• Title/Summary/Keyword: Failure Prognostic

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The Overexpression of p53 in Head and Neck Squamous Cell Carcinoma as Prognostic Marker (두경부 편평 세포암에서 예후인자로서의 p53 발현)

  • Jeong Seung-Won;Lee Hyung-Seok;Park Chul-Won;Park Yong-Wook;Park Chan-Keum;Jang Se-Jin;Tae Kyung
    • Korean Journal of Head & Neck Oncology
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    • v.17 no.2
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    • pp.169-173
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    • 2001
  • Objectives: The p53 tumor suppressor gene encodes a nuclear transcription factor that is critical regulator of cell growth and proliferation through its action in cell-cycle checkpoint control. The wide variety of stressful stmuli which include DNA damage, hypoxia, heat shock, metabolic changes activate the p53 protein, which in turn drives a series of events that culminate either in cell cycle arrest or apoptosis. Mutations of the p53 gene is the most common genetic alteration in human cancer. This gene is altered in approximately 40-60% of head and neck cancers. Whereas the wild-type form of the p53 protein plays a central role in cell-cycle control in response to DNA damage, most of the mutant forms are unable to do so. The high levels of p53 protein expression in tissues are related to the increased cellular proliferative activity and may be associated with the poor clinical outcome. To determine whether the expression of the p53 protein has prognostic significance and is associated with patterns of treatment failure in head and neck squamous cell carcinoma (HNSCC), We analyzed p53 overexpression in 40 cases of HNSCC. Materials and Methods: Immunohistochemical analysis with a monoclonal antibody (DO7) specific for p53 protein was used to detect expression of the protein in formalin-fixed, paraffin-embedded tumor samples from 40 HNSCC. We evaluated p53 protein expression and analyzed the relationship between the p53 overexpression and age, sex, primary tumor site, stage, survival rate, recurrence. All reported P values resulted from two-sided statistical tests. Results: Overexpression of p53 was detected in 20 cases(50%) among 40 cases of HNSCC. The p53 overexpression was not associated with age, sex, primary tumor site, stage, recurrence and survival rate. Conclusions: In our results, p53 was not significant prognostic factor in HNSCC. Based on many previous studies, It is evident that p53 has a certain role in tumorigenesis of HNSCC. So, the further study is needed to evaluate the prognostic significance of p53 in HNSCC.

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Differential Prognostic Implications of Pre- and Post-Stent Fractional Flow Reserve in Patients Undergoing Percutaneous Coronary Intervention

  • Jinlong Zhang;Doyeon Hwang;Seokhun Yang;Chee Hae Kim;Joo Myung Lee;Chang-Wook Nam;Eun-Seok Shin;Joon-Hyung Doh;Masahiro Hoshino;Rikuta Hamaya;Yoshihisa Kanaji;Tadashi Murai;Jun-Jie Zhang;Fei Ye;Xiaobo Li;Zhen Ge;Shao-Liang Chen;Tsunekazu Kakuta;Bon-Kwon Koo
    • Korean Circulation Journal
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    • v.52 no.1
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    • pp.47-59
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    • 2022
  • Background and Objectives: The influence of pre-intervention coronary physiologic status on outcomes post percutaneous coronary intervention (PCI) is not well known. We sought to investigate the prognostic implications of pre-PCI fractional flow reserve (FFR) combined with post-PCI FFR. Methods: A total of 1,479 PCI patients with pre-and post-PCI FFR data were analyzed. The patients were classified according to the median values of pre-PCI FFR (0.71) and post-PCI FFR (0.88). The primary outcome was target vessel failure (TVF) at 2 years. Results: The risk of TVF was higher in the low pre-PCI FFR group than in the high pre-PCI FFR group (hazard ratio, 1.82; 95% confidence interval, 1.15-2.87; p=0.011). In 4 group comparisons, the cumulative incidences of TVF at 2 years were 3.8%, 4.1%, 4.8%, and 10.2% in the high pre-/high post-, low pre-/high post-, high pre-/low post-, and low pre-/low post-PCI FFR groups, respectively. The risk of TVF was the highest in the low pre-/low post-PCI FFR group among the groups (p values for comparisons <0.05). In addition, the high pre-/low post-PCI FFR group presented a comparable risk of TVF with the high post-PCI FFR groups (p values for comparison >0.05). When the prognostic value of the post-PCI FFR was evaluated according to the pre-PCI FFR, the risk of TVF significantly decreased with an increase in post-PCI FFR in the low pre-PCI FFR group, but not in the high pre-PCI FFR group. Conclusions: Pre-PCI FFR was associated with clinical outcomes after PCI, and the prognostic value of post-PCI FFR differed according to the pre-PCI FFR.

