• Title/Summary/Keyword: 예후

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Prognostic Factors in Patients with Brain Metastases from Non-Small Cell Lung Carcinoma (비소세포성 폐암에 의한 뇌전이 환자의 예후인자)

  • Hong, Seong-Eon
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.197-204
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    • 1991
  • A retrospective study of 53 patients suffering from non-small cell carcinoma of lung with brain metastases is presented. They were treated in the Department of Therapeutic Radiology of Kyung Hee University Hospital from 1983 to 1990. There were 37 male and 10 female patients. The age range was 39 to 85 years (median=59). The most common histologic cell type of tumor was adenocarcinoma ($50.9\%$), followed by squamous cell carcinoma and large cell carcinoma. All patients were treated with whole-brain photon irradiation (WBI) using lateral opposing fields. The overall median survival time was 5 months. Age, sex, histologic type, and initial performance status were not prognostically important. The most important prognostic factors were the response to radiotherapy and the presence of brain metastases alone. increasing the dose of radiotherapy to the main bulk of tumor may improve the symptom-free survival or overall survival in patients who present with brain metastases as the sole site of extrathoracic disease.

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Prediction of Life-expectancy for Patients with Hepatocellular Carcinoma Based on Prognostic Factors (간암 환자에서 예후인자를 통한 생존기간의 예측)

  • Yeom, Chang-Hwan;Shim, Jae-Yong;Lee, Hye-Ree;Hong, Young-Sun
    • Journal of Hospice and Palliative Care
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    • v.1 no.1
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    • pp.30-38
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    • 1998
  • Background : Hepatocellular carcinomoma is the 3rd most common malignancy and the 2nd most common cause of death in Korea. The prediction of life-expectancy in terminal cancer patients is a major problem for patients, families, and physicians. We would like to investigate the prognostic factors of hepatocellular carcinoma, and therefore contribute to the prediction of the survival time of patients with hepatocellular carcinoma. Methods : A total of 91 patients(male 73, female 18) with hepatocellular carcinoma who were admitted to the hospital between January and lune 1995 were entered into the study, and data were collected prospectively on 28 clinical parameters through medical obligation record. We surveyed an obligation and local district office records, and confirmed the surivival of patients till July, 1996. Using Cox-proportional hazard model, give the significant variables related to survival. These determined prognostic factors. Life regressional analysis was used, there were calculated predicted survival day based on combinations of the significant prognostic factors. Results : 1) Out of 91 patients, 73 were male, and 18 were female. The mean age was $56.7{\pm}10.6$ ears. During the study, except for 16 patients who could not follow up, out of 75 patients, the number of deaths was 57(76%) and the number of survivals was 18(24%). 2) Out of the 28 clinical parameters, the prognostic factors related to reduced survival rate were prothrombin time<40%(relative risk:10.8), weight loss(RR:4.4), past history of hypertension (RR:3.2), ascites(RR:2.8), hypocalcemia(RR:2.5)(P<0.001). 3) Out of five factors, the survival day is 1.7 in all of five, $4.2{\sim}10.0$ in four, $10.4{\sim}41.9$ in three, $29.5{\sim}118.1$ in two, $124.0{\sim}296.6$ in one, 724.0 in none. Conclusion : In hepatocellular carcinoma we found that the prognostic factors related to reduce survival rate were prolonged prothrombin time(<40%), weight loss, past history of hypertension, ascites, and hypocalcemia(<8.7mg/dl). The five prognostic factors enabled the prediction of life-expectancy in patients with hepatocellular carcinoma and may assist in managing patients with hepatocellular carcinomal.

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Predictive Factors for Prognosis of Neonatal Intrahepatic Cholestasis : Non-Familial, Non-Metabolic, Non-Syndromic Cholestasis (신생아 간내 담즙 정체증의 예후 인자: 비가족성, 비대사성, 비증후성 담즙 정체증)

  • Kim, Hyung Suck;Lee, Chang Hoon;Kim, In Ju;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.2
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    • pp.208-214
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    • 2004
  • Purpose: The prognosis of neonates with cholestasis is not clear. Some factors, such as high peak bilirubin levels and liver histologic findings have been claimed to affect the prognosis adversely. Our study aims to define which factors influence the prognosis of neonatal intrahepatic cholestasis. Methods: Retrospective reviews of the medical records were performed in 32 cases with neonatal intrahepatic cholestasis, who were admitted to Department of Pediatrics, Pusan National University Hospital from July 1995 to July 2002. Neonates were classified into 2 groups according to the duration of elevated serum alanine aminotransferase (ALT) levels more or less than 6 months. The data, such as biochemical, histopathologic and radiologic findings, were compared in both groups. Biochemical data included mean peak level of serum ALT, total bilirubin, direct bilirubin, and alkaline phosphatase. Histologic parameters related to lobular architecture, fibrosis, inflammatory infiltration and degenerative features of hepatocytes were arbitrary estimated on a scale of 1 to 3. Results: There were 19 males and 13 females, whose mean age was 48 days (14~77 days). The peak serum ALT levels were higher in the poor outcome group. Ductular proliferation and portoportal bridging were more severe in the poor outcome group. But the degree of multinucleated hepatocytes, hepatocellular swelling and canalicular plug did not appear to be significantly related to the long-term outcome. The DISIDA scintigraphy by visualization time of gall bladder and intestine was not useful in predicting outcome of neonatal intrahepatic cholestasis. Conclusion: Neonates who have intrahepatic cholestasis with high serum ALT levels, severe ductular proliferation and portoportal bridging in the liver biopsy specimen should be carefully followed up because they may have a poor prognosis.

