim, Dae Sik;Kang, Kun Woo;Nam, Yun Teak;Oh, Ji Eun;Cho, Eun Kyung
Korean Journal of Clinical Laboratory Science
/
v.50
no.4
/
pp.477-483
/
2018
Transcranial doppler is a non-invasive method that measures the blood flow velocity and the direction of cerebral blood vessels through the doppler principle. The pulsatility index is an index for measuring the transcranial doppler that reflects the distal vascular resistance and is used as an index for the presence and diffusion of cerebral small vessel diseases. The purpose of this study was to evaluate the risk factors affecting the basilar artery pulsatility index in ischemic stroke patients. From January 2014 to May 2015, 422 patients were selected by measuring the transcranial doppler pulsatility index, considering their basilar artery pulsatility index. Univariate analysis was performed using the basilar artery pulsatility index as a dependent variable. Multiple regression analysis was performed considering the factors affecting the pulsatility index as variables. Univariate analysis revealed age, presence of hypertension, presence of diabetes mellitus, presence of hyperlipidemia, and hematocrit (P<0.1) as factors. Multiple regression analysis showed statistically significant results with age (P<0.001), presence of diabetes (P=0.004), and presence of hyperlipidemia (P=0.041). The risk factors affecting the basilar artery pulsatility index of transcranial doppler were age, diabetes, and hyperlipidemia. Further research will be needed to increase the cerebral pulsatility index as a surrogate marker of the elderly, diabetes, and hyperlipidemia.
This paper is an effort to describe dietary behaviors to keep them healthy among adults. A probability sample was drawn from residents aged between 15 and 60 living in Ulsan City area through a multi-staged cluster sampling method. The data collected by face-to-face interview includes 1,232 respondents. Both univariate and bivariate analyses were employed to describe the dietary behaviors. The dietary behaviors in this study includes preference of taking fat-part of meat, fried food, salty food, hot-taste food, drinking coffee and milk, and taking supplementary medicine. About half of the respondents reported to take fat removed when eating meat, and more than 68% of them preferred not to take any kinds of fried food. With respect to preference of salty and hot-taste food, 39.6% of the respondents take medium-salty and 39.4% do hot-taste food. A third of the respondents drink two-four cups of coffee a day. Those who reported not to drink milk at all were prevalent(37.4% of the respondents) than expected. However, less than 20% of the respondents reported to have any kinds of supplementary health food in a year. These dietary behaviors were examined by sociodemographic characteristics for bivariate analyses.
Purpose: This paper reports a study exploring factors related to patient satisfaction and dissatisfaction with inpatient care. Method: A cross-sectional study design was used, employing data from the National Health and Nutrition Survey conducted in 2001. Socio-demographic factors, utilization, self-rated health status, and disease characteristics were assessed by employing univariate comparisons and multivariate logistic regression analyses. Result: Out of 37,769 respondents, 1,043 aged 20 years and over had been admitted to a hospital or clinic at least once during the past year. About a quarter of the respondents were discharged from tertiary hospitals and $21\%$ from clinics. The majority of patients ($58\%$) were satisfied with inpatient care received, whereas $11\%$ were dissatisfied. Greater satisfaction was found in patients aged 45-64 years and those having formal education, discharge from tertiary hospitals, national health insurance as a payer, medical expenses not being burdensome, good self-rated health status, and neoplasm. Living in non-metropolitan urban areas, shorter length of stay, and musculoskeletal diseases were associated with greater dissatisfaction. Conclusion: Different factors were related to patient satisfaction and dissatisfaction with care. Those factors need to be taken into account when evaluating and comparing satisfaction levels between health care institutions.
Outliers and influential observations often distort many numerical measures for data analysis. Jang and Anderson-Cook (Quality and Reliability Engineering International, 30, 1409-1425, 2014) proposed a graphical firework plot method for exploratory analysis purpose to provide a possible visualization of the trace of the impact of the possible outlying and influential observations on the univariate/bivariate data analysis and regression. They developed 3-D plot as well as pairwise plot for the appropriate measures of interest. We use firework plots as a graphical exploratory data analysis tool to detect outliers and evaluate the impact of outliers in statistical inference.
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