The impact of radiotherapy on clinical outcomes in parameningeal rhabdomyosarcoma

  • Choi, Yunseon;Lim, Do Hoon
    • Radiation Oncology Journal
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    • v.34 no.4
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    • pp.290-296
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    • 2016
  • Purpose: Radiotherapy (RT) is considered a mainstay of treatment in parameningeal rhabdomyosarcoma (PM-RMS). We aim to determine the treatment outcomes and prognostic factors for PM-RMS patients who treated with RT. In addition, we tried to evaluate the adequate dose and timing of RT. Materials and Methods: Twenty-two patients with PM-RMS from 1995 to 2013 were evaluated. Seven patients had intracranial extension (ICE) and 17 patients had skull base bony erosion (SBBE). Five patients showed distant metastases at the time of diagnosis. All patients underwent chemotherapy and RT. The median radiation dose was 50.4 Gy (range, 40.0 to 56.0 Gy). Results: The median follow-up was 28.7 months. Twelve patients (54.5%) experienced failure after treatment; 4 local, 2 regional, and 6 distant failures. The 5-year local control (LC) and overall survival (OS) were 77.7% and 38.5%, respectively. The 5-year OS rate was 50.8% for patients without distant metastases and 0% for patients with metastases (p < 0.001). Radiation dose (<50 Gy vs. ${\geq}50Gy$) did not compromise the LC (p = 0.645). However, LC was affected by ICE (p = 0.031). Delayed administration (>22 weeks) of RT was related to a higher rate of local failure (40.0%). Conclusion: RT resulted in a higher rate of local control in PM-RMS. However, it was not extended to survival outcome. A more effective treatment for PM-RMS is warranted.

Fault Prognostics of a SMPS based on PCA-SVM (PCA-SVM 기반의 SMPS 고장예지에 관한 연구)

  • Yoo, Yeon-Su;Kim, Dong-Hyeon;Kim, Seol;Hur, Jang-Wook
    • Journal of the Korean Society of Manufacturing Process Engineers
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    • v.19 no.9
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    • pp.47-52
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    • 2020
  • With the 4th industrial revolution, condition monitoring using machine learning techniques has become popular among researchers. An overload due to complex operations causes several irregularities in MOSFETs. This study investigated the acquired voltage to analyze the overcurrent effects on MOSFETs using a failure mode effect analysis (FMEA). The results indicated that the voltage pattern changes greatly when the current is beyond the threshold value. Several features were extracted from the collected voltage signals that indicate the health state of a switched-mode power supply (SMPS). Then, the data were reduced to a smaller sample space by using a principal component analysis (PCA). A robust machine learning algorithm, the support vector machine (SVM), was used to classify different health states of an SMPS, and the classification results are presented for different parameters. An SVM approach assisted by a PCA algorithm provides a strong fault diagnosis framework for an SMPS.

