• Title/Summary/Keyword: Cox model

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Ki67 Index Is the Most Powerful Factor for Predicting the Recurrence in Atypical Meningioma : Retrospective Analysis of 99 Patients in Two Institutes

  • Lee, Sang Hyuk;Lee, Eun Hee;Sung, Kyoung Su;Kim, Dae Cheol;Kim, Young Zoon;Song, Young Jin
    • Journal of Korean Neurosurgical Society
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    • v.65 no.4
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    • pp.558-571
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    • 2022
  • Objective : The primary objective of this study was to identify predicting factors for local control (LC) of atypical meningioma, and we validated them with comparing the predicting factors for recurrence-free survival (RFS). We also examined the rate of LC after surgical resection with or without adjuvant treatment and RFS. Methods : Clinical and radiological records of patients with atypical meningiomas diagnosed at two institutes from January 2000 to December 2018 were reviewed retrospectively. Histopathological features were also reviewed using formalin-fixed paraffin embedded samples from pathological archives. Results : Of the 99 atypical meningiomas eligible for analysis, 36 (36.4%) recurred during the follow-up period (mean, 83.3 months; range, 12-232 months). The rate of 3-year LC and 5-year LC was 80.8% and 74.7%, respectively. The mean time-to-recurrence was 49.4 months (range, 12-150). The mean RFS was 149.3 months (95% confidence interval, 128.8-169.8 months) during the mean follow-up duration of 83.3 months (range, 12-232 months). Multivariate analysis using Cox proportional-hazard regression model showed that the extent of resection (hazard ratio [HR], 4.761; p=0.013), Ki67 index (HR, 8.541; p=0.004), mitotic index (HR, 3.275; p=0.044), and tumor size (HR, 3.228; p=0.041) were independently associated with LC. These factors were also statistically associated with RFS. In terms of radiotherapy after surgical resection, the recurrence was not prevented by immediate radiotherapy because of the strong effect of proliferative index on recurrence. Conclusion : The present study suggests that the extent of resection, proliferative index (according to Ki67 expression) and mitotic index, and tumor size are associated with recurrence of atypical meningiomas. However, our results should be further validated through prospective and randomized clinical trials to overcome the inborn bias of retrospective nature of the study design.

Anti-inflammatory effects of Lespedeza Cuneata in vivo and in vitro (야관문(夜關門)의 항염증효과(抗炎症效果))

  • Lee, Hoil;Jung, Ji Yun;Hwangbo, Min;Ku, Sea Kwang;Kim, Young Woo;Jee, Seon Young
    • The Korea Journal of Herbology
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    • v.28 no.4
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    • pp.83-92
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    • 2013
  • Objectives : Lespedeza Cuneata has been used to treat leukorrhea, asthma, stomach pain, diarrhea, acute mastitis, in Korean traditional medicine. According to recent studies, Lespedeza Cuneata has antioxidation, hypoglycemia, cell protective, insulin secretion, whitening, corpora cavernosa smooth muscle relaxation and antimicrobial activities, but it has been rarely conducted to evaluate the immuno-biological activity. The present study was examined to evaluate the anti-inflammatory effects of the Lespedeza Cuneata MeOH extract (LCE) in vivo and in vitro. Methods : In vitro, inflammatory mediators, such as cytokines, nitric oxide and prostaglandin $E_2$ were detected after the addition of LPS with or without LCE in Raw 264.7 macrophage cell line. In vivo, anti-edema effect of LCE was determined in the carrageenan-induced paw edema model in rats. Results : In vitro assay, LCE decreased release of nitric oxide (NO) and prostaglandin $E_2$ ($PGE_2$) via suppression of iNOS and COX-2 expression. LCE inhibited the phosphorylation of $I{\kappa}B$ indicating the suppression of NF-${\kappa}B$ pathway. In vivo assay, LCE significantly inhibited the formation of paw edema induced by carrageenan injection in rats. LCE effectively inhibited increases of hind paw skin thickness and inflammatory cell infilterations. Conclusion : These findings demonstrate that LCE has inhibitory effect on inflammatory mediators in LPS-activated Raw 264.7 cells and on paw edema in carrageenan-stimulated rats, showing the possibility of anti-inflammatory use of Lespedeza Cuneata.

