• Title/Summary/Keyword: Long-Term Survival

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Effect of Neurotrophic Factors on Neuronal Stem Cell Death

  • KimKwon, Yun-Hee
    • BMB Reports
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    • v.35 no.1
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    • pp.87-93
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    • 2002
  • Neural cell survival is an essential concern in the aging brain and many diseases of the central nervous system. Neural transplantation of the stem cells are already applied to clinical trials for many degenerative neurological diseases, including Huntington's disease, Parkinson's disease, and strokes. A critical problem of the neural transplantation is how to reduce their apoptosis and improve cell survival. Neurotrophic factors generally contribute as extrinsic cues to promote cell survival of specific neurons in the developing mammalian brains, but the survival factor for neural stem cell is poorly defined. To understand the mechanism controlling stem cell death and improve cell survival of the transplanted stem cells, we investigated the effect of plausible neurotrophic factors on stem cell survival. The neural stem cell, HiB5, when treated with PDGF prior to transplantation, survived better than cells without PDGF. The resulting survival rate was two fold for four weeks and up to three fold for twelve weeks. When transplanted into dorsal hippocampus, they migrated along hippocampal alveus and integrated into pyramidal cell layers and dentate granule cell layers in an inside out sequence, which is perhaps the endogenous pathway that is similar to that in embryonic neurogenesis. Promotion of the long term-survival and differentiation of the transplanted neural precursors by PDGF may facilitate regeneration in the aging adult brain and probably in the injury sites of the brain.

Long Term Therapeutic Plan for Patients with Non-Small Cell Lung Cancer Harboring EGFR Mutation

  • Jang, Seung Hun
    • Tuberculosis and Respiratory Diseases
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    • v.76 no.1
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    • pp.8-14
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    • 2014
  • Non-small cell lung cancer harboring epidermal growth factor receptor (EGFR) sensitizing mutations has a distinct disease entity. Patients with this cancer have better prognosis, and frequently achieve long-term survival. EGFR-tyrosine kinase inhibitor (TKI) is the drug of choice for this cancer; but the disease inevitably progresses, after durable response. The tumor is a mixture of EGFR-TKI sensitive clones and resistant clones, regardless of their molecular mechanisms. EGFR-TKI sensitive clones are very susceptible to this drug, but rarely eradicated; so, withdrawal of the drug permits rapid regrowth of drug sensitive clones, possibly causing "disease flare." Re-administration or continuation of EGFR-TKI can effectively suppress the expansion of drug sensitive clones, even when the total tumor volume continuously increases. Chemotherapy can definitely prolong the survival of patients experiencing EGFR-TKI failure. Prospective clinical trials are warranted to compare efficacies of chemotherapeutic agents. A few retrospective studies suggested that a taxanebased regimen may be superior to others. Here, we reviewed therapeutic options and clinical evidence about this unique disease entity.

Surgical Treatment of T4 Lung Cancer with the Use of Extracorporeal Circulation -A case report of long-term survival - (체외순환을 이용한 T4 폐암의 수술적 치험 -장기 생존 1예 보고-)

  • 조규도;조민섭;윤정섭;김치경;곽문섭
    • Journal of Chest Surgery
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    • v.37 no.2
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    • pp.180-183
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    • 2004
  • We report a case of a patient with lung cancer, which invaded the left atrium and pericardium. Right middle and lower lobectomy was performed with the use of the extracorporeal circulation. Postoperative pathologic examination revealed the stage of IIIB (T4N1MO). Although the postoperative clinical course was complicated by acute localized right sided pulmonary edema and the bronchopleural fistula, the patient recovered smoothly after the procedure of omentopexy with pedicled graft of greater omentum in closing the BPF. As of August 2003, he has been followed up for 6 years and he is healthy without any evidence of recurrence. We could not find any report concerning lung cancer resection using cardiopulmonary bypass in Korean literature and believe this is the first report, especially with long-term survival.