Health prognostics of stator Windings in Water-Cooled Generator using Fick's second law (Fick's second law 를 이용한 수냉식 발전기 고정자 권선의 건전성 예지)

  • Youn, Byeng D.;Jang, Beom-Chan;Kim, Hee-Soo;Bae, Yong-Chae
    • Proceedings of the Korean Society for Noise and Vibration Engineering Conference
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    • 2014.10a
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    • pp.533-538
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    • 2014
  • Power generator is one of the most important component of electricity generation system to convert mechanical energy to electrical energy. I t designed robustly to maintain high system reliability during operation time. But unexpected failure of the power generator could happen and it cause huge amount of economic and social loss. To keep it from unexpected failure, health prognostics should be carried out In this research, We developed a health prognostic method of stator windings in power generator with statistical data analysis and degradation modeling against water absorption. We divided whole 42 windings into two groups, absorption suspected group and normal group. We built a degradation model of absorption suspected winding using Fick's second law to predict upcoming absorption data. Through the analysis of data of normal group, we could figure out the distribution of data of normal windings. After that, we can properly predict absorption data of normal windings. With data prediction of two groups, we derived upcoming Directional Mahalanobis Distance (DMD) of absorption suspected winding and time vs DMD curve. Finally we drew the probability distribution of Remaining Useful Life of absorption suspected windings.

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Breast Conservation Therapy Versus Mastectomy - Preliminary Results of Pattern of Failure and Survival Rate in Early Breast Cancer (조기유방암에서 유방보존치료와 유방전절제술의 치료결과 및 실패양상 비교)

  • Kim Yeon-Sil;Yoon Sei-Chul;Chung Su-Mi;Ryu Mi-Ryeong;Jung Sang-Sul;Choi Ihl-Bohng
    • Radiation Oncology Journal
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    • v.22 no.2
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    • pp.115-123
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    • 2004
  • Purpose : This retrospective study was conducted to compare early preliminary results of breast conservation therapy (BCT) with mastectomy In early breast cancer. Materials and Methods : We evaluated 171 women with AJCC stage I and II breast cancer who had been treated at Kangnam St. Mary's Hospital from March 1989 to August 1996. Eighty-eight patients underwent mastectomy and 85 patients did conservative surgery with breast irradiation. in the BCT group, all patients received whole breast irradiation to a total dose of 45$\~$50 Gy/5$\~$6 wks, followed by a boost to the original tumor site at least 60 Gy. Chemotherapy was administered to 29 (34.1$\%$) patients in BCT and 40 (45.5$\%$) in mastectomy, with various sequencing of surgery and/or radiation. We compared survival rate, patterns of failure in each treatment group and the prognostic factors that had a significant effect on treatment failure. The median follow-up time was 63 months (19$\~$111 months). Log rank test was used to estimate the prognostic factors for treatment failure. Results : Overall survival, disease free survival, locoregional recurrence and distant metastasis rates were not significantly different between the two treatment groups. During the follow-up period, 11 patients (12.5$\%$)in the mastectomy group and 10 patients (11.8%$\%$ in the BCT group were failed. Six local recurrences occurred after mastectomy and 5 after BCT Five patients fatted at distant site in mastectomy and 4 in BCT. Of the local recurrence cases, five of 6 mastectomy patients and 3 of S BCT patients were alive with no evidence of disease after salvage surgery and/or chemoirradiation. Our results indicated that the major influence on survival was distant metastasis. Unfortunately, control of distant metastasisis was not frequently achieved. Even with salvage systemic therapy or radiotherapy, most of distant metastasis patients died or had uncontrolled disease in both treatment groups: only one of 4 BCT patients and none of mastectomy patients were alive without disease. There was no apparent difference in the incidence rate of contralateral breast cancer and non-breast 2$^{nd}$ primary tumor between the two treatment groups. Univariate Log-rank test identified the N stage and the involved axillary LN number as distinct prognostic factors that were highly predictive of treatment failure in both treatment groups. Additionally, marginal status in BCT and histologic nuclear grade In the mastectomy group were risk factors for treatment fallure (p < 0.05). Concousion : Although further careful follow-up is necessary to confirm the trends evident In this serles, it would appear that patterns of failure and survival rate following conservative surgery and radiotherapy in early breast cancer are similar to those following mastectomy. The great majority of patients with local recurrence had an exellent salvage rate in both treatment groups. Therefore, these preliminary short term results support BCT as an equally effective management for early breast cancer as an alternative to mastectomy.

