• Title/Summary/Keyword: Cohort Analysis

Search Result 882, Processing Time 0.022 seconds

CT-Based Fagotti Scoring System for Non-Invasive Prediction of Cytoreduction Surgery Outcome in Patients with Advanced Ovarian Cancer

  • Na Young Kim;Dae Chul Jung;Jung Yun Lee;Kyung Hwa Han;Young Taik Oh
    • Korean Journal of Radiology
    • /
    • v.22 no.9
    • /
    • pp.1481-1489
    • /
    • 2021
  • Objective: To construct a CT-based Fagotti scoring system by analyzing the correlations between laparoscopic findings and CT features in patients with advanced ovarian cancer. Materials and Methods: This retrospective cohort study included patients diagnosed with stage III/IV ovarian cancer who underwent diagnostic laparoscopy and debulking surgery between January 2010 and June 2018. Two radiologists independently reviewed preoperative CT scans and assessed ten CT features known as predictors of suboptimal cytoreduction. Correlation analysis between ten CT features and seven laparoscopic parameters based on the Fagotti scoring system was performed using Spearman's correlation. Variable selection and model construction were performed by logistic regression with the least absolute shrinkage and selection operator method using a predictive index value (PIV) ≥ 8 as an indicator of suboptimal cytoreduction. The final CT-based scoring system was internally validated using 5-fold cross-validation. Results: A total of 157 patients (median age, 56 years; range, 27-79 years) were evaluated. Among 120 (76.4%) patients with a PIV ≥ 8, 105 patients received neoadjuvant chemotherapy followed by interval debulking surgery, and the optimal cytoreduction rate was 90.5% (95 of 105). Among 37 (23.6%) patients with PIV < 8, 29 patients underwent primary debulking surgery, and the optimal cytoreduction rate was 93.1% (27 of 29). CT features showing significant correlations with PIV ≥ 8 were mesenteric involvement, gastro-transverse mesocolon-splenic space involvement, diaphragmatic involvement, and para-aortic lymphadenopathy. The area under the receiver operating curve of the final model for prediction of PIV ≥ 8 was 0.72 (95% confidence interval: 0.62-0.82). Conclusion: Central tumor burden and upper abdominal spread features on preoperative CT were identified as distinct predictive factors for high PIV on diagnostic laparoscopy. The CT-based PIV prediction model might be useful for patient stratification before cytoreduction surgery for advanced ovarian cancer.

Analysis of nursing doctoral dissertation formats over a decade: A comparative research between traditional and publication format at a university (간호학 박사학위논문 제도의 출판 형식 도입 10년 현황 분석: 일 대학 학위과정의 전통 형식과 출판 형식의 비교)

  • Choi, Subin;Park, Jee-Eun;Woo, Kyungmi
    • The Journal of Korean Academic Society of Nursing Education
    • /
    • v.30 no.2
    • /
    • pp.101-112
    • /
    • 2024
  • Purpose: The study aimed to examine doctoral students' degree acquisition paths and postgraduate research achievements and explore whether there are differences in the research achievements of doctoral degree holders in relation to the dissertation format. Methods: This study is a retrospective cohort study of nursing doctoral graduates whose degree conferral dates were between August 2013 and August 2023 that compared two dissertation tracks: traditional and publication. We evaluated the proportion of graduates in each track, publication of their dissertations, time to graduation, and the number of peer-reviewed journal publications after graduation. Results: Of the sample, 160 (87.4%) graduated in the traditional track, with only 56 (35.0%) of them publishing their dissertations after graduation. Excluding dissertations, 114 of the graduates (71.3%) published first-authored articles in the traditional track, while 12 (52.2%) did so in the publication track. The time to graduation was significantly shorter in the traditional track, with an average of 5.47±2.45 years, compared to 6.61±2.57 years in the publication track (z=2.26, p=.023). In the traditional track, 64 of graduates (40.0%) majored in adult health nursing, whereas in the publication track, 8 (34.8%) studied community health nursing. Conclusion: This study emphasizes the significance of the publication track for nursing doctoral dissertations in terms of research dissemination. Despite its numerous advantages, it is not yet the preferred choice for both students and faculty. Maintaining the publication track as an additional graduation option is worthwhile, as it allows students to gain research publishing experience before graduation and to effectively disseminate scientific findings in nursing.