Comparison of long-term result of Hancock and Carpentier-Edward bioprosthetic valves (Hancock과 Carpentier-Edward 이종판막의 장기 임상성적에 대한 비교 연구)

  • 김정택
    • Journal of Chest Surgery
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    • v.26 no.1
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    • pp.24-31
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    • 1993
  • The long term clinical results following valve replacement with Hancock and Carpentier-Edwards bioprostheses were compared between tow valve models and between tow groups totaling 249 patients who were discharged after valve replacement from 1976 to 1986. The two groups of patients were treated with nonrandomized fashion. Follow-up was 87% complete. Cummulative duration of follow-up was 1909 patient-years, with maximum follow-up duration of 15 years. The actuarial survival for 122 patients with Hancock valves was 95.2%[\ulcornerstandard deviation] and 84.4% after 5 and 10 years of follow-up, respectively. Comparable figures for 127 patients undergoing valve replacement with Carpentier-Edwards valves were 87.3% and 76.4%, respectively[p=NS]. The probability of freedom from structural valve deterioration after 5 and 10 years of follow-up was 97.2% and 60.6%, respectively, with Hancock valves and 97.2% and 55.7%, respectively, with Carpentier-Edwards valves[p=NS]. Considering all 249 patients, multivariate [Cox model] regression revealed that ejection fraction was only significant predictor of structural valve deterioration. The probability of freedom from thromboembolism after 5 and 10 years of follow-up was 91.3% and 86.4%, respectively, with Hancock valves and 94.2% and 82.5%, respectively, with Carpentier-Edwards valves[p=NS]. Hence more strict control of anticoagulation should be done on patients with left atrial factors. In summary, there were no significant differences in actuarial survival rate and major valve related complications between tow valve models. These results suggests that its use should be confined to older patients or patients with a contraindication of anticoagulation.

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Mid term experience with CarboMedics Medical Valve (CarboMedics 기계판막의 임상경험)

  • 김기출
    • Journal of Chest Surgery
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    • v.26 no.10
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    • pp.753-760
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    • 1993
  • The CarboMedics valve is a bileaflet prosthesis with excellent hemodynamic characteristics, but the long term surgical experience with this valve, its durability and its biocompatibility are unknown. During a 5 year period from october 1988 to July 1993, 748 prostheses [402 mitral, 261 aortic, 58 tricuspid, 27 pulmonic] were inserted in 552 patients [mean age 40.2 years]. The operative mortality was 6.6% [37/560, 13.2% in age group below 15 years and 5.7% above 15 years]. and the main causes of death were complex congenital malformation and left ventricular failure. Follow up was totaled 1182 patient- years and mean follow up was 28.3 months/patient. No structural failure has been observed. Hemorrhage was the most frequent valve related complication[1.78% / Patient-year]. Embolism occurred at a rate of 0.93% / Patient-year. There were 5 cases of valve thrombosis [0.42% / Patient-year, two fatal]. There occurred 11 late deaths[6 valve related] and 42 valve related complications. Actuarial survival at 5 years is 97.18 0.94% and actuarial complication free survival at 5 years is 89.07 1.54%. In summary, the CarboMedics valve stands for a durable valve substitute, with low valve related complications.

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Long Term Results of Right Ventricular Outflow Tract Reconstruction with Homografts

  • Kim, Hye-Won;Seo, Dong-Man;Shin, Hong-Ju;Park, Jeong-Jun;Yoon, Tae-Jin
    • Journal of Chest Surgery
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    • v.44 no.2
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    • pp.108-114
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    • 2011
  • Background: Homograft cardiac valves and valved-conduits have been available in our institute since 1992. We sought to determine the long-term outcome after right ventricular outflow tract (RVOT) reconstruction using homografts, and risk factors for reoperation were analyzed. Materials and Methods: We retrospectively reviewed 112 patients who had undergone repair using 116 homografts between 1992 and 2008. Median age and body weight at operation were 31.2 months and 12.2 kg, respectively. The diagnoses were pulmonary atresia or stenosis with ventricular septal defect (n=93), congenital aortic valve diseases (n=15), and truncus arteriosus (N=8). Mean follow-up duration was $79.2{\pm}14.8$ months. Results: There were 10 early and 4 late deaths. Overall survival rate was 89.6%, 88.7%, 86.1% at postoperative 1 year, 5 years and 10 years, respectively. Body weight at operation, cardiopulmonary bypass (CPB) time and aortic cross-clamping (ACC) time were identified as risk factors for death. Forty-three reoperations were performed in thirty-nine patients. Freedom from reoperation was 97.0%, 77.8%, 35.0% at postoperative 1 year, 5 years and 10 years respectively. Small-sized graft was identified as a risk factor for reoperation. Conclusion: Although long-term survival after RVOT reconstruction with homografts was excellent, freedom from reoperation was unsatisfactory, especially in patients who had small grafts upon initial repair. Thus, alternative surgical strategies not using small grafts may need to be considered in this subset.