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The Clinicopathological Factors That Determine a Local Recurrence of Rectal Cancers That Have Been Treated with Surgery and Chemoradiotherapy (직장암의 수술 후 방사선 치료 시 국소 재발의 임상 병리적 예후 인자)

  • Choi, Chul-Won;Kim, Min-Suk;Lee, Seung-Sook;Yoo, Seong-Yul;Cho, Chul-Koo;Yang, Kwang-Mo;Yoo, Hyung-Jun;Seo, Young-Seok;Hwang, Dae-Yong;Moon, Sun-Mi;Kim, Mi-Sook
    • Radiation Oncology Journal
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    • v.24 no.4
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    • pp.255-262
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    • 2006
  • $\underline{Purpose}$: To evaluate the pathological prognostic factors related to local recurrence after radical surgery and adjuvant radiation therapy in advanced rectal cancer. $\underline{Materials\;and\;Methods}$: Fifty-four patients with advanced rectal cancer who were treated with radical surgery followed by adjuvant radiotherapy and chemotherapy between February 1993 and December 2001 were enrolled in this study. Among these patients, 14 patients experienced local recurrence. Tissue specimens of the patients were obtained to determine pathologic parameters such as histological grade, depth of invasion, venous invasion, lymphatic invasion, neural invasion and immunohistopathological analysis for expression of p53, Ki-67, c-erb, ezrin, c-met, phosphorylated S6 kinase, S100A4, and HIF-1 alpha. The correlation of these parameters with the tumor response to radiotherapy was statistically analyzed using the chi-square test, multivariate analysis, and the hierarchical clustering method. $\underline{Results}$: In univariate analysis, the histological tumor grade, venous invasion, invasion depth of the tumor and the over expression of c-met and HIF-1 alpha were accompanied with radioresistance that was found to be statistically significant. In multivariate analysis, venous invasion, invasion depth of tumor and over expression of c-met were also accompanied with radioresistance that was found to be statistically significant. By analysis with hierarchical clustering, the invasion depth of the tumor, and the over expression of c-met and HIF-1 alpha were factors found to be related to local recurrence. Whereas 71.4% of patients with local recurrence had 2 or more these factors, only 27.5% of patients without local recurrence had 2 or more of these factors. $\underline{Conclusion}$: In advanced rectal cancer patients treated by radical surgery and adjuvant chemo-radiation therapy, the poor prognostic factors found to be related to local recurrence were HIF-1 alpha positive, c-met positive, and an invasion depth more than 5.5 mm. A prospective study is necessary to confirm whether these factors would be useful clinical parameters to measure and predict a radio-resistance group of patients.

The Correlation Between Early Clinical State and Functional Outcome in Acute Stroke Patients (급성기 뇌졸증 환자의 상태와 기능회복도와의 상관관계)

  • Choi, Eun-Jung;Lee, Won-Chul
    • The Journal of Dong Guk Oriental Medicine
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    • v.6 no.2
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    • pp.167-190
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    • 1998
  • Nowadays there were two tendencies of studies about prognostic factors in stroke. One way was to define prognostic factors according to the radiological features. And the other way was to define according to the mental state, recognition, perception, motors, language, urinary&bowel incontinence etc.. The former could be objectively investigated, while the latter was difficult. The purpose of this study was to determine which variables would be predictors of stroke and which factors would be affect predictions most. The subjects of this study were 32 patients who were admitted to the Dept. of Internal Medicine, Dongguk Univ. College of Oriental Medicine whthin 48 hours from attack, Medical records were reviewed FIM, CNS, NIH stroke scale. We compared each sub-items of FIM, CNS, NIH stroke scale about mental state, recognition, perception, motors, language, urinary&bowel incontinence with MBI score at 4 weeks from admission. Also, we analyzed the correlations of sub-items and groups which devided into 5 according to independence of MBI score. And we found out the most influent factors with multiple regression analysis. The major results were as follows; 1. In mean of MBI score at 4 weeks of each groups devided low, middle, high score at mental state, recognition, perception, motors, language, urinary&bowel incontinence items, there were statistical differences in all items. 2. The mental state and lim ataxia sub-items had no significant correlations with groups divided according to independence of MBI score. All the other items were significantly correlated. 3. The most influent factors was recognition. The second was sensory and the third was bowel incontinence. 4. The most influent scales was FIM, and the second was CNS, and NlH had no statistical significancy.