The protective effect of Areca Semen and Toosendan Fructus mixture in a chronic model of reflux esophagitis (빈랑자와 천련자 복합물의 만성 역류성 식도염에서 보호 효과)

  • Shin, Mi-Rae;Lee, Jin A;Kim, Min Ju;An, Hyo-Jin;Roh, Seong-Soo
    • The Korea Journal of Herbology
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    • v.35 no.1
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    • pp.57-68
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    • 2020
  • Objective : The aim of present study was to clarify the effect of Areca Semen and Toosendan Fructus Mixture (AT-mix) on chronic reflux esophagitis (CRE) in rats. Methods : The antioxidant activity of AT-mix was measured through DPPH and ABTS radical scavenging activities in vitro. CRE was induced in SD rats (5 weeks, male) by ligating the border forestomach and granular portion with 2-0 silk and the duodenum near the pyloric portion was covered with 2-mm wide piece of 18-Fr Nélaton catheter. And then rats were treated AT-mix 200 mg/kg one daily for 14 days. The anti-oxidant and inflammatory protein levels were evaluated using western blotting. Results : Gross lesion of esophageal mucosa after AT-mix treatment showed a superior enhancement compared with that of CRE control rats. AT-mix treatment strongly reduced both DPPH and ABTS radical scavenging activities (DPPH, IC50 8.15±0.14 ㎍/mL; ABTS, IC50 24.69±0.03 ㎍/mL, repspectively). Levels of the NADPH oxidase subunit including NOX4 and p22phox increased in CRE control rats. Otherwise, AT-mix treatment significantly reduced. The activation of Nuclear factor-erythroid 2-related factor 2 (Nrf2) led to significantly the up-regulation of HO-1. The inhibition of IκBα phosphorylation led to NF-κB inactivation. Subsequently, NF-κB inactivation significantly induced the decrease of COX-2, iNOS, TNF-α, and IL-6 protein expressions. Conclusion : Taken together, these results suggest that AT-mix treatment can attenuate the esophageal mucosal ulcer though inhibiting NF-κB pathway and enhancing Nrf2/HO-1 pathway. Thus, the additional mechanism study about AT-mix would need for the development as a safe herbal therapy for CRE.

A study on the change in the business closure rate before and after the outbreak of COVID-19 using survival analysis - Focused on Gangnam-gu, Seoul and Suseong-gu, Daegu (코로나19 발생 전후 상권 생존율 변화 분석 - 서울 강남구와 대구 수성구를 중심으로)

  • Park, Jinbaek;Kim, Minseop
    • The Journal of the Convergence on Culture Technology
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    • v.8 no.6
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    • pp.121-126
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    • 2022
  • This study analyzed the survival rate of commercial districts before and after the outbreak of COVID-19 by analyzing Gangnam-gu, Seoul and Suseong-gu, Daegu as independent regions, although the background and distribution of commercial districts are similar. In the basic analysis, the size of the commercial districts was much larger in Gangnam-gu, Seoul, but it was confirmed that the distribution by industry was similar. In both regions, there were more openings than closings before the outbreak of COVID-19 in common, but as the COVID-19 outbreak occurred, the closure ratio of businesses centered on face-to-face services increased significantly. As a result of the survival analysis, it was analyzed that most industries were indifferent to the risk of closure of private institutes before Corona 19, but after the outbreak of Corona 19, it was confirmed that the risk of closure of private institutes increased, especially in Daegu, which was the initial spread of Corona 19. As a result of comparing the survival rate between regions, it was analyzed that the risk of business closure in Gangnam-gu increased relatively after the outbreak of Corona 19, confirming that the contraction in the commercial area of Seoul with a large floating population was greater.