Immunogenicity of the ChAdOx1 nCoV-19 vaccine in patients with hematologic malignancies

  • Chayapa Thookhamme;Manassamon Navinpipat;Aimwipa Sasakul;Pakthipa Pattarakosol;Kamoltip Lertchaisataporn;Kriangkrai Tawinprai;Pannee Praditsuktavorn
    • Clinical and Experimental Vaccine Research
    • /
    • v.12 no.2
    • /
    • pp.107-115
    • /
    • 2023
  • Purpose: The present study aimed to study the immunogenicity of the ChAdOx1 nCoV-19 vaccine in patients with hematologic malignancies. Materials and Methods: This prospective cohort study of hematology patients aimed to evaluate their antibody levels against the receptor-binding domain of the severe acute respiratory syndrome coronavirus 2 spike protein and seroconversion rates following two doses of the ChAdOx1 nCoV-19 vaccine. Between June and July 2021, we enrolled 61 patients and included 44 patients in our analysis. Antibody levels were assessed 8 and 4 weeks after the first and second injections, respectively, and compared with those of a healthy group. Results: Eight weeks after the first dose, the geometric mean antibody level was 1.02 binding antibody units (BAU)/mL in the patient group and 37.91 BAU/mL in the healthy volunteer group (p<0.01). Four weeks after the second dose, the geometric mean antibody level was 9.44 BAU/mL in patients and 641.6 BAU/mL in healthy volunteers (p<0.01). The seroconversion rates 8 weeks after the first dose were 27.27% and 98.86% in the patient and healthy volunteer groups, respectively (p<0.001). The seroconversion rate 4 weeks after the second dose was 47.73% in patients and 100% in healthy volunteers. Factors leading to lower seroconversion rates were rituximab therapy (p=0.002), steroid therapy (p<0.001), and ongoing chemotherapy (p=0.048). Factors that decreased antibody levels were hematologic cancer (p<0.001), ongoing chemotherapy (p=0.004), rituximab (p<0.001), steroid use (p<0.001), and absolute lymphocyte count <1,000/mm3 (p=0.009). Conclusion: Immune responses were impaired in individuals with hematologic malignancies, particularly patients undergoing ongoing therapy and B-cell-depleting therapy. Additional vaccinations should be considered for these patients, and further investigated.

Population Characteristics of the Venomous Giant Jellyfish, Nemopilema nomurai, found in the Yellow and Northern East China Seas (황해 중앙부와 동중국해 북부 해역에서의 대형 독성 노무라입깃해파리의 개체군 특성 연구)

  • Soo-Jung Chang;Jang-Seu Ki
    • Journal of Environmental Science International
    • /
    • v.33 no.1
    • /
    • pp.87-95
    • /
    • 2024
  • The giant jellyfish, Nemopilema nomurai, is an endemic species found in Northeast Asian waters and their population structures, such as size and genetics, and their environmental characteristics were investigated. N. nomurai was obtained from the Yellow and Northern East China Seas during the summers of 2006, 2007, and 2009. In the northern Yellow Sea, small-sized jellyfish were found to be dominant and towards the southern seas, the size of the jellyfish increased. In the northern East China Sea, only one mode of jellyfish was found in May, and the number of modes increased up-to five in July. However, at the center of the Yellow Sea, one or two modes were found in July, 2007. Thus, different jellyfish populations were present in the northern East China Sea and the Yellow Sea. However, based on first appearance and a cohort analysis using the bell diameter, the jellyfish population in the northern Yellow Sea might be recognized as a distinct group that differed from those found in the northern East China Sea. Furthermore, mitochondrial DNA sequences (cytochrome c oxidase subunit I) of N. nomurai were, determined and compared with genetic structures obtained from jellyfish in the Yellow Sea. The genetic diversity of N. nomurai was highest in the regions around the northern East China Sea and at the center of the Yellow Sea and was the lowest around the northern Yellow Sea. Thus, N. nomurai populations in the Yellow Sea and northern East China Sea might be different concerning their seeding places.

Pretherapy 18F-FDG PET/CT in Predicting Disease Relapse in Patients With Immunoglobulin G4-Related Disease: A Prospective Study