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Long-term outcomes of infantile spasms (영아 연축 환아의 장기적 예후에 관한 고찰)

  • Oh, Seak Hee;Lee, Eun-Hye;Joung, Min-Hee;Yum, Mi-Sun;Ko, Tae-Sung
    • Clinical and Experimental Pediatrics
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    • v.53 no.1
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    • pp.80-84
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    • 2010
  • Purpose : The aims of this study were to investigate the long-term outcomes in children with infantile spasms (IS) and to identify the prognostic factors influencing their neurodevelopment. Methods : We retrospectively evaluated seventy two children over five years old who were treated for IS at Asan Medical Center, Seoul, Korea, between 1994 and 2007. Forty-three children were contacted by telephone or medical follow-up to assess their current neurodevelopmental status. Multiple logistic regression was used to calculate odds ratios (ORs) and 95% confidence interval (95% CIs) of risk factors for unfavorable outcomes.Results : The mean follow-up duration for these 43 children was $7.2{\pm}1.5$ years (range, 4.5 to 13.0 years). Of these, 13 (30.2%) had cryptogenic and 30 (69.8%) had symptomatic IS. Eleven (25.6%) children were initially treated with adrenocorticotrophic hormone (ACTH) therapy, with a mean treatment lag of $1.3{\pm}1.9$ months (range; 0.1 to 7.0 months). Eighteen (41.8%) children clinically responded to initial treatment, as shown by EEG response. Overall, 22 (51.2%) children had at least moderate neurodevelopmental disorders and 2 (4.8%) died. In univariate analysis, etiology (symptomatic) and poor electroclinical response to initial treatment were related to long-term unfavorable outcomes. In multivariate analysis, response to primary treatment was the sole significant independent risk factor with a high OR. Conclusion : Overall prognosis of children with IS was poor. Electroclinical non-responsiveness to initial treatment was related to unfavorable long-term outcomes, indicating that initial control of seizures may be important in reducing the likelihood of poor neurodevelopment.

Prognostic Factors in Childhood IgA Nephropathy (소아 IgA 신병증의 예후에 관한 고찰)

  • Park Jae-Hyun;Kim Pyung-Kil;Jeong Hyeon-Joo;Choi In-Joon
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.17-23
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    • 1997
  • After the first description of IgA nephropathy by Berger in 1968, the prognosis of this disease was considered favourable. However recent studies have revealed that IgA nephropathy result in end stage renal desease in 25-30% by 20 years. Heavy proteinuria, hypertension, histological high class are regarded as poor prognostic factors. In 1996, Yagame et al reported the new histopathologic grading with a strong correlation between the grading, heavy proteinuria, high s-Cr level and renal survival. The aims of this study are to determine whether the pathological grading and other clinical parameters could contribute to predicting the outcome of this disease eventhough pediatric patients. Seventy nine patients (59 males, 20 females) with IgA nephropathy were examined. Patients were 2.08-15.17 years of age ($9.85{\pm}2.83$). The mean follow-up duration were $27{\pm}28$ months. Six of seventy nine patients progressed to chronic renal failure during the follow-up periods. High 24h urinary protein excretion at diagnosis were significantly higher in chronic renal failure patients (p<0.05). Hypertension at diagnosis were the significant associated factors in progression of chronic renal failure (p<0.05). Histological changes of IgA nephropathy in light microscopy were classified into five classes by WHO classification, four grades in Yagame's gradings. Among the seventy nine patients, 24 were as class 1, 30 as class 2, 23 as class 3; 4 as class 4, 0 as class 5 by WHO classification. 23 were classified grade 1, 31 as grade 2, 24 as grade 3, 1 as grade 4 by Yagame's grading. Among six patients who progressed to chronic renal failure, 1 clssified as class 1, 1 as class 2, 3 as class 3, 1 as class 4, 0 as class 5 by WHO Classification. 1 patients were classified as grade 1, 1 as grade 2, 3 as grade 3, 1 as grade 4 by Yagame's grading. (p>0.05) In conclusion, hypertension and heavy proteinuria at initial presentation were significantly associated with progression of chronic renal failure. The classification of WHO & Yagame's grading has no significant association with the progression of chronic renal failure in pediatric patients.

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Primary Pul monary Carcinosarcorna -A case of report- (폐의 원발성 암육종 -1례 보고-)

  • 안상구;김재영
    • Journal of Chest Surgery
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    • v.29 no.9
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    • pp.1036-1039
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    • 1996
  • Pulmonary carcinosarcon!as are rare malignant tumors consisting of an admixture of epithelial and mas- enchymal elements of the type ordinarily seen in malignancies of adults. Compared with all pulmonary neoplasms it occurs with a frequency of 0.3% and has a strong association with smoking. Carcinosarcomas be divided into two clinicopathologic groups based on the locution of the lung: a solid parenchymal type and a central or endobronchial lesion Noninvasive diagnostic tests have a rather low yield in detecting carcinosarcoma. The most frequent metastatic sites are hilar and mediastinal Lymph nodes. Surgical resection is both diagnostic and the initial treatment. The prognosis is poor and average postoperative survival is 9 months. We report one case of pulmonary carcinosarcoma demonstrated by immunohlstochemical staining in a 61 year old male patient with a review of literatures.

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