The Relationship between 5-year Overall Survival Rate, Socioeconomic Status and SEER Stage for Four Target Cancers of the National Cancer Screening Program in Korea: Results from the Gwangju-Jeonnam Cancer Registry (국가 암검진 사업의 주요 암종별 5년 생존율과 사회경제적 수준 및 요약병기의 관련성: 광주·전남 지역암등록본부 자료를 중심으로)

  • Kang, Jeong-Hee;Kim, Chul-Woung;Kweon, Sun-Seog
    • Research in Community and Public Health Nursing
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    • v.33 no.2
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    • pp.237-246
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    • 2022
  • Purpose: The aim of this study was to investigate the relationship between the 5-year survival rate, socioeconomic status, and SEER (Surveillance Epidemiology and End Results) stage of stomach, colorectal, breast and cervical cancer patients. Methods: A total of 11,770 cases of four target cancers, which were diagnosed during 2005-2007, were extracted from the database of Gwangju-Jeonnam Regional Cancer Registry. The subjects of the study were 11,770 including stomach (n=5,479), colorectal (n=3,565), breast (n=1,516) and cervical cancers (n=710). Cox's proportional hazards model was used to obtain the hazards ratio (HR) according to the SEER stage and socioeconomic status. Results: Stomach cancer had a significantly higher HR in the medical aid recipients (HR=1.39), and the group below 20% (HR=1.20) compared to the group with the highest income level. Colorectal cancer had a significantly higher HR in the medical aid recipients (HR=1.26) than in the group with the highest income level. In addition, stomach, colorectal, breast and cervical cancers had a significantly higher HR according to the SEER stage in regional direct (stomach=4.10, colorectal=1.76, breast=12.90, cervical=3.10), regional lymph only(stomach=2.58, colorectal=2.33, breast=4.32, cervical=4.43), regional both (stomach=6.74 colorectal=3.04, breast=15.57 cervical=6.50), and regional NOS (Not Otherwise Specified)/distant (stomach=17.53, colorectal=11.53, breast=25.34, cervical=26.51) than in situ and localized only. Conclusion: In order to increase the cancer survival rate, a support system for early detection and early treatment of cancer should be established for groups with low individual income levels, and regular health checkups and management measures should be actively implemented through the National Cancer Screening Program.

Risk factors for cancer-specific survival in elderly gastric cancer patients after curative gastrectomy

  • Liu, Xiao;Xue, Zhigang;Yu, Jianchun;Ma, Zhiqiang;Kang, Weiming;Ye, Xin;Li, Zijian
    • Nutrition Research and Practice
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    • v.16 no.5
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    • pp.604-615
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    • 2022
  • BACKGROUND/OBJECTIVES: This study aimed to investigate cancer-specific survival (CSS) and associated risk factors in elderly gastric cancer (EGC) patients. SUBJECTS/METHODS: EGC patients (≥ 70 yrs) who underwent curative gastrectomy between January 2013 and December 2017 at our hospital were included. Clinicopathologic characteristics and survival data were collected. Receiver operating characteristic (ROC) analysis was used to extract the best cutoff point for body mass index (BMI). A Cox proportional hazards model was used to determine the risk factors for CSS. RESULTS: In total, 290 EGC patients were included, with a median age of 74.7 yrs. The median follow-up time was 31 (1-77) mon. The postoperative 1-yr, 3-yr and 5-yr CSS rates were 93.7%, 75.9% and 65.1%, respectively. Univariate analysis revealed risk factors for CSS, including age (hazard ratio [HR] = 1.08; 95% confidence interval [CI], 1.01-1.15), intensive care unit (ICU) admission (HR = 1.73; 95% CI, 1.08-2.79), nutritional risk screening (NRS 2002) score ≥ 5 (HR = 2.33; 95% CI, 1.49-3.75), and preoperative prognostic nutrition index score < 45 (HR = 2.06; 95% CI, 1.27-3.33). The ROC curve showed that the best BMI cutoff value was 20.6 kg/m2. Multivariate analysis indicated that a BMI ≤ 20.6 kg/m2 (HR = 2.30; 95% CI, 1.36-3.87), ICU admission (HR = 1.97; 95% CI, 1.17-3.30) and TNM stage (stage II: HR = 5.56; 95% CI, 1.59-19.43; stage III: HR = 16.20; 95% CI, 4.99-52.59) were significantly associated with CSS. CONCLUSIONS: Low BMI (≤ 20.6 kg/m2), ICU admission and advanced pathological TNM stages (II and III) are independent risk factors for CSS in EGC patients after curative gastrectomy. Nutrition support, better perioperative management and early diagnosis would be helpful for better survival.