  • Mei-Fang Cheng;Yue Leon Guo;Ruoh-Fang Yen;Yen-Wen Wu;Hsiu-Po Wang
    • Korean Journal of Radiology
    • /
    • v.24 no.6
    • /
    • pp.590-598
    • /
    • 2023
  • Objective: To investigate whether the levels of inflammation detected by 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) can predict disease relapse in immunoglobulin G4-related disease (IgG4-RD) patients receiving standard induction steroid therapy. Materials and Methods: This prospective study analyzed pretherapy FDG PET/CT images from 48 patients (mean age, 63 ± 12.9 years; 45 males and 3 females) diagnosed with IgG4-RD between September 2008 and February 2018, who subsequently received standard induction steroid therapy as the first-line treatment. Multivariable Cox proportional hazards models were used to identify the potential prognostic factors associated with relapse-free survival (RFS). Results: The median follow-up time for the entire cohort was 1913 days (interquartile range [IQR], 803-2929 days). Relapse occurred in 81.3% (39/48) patients during the follow-up period. The median time to relapse was 210 days (IQR, 140-308 days) after completion of standardized induction steroid therapy. Among the 17 parameters analyzed, Cox proportional hazard analysis identified whole-body total lesion glycolysis (WTLG) > 600 on FDG-PET as an independent risk factor for disease relapse (median RFS, 175 vs. 308 days; adjusted hazard ratio, 2.196 [95% confidence interval: 1.080-4.374]; P = 0.030). Conclusion: WTLG on pretherapy FDG PET/CT was the only significant factor associated with RFS in IgG-RD patients receiving standard steroid induction therapy.

Whole Exome Sequencing in Patients with Phenotypically Associated Familial Intracranial Aneurysm

  • Yunsun Song;Jong-Keuk Lee;Jin-Ok Lee;Boseong Kwon;Eul-Ju Seo;Dae Chul Suh
    • Korean Journal of Radiology
    • /
    • v.23 no.1
    • /
    • pp.101-111
    • /
    • 2022
  • Objective: Familial intracranial aneurysms (FIAs) are found in approximately 6%-20% of patients with intracranial aneurysms (IAs), suggesting that genetic predisposition likely plays a role in its pathogenesis. The aim of this study was to identify possible IA-associated variants using whole exome sequencing (WES) in selected Korean families with FIA. Materials and Methods: Among the 26 families in our institutional database with two or more IA-affected first-degree relatives, three families that were genetically enriched (multiple, early onset, or common site involvement within the families) for IA were selected for WES. Filtering strategies, including a family-based approach and knowledge-based prioritization, were applied to derive possible IA-associated variants from the families. A chromosomal microarray was performed to detect relatively large chromosomal abnormalities. Results: Thirteen individuals from the three families were sequenced, of whom seven had IAs. We noted three rare, potentially deleterious variants (PLOD3 c.1315G>A, NTM c.968C>T, and CHST14 c.58C>T), which are the most promising candidates among the 11 potential IA-associated variants considering gene-phenotype relationships, gene function, co-segregation, and variant pathogenicity. Microarray analysis did not reveal any significant copy number variants in the families. Conclusion: Using WES, we found that rare, potentially deleterious variants in PLOD3, NTM, and CHST14 genes are likely responsible for the subsets of FIAs in a cohort of Korean families.

Prognostic Value of Radiologic Extranodal Extension in Human Papillomavirus-Related Oropharyngeal Squamous Cell Carcinoma

  • Boeun Lee;Young Jun Choi;Seon-Ok Kim;Yoon Se Lee;Jung Yong Hong;Jung Hwan Baek;Jeong Hyun Lee
    • Korean Journal of Radiology
    • /
    • v.20 no.8
    • /
    • pp.1266-1274
    • /
    • 2019
  • Objective: To determine whether radiologic extranodal extension (ENE) appearing on pretreatment CT and MRI could predict the prognosis in patients with human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC). Materials and Methods: The study population was obtained from a historical cohort diagnosed with HPV-related OPSCC. A total of 134 OPSCC patients who had a metastatic lymph node on pretreatment CT or MRI were included, and radiologic ENE was evaluated by two experienced head and neck radiologists. Kaplan-Meier and multivariate Cox regression analyses were performed to evaluate the impact of radiologic ENE on progression-free survival (PFS). The diagnostic performance of CT and MRI for the diagnosis of ENE was also evaluated in patients who underwent neck dissection. Results: Seventy patients (52.2%) showed radiologic ENE-positive findings. Although patients showing radiologic ENE had a worse 3-year PFS (83.7% vs. 95.3%, p = 0.023), the association between radiologic ENE and PFS was not statistically significant on multivariate analysis (p = 0.141; hazard ratio, 2.68; 95% confidence interval, 0.72-9.97). CT or MRI had a sensitivity of 62%, specificity of 77.8%, and accuracy of 71.9% for predicting pathologic ENE. Conclusion: Radiologic ENE on CT or MRI did not predict poor PFS in patients with HPV-related OPSCC, although there was a trend towards worse PFS. Further studies are warranted to determine whether radiologic ENE is a useful imaging biomarker to risk-stratify patients with HPV-related OPSCC.