Acetaminophen Poisoning (아세트아미노펜 중독)

  • Chung, Sung-Pil;Kim, Seung-Ho;Lee, Hahn-Shick
    • Journal of The Korean Society of Clinical Toxicology
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    • v.6 no.1
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    • pp.1-8
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    • 2008
  • Acetaminophen (AAP) overdose can result in potentially serious hepatotoxicity. The ingested dose and time from ingestion to presentation are important prognostic factors. Toxic dose in adult is thought to be at least 10 g or 200 mg/kg. However, early management of acute overdose should be guided by the plasma AAP concentration. The antidote for AAP poisoning is N-acetylcysteine (NAC). It provides complete protection against hepatotoxicity if given within 8 h of acute overdose. If the concentration is above the possible toxicity line as predicted by the Rumack-Matthew nomogram, either the 72-hr oral or the 20-hr intravenous NAC regimen should be administered. NAC is also effective if started late in patients with established hepatic failure. This article summarizes the current consensus of clinical assessment and management for acute AAP overdose.

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Clinical Study of the Myasthenia Gravis (중증 근무력증의 임상적 고찰)

  • 지청현
    • Journal of Chest Surgery
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    • v.24 no.11
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    • pp.1125-1132
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    • 1991
  • Myasthenia gravis is a disorder of neuromuscular transmission which is characterized fatigue and weakness of the voluntary muscle. From 1985. 1 to 1991.6, 34 patients underwent managed including 12 patient thymectomy, at the kyunghee medical center. A clinical analysis was performed and following result was obtained. Among the 34 patients, male to female ratio was 11 : 23 and the age was ranged from 2 years to 63 years. Thymectomy was done in 12 case and 1 case of malignant thymoma was not resectable. There were 2 deaths after operation due to respiratory failure and 1 death dur to gradually progression. THe effect of thymectomy in mtasthenia graves was 66.7% (8cases). The prognostic factors were severity of the disease and histopathological findings. Others were not related to the prognosis of the mayasthenia gravis. The severity of the myasthenia gravis was classified by Osserman modified classification.

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Recurrent carpal tunnel syndrome associated with extension of flexor digitorum muscle bellies into the carpal tunnel: A case series

  • Castillo, Rochelle;Sheth, Khushboo;Babigian, Alan;Scola, Christopher
    • Archives of Plastic Surgery
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    • v.45 no.5
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    • pp.474-478
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    • 2018
  • While the success or failure of carpal tunnel release ultimately depends on the interplay of a wide array of factors, a broad understanding of the normal anatomy of the carpal tunnel accompanied by awareness of the possible variations of the individual structures that make up its contents is crucial to optimizing surgical outcomes. While anatomic variants such as extension of the flexor digitorum muscle bellies have been described as a cause of primary carpal tunnel syndrome (CTS), there have been no reports depicting its association with recurrent CTS following initially successful carpal tunnel release, a finding with potentially significant prognostic implications that can aid in operative planning. In such cases where muscle extension is identified preoperatively, careful debulking of the muscle belly may be beneficial in improving long-term surgical outcomes.

Study for Fault Diagnosis Methodologies Using Diagnosis for Monopropellant Propulsion System (단일 추진시스템 진단을 통한 고장진단 방법론에 관한 연구)

  • Song, Chang-Hwan;Lee, Young-Jin;Ku, Kyung-Wan;Lee, Kwon-Soon
    • Proceedings of the KIEE Conference
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    • 2009.07a
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    • pp.2041_2042
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    • 2009
  • The diagnostic/prognostic problems for condition based maintenance or Prognostics and Health Management has been used. Primary objectives of diagnosis/prognosis are maximizing system availability and minimizing downtime from fault isolation through more effective troubleshooting efforts. Diagnosis aims to detect the onset of failures to improve system performance and reduce life cycle cost by reducing the failure time. The prognosis can reduce operational and support total ownership cost and improve safety of machinery and complex systems. In this Paper, a fault diagnosis methodology has been described using a monopropellant propulsion system model as a test bench.

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