Ficus vasculosa Wall. ex Miq. Inhibits the LPS-Induced Inflammation in RAW264.7 Macrophages

  • Ji-Won, Park;Jin-Mi, Park;Sangmi, Eum;Jung Hee, Kim;Jae Hoon, Oh;Jinseon, Choi;Tran The, Bach;Nguyen, Van Sinh;Sangho, Choi;Kyung-Seop, Ahn;Jae-Won, Lee
    • Microbiology and Biotechnology Letters
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    • v.50 no.4
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    • pp.574-583
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    • 2022
  • Ficus vasculosa Wall. ex Miq. (FV) has been used as a herbal medicine in Southeast Asia and its antioxidant activity has been shown in previous studies. However, it has not yet been elucidated whether FV exerts anti-inflammatory effects on activated-macrophages. Thus, we aimed to evaluate the ameliorative property of FV methanol extract (FM) on lipopolysaccharide (LPS)-induced inflammatory responses and the underlying molecular mechanisms in RAW264.7 macrophages. The experimental results indicated that FM decreased the production of inflammatory mediators (NO/PGE2) and the mRNA/protein expression of iNOS and COX-2 in LPS-stimulated RAW264.7 cells. FM also reduced the secretion of interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α and monocyte chemoattractant protein (MCP)-1 in LPS-stimulated RAW264.7 cells. Results also demonstrated that FM improved inflammatory response in LPS-stimulated A549 airway epithelial cells by inhibiting the production of cytokines, such as IL-1β, IL-6 and TNF-α. In addition, FM suppressed MAPK activation and NF-κB nuclear translocation induced by LPS. FM also upregulated the mRNA/protein expression levels of heme oxygenase-1 and the nuclear translocation of nuclear factor erythroid 2-related factor 2 in RAW264.7 cells. In an experimental animal model of LPS-induced acute lung injury, the increased levels of molecules in bronchoalveolar lavage (BAL) fluid were suppressed by FM administration. Collectively, it was founded that FM has anti-inflammatory properties on activated-macrophages by suppressing inflammatory molecules and regulating the activation of MAPK/NF-κB signaling.

Characteristics of Patients with Surgical Closure of an Atrial Septal Defect during Infancy

  • Byeong A Yoo;Su Jin Kwon;Yu-Mi Im;Dong-Hee Kim;Eun Seok Choi;Bo Sang Kwon;Chun Soo Park;Tae-Jin Yun
    • Journal of Chest Surgery
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    • v.56 no.3
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    • pp.155-161
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    • 2023
  • Background: Surgical closure of an atrial septal defect (ASD) is infrequently indicated during infancy. We evaluated the clinical characteristics and outcomes of patients who underwent surgical ASD closure during infancy. Methods: A single-center retrospective review was performed for 39 patients (19 males) who underwent surgical ASD closure during infancy between 1993 and 2020. The median body weight percentile at the time of operation was 9.3. Results: During a median follow-up of 60.9 months, 4 late deaths occurred due to chronic respiratory failure. A preoperative history of bronchopulmonary dysplasia (BPD) was the only risk factor for late mortality identified in Cox regression (hazard ratio, 3.54; 95% confidence interval [CI], 1.75-163.04; p=0.015). The 5-year survival rate was significantly lower in patients with preoperative history of BPD (97.0% vs. 50.0%, p<0.001) and preoperative ventilatory support (97.1% vs. 40.4%, p<0.001). There were significant postoperative increases in left ventricular end-diastolic (p=0.017), end-systolic (p=0.014), and stroke volume (p=0.013) indices. A generalized estimated equation model showed significantly better postoperative improvement in body weight percentiles in patients with lower weight percentiles at the time of operation (<10th percentile, p=0.01) and larger indexed ASD diameter (≥45 mm/m2, p=0.025). Conclusion: Patients with ASD necessitating surgical closure during infancy are extremely small preoperatively and remain small even after surgical closure. However, postoperative somatic growth was more prominent in smaller patients with larger defects, which may be attributable to an increase in postoperative cardiac output due to changes in ventricular septal configuration. The benefits of ASD closure in patients with BPD are undetermined.