Accuracy of administrative claim data for gastric adenoma after endoscopic resection

  • Ga-Yeong Shin;Hyun Ho Choi;Jae Myung Park;Sang Yoon Kim;Jun Young Park;Donghoon Kang;Yu Kyung Cho;Sung Soo Kim;Myung-Gyu Choi
    • Clinical Endoscopy
    • /
    • v.56 no.3
    • /
    • pp.325-332
    • /
    • 2023
  • Background/Aims: Administrative databases provide valuable information for large-cohort studies. This study aimed to evaluate the diagnostic accuracy of an administrative database for resected gastric adenomas. Methods: Data of patients who underwent endoscopic resection for benign gastric lesions were collected from three hospitals. Gastric adenoma cases were identified in the hospital database using International Classification of Diseases (ICD) 10-codes. The non-adenoma group included patients without gastric adenoma codes. The diagnostic accuracy for gastric adenoma was analyzed based on the pathological reports of the resected specimen. Results: Among 5,095 endoscopic resections with codes for benign gastric lesions, 3,909 patients were included in the analysis. Among them, 2,831 and 1,078 patients were allocated to the adenoma and non-adenoma groups, respectively. Regarding the overall diagnosis of gastric adenoma with ICD-10 codes, the sensitivity, specificity, positive predictive value, and negative predictive value were 98.7%, 88.5%, 95.2%, and 96.8%, respectively. There were no significant differences in these parameters between the tertiary and secondary centers. Conclusions: Administrative codes of gastric adenoma, according to ICD-10 codes, showed good accuracy and can serve as a useful tool to study prognosis of these patients in real-world data studies in the future.

Association Between Persistent Treatment of Alzheimer's Dementia and Osteoporosis Using a Common Data Model

  • Seonhwa Hwang;Yong Gwon Soung;Seong Uk Kang;Donghan Yu;Haeran Baek;Jae-Won Jang
    • Dementia and Neurocognitive Disorders
    • /
    • v.22 no.4
    • /
    • pp.121-129
    • /
    • 2023
  • Background and Purpose: As it becomes an aging society, interest in senile diseases is increasing. Alzheimer's dementia (AD) and osteoporosis are representative senile diseases. Various studies have reported that AD and osteoporosis share many risk factors that affect each other's incidence. This aimed to determine if active medication treatment of AD could affect the development of osteoporosis. Methods: The Health Insurance Review and Assessment Service provided data consisting of diagnosis, demographics, prescription drug, procedures, medical materials, and healthcare resources. In this study, data of all AD patients in South Korea who were registered under the national health insurance system were obtained. The cohort underwent conversion to an Observational Medical Outcomes Partnership-Common Data Model version 5 format. Results: This study included 11,355 individuals in the good persistent group and an equal number of 11,355 individuals in the poor persistent group from the National Health Claims database for AD drug treatment. In primary analysis, the risk of osteoporosis was significantly higher in the poor persistence group than in the good persistence group (hazard ratio, 1.20 [95% confidence interval, 1.09-1.32]; p<0.001). Conclusions: We found that the good persistence group treated with anti-dementia drugs for AD was associated with a significant lower risk of osteoporosis in this nationwide study. Further studies are needed to clarify the pathophysiological link in patients with two chronic diseases.

Clinical outcomes of permanent stenting with endoscopic ultrasound gallbladder drainage

  • Eisuke Suzuki;Yuji Fujita;Kunihiro Hosono;Yuji Koyama;Seitaro Tsujino;Takuma Teratani;Atsushi Nakajima;Nobuyuki Matsuhashi
    • Clinical Endoscopy
    • /
    • v.56 no.5
    • /
    • pp.650-657
    • /
    • 2023
  • Background/Aims: Endoscopic ultrasound gallbladder drainage (EUS-GBD) is gaining attention as a treatment method for cholecystitis. However, only a few studies have assessed the outcomes of permanent stenting with EUS-GBD. Therefore, we evaluated the clinical outcomes of permanent stenting using EUS-GBD. Methods: This was a retrospective, single-center cohort study. The criteria for EUS-GBD at our institution are a high risk for surgery, inability to perform surgery owing to poor performance status, and inability to obtain consent for emergency surgery. EUS-GBD was performed using a 7-Fr double-pigtail plastic stent with a dilating device. The primary outcomes were the recurrence-free rate of cholecystitis and the late-stage complication-avoidance rate. Secondary outcomes were technical success, clinical success, and procedural adverse events. Results: A total of 41 patients were included in the analysis. The median follow-up period was 168 (range, 10-1,238) days. The recurrence-free and late-stage complication-avoidance rates during the follow-up period were 95% (38 cases) and 90% (36 cases), respectively. There were only two cases of cholecystitis recurrence during the study period. Conclusions: EUS-GBD using double-pigtail plastic stent was safe and effective with few complications, even in the long term, in patients with acute cholecystitis.