Association between Participation in a Rehabilitation Program and 1-Year Survival in Patients Requiring Prolonged Mechanical Ventilation

  • Wanho Yoo;Myung Hun Jang;Sang Hun Kim;Soohan Kim;Eun-Jung Jo;Jung Seop Eom;Jeongha Mok;Mi-Hyun Kim;Kwangha Lee
    • Tuberculosis and Respiratory Diseases
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    • v.86 no.2
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    • pp.133-141
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    • 2023
  • Background: The present study evaluated the association between participation in a rehabilitation program during a hospital stay and 1-year survival of patients requiring at least 21 days of mechanical ventilation (prolonged mechanical ventilation [PMV]) with various respiratory diseases as their main diagnoses that led to mechanical ventilation. Methods: Retrospective data of 105 patients (71.4% male, mean age 70.1±11.3 years) who received PMV in the past 5 years were analyzed. Rehabilitation included physiotherapy, physical rehabilitation, and dysphagia treatment program that was individually provided by physiatrists. Results: The main diagnosis leading to mechanical ventilation was pneumonia (n=101, 96.2%) and the 1-year survival rate was 33.3% (n=35). One-year survivors had lower Acute Physiology and Chronic Health Evaluation (APACHE) II score (20.2±5.8 vs. 24.2±7.5, p=0.006) and Sequential Organ Failure Assessment score (6.7±5.6 vs. 8.5±2.7, p=0.001) on the day of intubation than non-survivors. More survivors participated in a rehabilitation program during their hospital stays (88.6% vs. 57.1%, p=0.001). The rehabilitation program was an independent factor for 1-year survival based on the Cox proportional hazard model (hazard ratio, 3.513; 95% confidence interval, 1.785 to 6.930; p<0.001) in patients with APACHE II scores ≤23 (a cutoff value based on Youden's index). Conclusion: Our study showed that participation in a rehabilitation program during hospital stay was associated with an improvement of 1-year survival of PMV patients who had less severe illness on the day of intubation.

Anti-osteoarthritis effect of Boswellia serrata gum resin extract in monosodium iodoacetate-induced osteoarthritic Sprague-Dawley rats (Monosodium iodoacetate 유도 골관절염 동물모델에서 보스웰리아 검레진 추출물의 항골관절염 효과 연구)

  • Jae In Jung;Ryong Kim;Eun Ji Kim
    • Journal of Nutrition and Health
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    • v.56 no.3
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    • pp.231-246
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    • 2023
  • Purpose: The aim of this study was to investigate the anti-osteoarthritic effect of the ethanol extract of Boswellia serrata gum resin (FJH-UBS) enriched with keto-β-boswellic acid and 3-O-acetyl-11-keto-β-boswellic acid compared to the conventional Boswellia serrata extract by adding the process of removing oil with hexane, in the monosodium iodoacetate (MIA)-induced osteoarthritis rat model. Methods: Sprague-Dawley (SD) rats were orally administered 0, 40, or 80 mg of FJH-UBS/kg body weight (BW)/day for 5 weeks and injected with MIA intra-articularly into right knee joints on day 15 to induce osteoarthritis. Changes in the knee joint microarchitecture, cartilage degradation, the expression of inflammatory mediators, cytokines, and matrix metalloproteinases (MMPs) in serum and synovia were observed. Results: Oral administration of FJH-UBS (80 mg/kg BW/day) reduced MIA-induced knee swelling and cartilage degradation and increased the expression of type II collagen and aggrecan in articular cartilage. Furthermore, FJH-UBS administration reduced MIA-induced increases in the serum levels of prostaglandin E2, leukotriene B4, interleukin (IL)-1β, IL-6, and MMP-13, and MIA-induced increases in the mRNA expressions of inducible nitric oxide synthase, cyclooxygenase-2, 5-lipoxygenase, IL-1β, IL-6, TNF-α, MMP-2, MMP-9, and MMP-13 in the synovia of knee joints. Conclusion: These results indicate that FJH-UBS exerts its anti-osteoarthritic effects by suppressing the expressions of inflammatory cytokines and MMPs and, thus, cartilage degradation. Furthermore, they suggest that FJH-UBS has potential use as a functional food that improves joint and cartilage health.