Long-term Retrospective Clinical Study Comparing Submerged Type with External Hex Connection and Non-submerged Type with Internal Morse Taper Connection Implants

  • Kwoen, Min-Jeong;Kim, Sang-Yun;Kim, Young-Kyun
    • Journal of Korean Dental Science
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    • v.12 no.1
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    • pp.29-37
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    • 2019
  • Purpose: This study was aimed to compare the survival and success rates, and long-term crestal bone loss according to the use of 2 connection types of dental implants (submerged-USII and non-submerged-SSII; Osstem $Implant^{(R)}$) by analyzing the change in alveolar bone height after 1 year under load and during final follow-up period. Materials and Methods: Between December 2004 and August 2008, patients with two types of Osstem implants (USII and SSII) were retrieved retrospectively. A total of 92 patients with 284 implants (USII=60, SSII=224) was finally selected. Their mean follow-up period was 7.5 years. The mesial and distal alveolar crestal bone changes were measured using radiographic images and the average was calculated at 1 year after loading and during final follow-up period. Result: Among the 284 implants, 4 USII and 7 SSII implants were removed, indicating 93.3% and 96.9% survival rates. Of the survived implants, mean crestal bone loss 1 year after loading was 0.39 mm for USII and 0.19 mm for SSII (P=0.018). During the final follow-up, mean crestal bone loss was 0.63 mm and 0.35 mm for USII and SSII, respectively, without statistical significance (P=0.092). According to the criteria for the success and failure of the implant by Albreksson and colleagues, final success rate was estimated as 86.7% for USII and 91.5% for SSII, respectively. Conclusion At 1 year after loading, the average crestal bone loss was significantly different between USII and SSII; however, both types met the criteria for implant success. During the final follow-up, both groups showed insignificant bone resorption patterns and did not show any pathological clinical symptoms. Therefore, both implants exhibited high long-term stability.

Survival analysis for contract maintenance period using life insurance data (생명보험자료를 이용한 계약유지기간에 대한 생존분석)

  • Yang, Dae Geon;Ha, Il Do;Cho, Geon Ho
    • The Korean Journal of Applied Statistics
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    • v.31 no.6
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    • pp.771-783
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    • 2018
  • The life insurance industry is interested in various factors that influence the long-term extensions of insurance contracts such as the necessity for the advisors' long-term management of consumers, product consulting, and improvement of the investment aspects. This paper investigates important factors leading to a long-term contract that forms an important part of the life insurance industry in Korea. For this purpose we used the data of contents (i.e., data from Jan 1, 2011 to Dec 31, 2016) of the contracts of xxx insurance company. In this paper, we present how to select important variables to influence the duration of the contract maintenance via a penalized Cox's proportional hazards (PH) modelling approach using insurance life data. As the result of analysis, we found that the selected important factors were the advisor's status, the reward type 2 (annuity insurance) and tendency 4 (safety-pursuing type).

Long-Term Outcomes of Colon Conduits in Surgery for Primary Esophageal Cancer: A Propensity Score-Matched Comparison to Gastric Conduits

  • Jae Hoon Kim;Jae Kwang Yun;Chan Wook Kim;Hyeong Ryul Kim;Yong-Hee Kim
    • Journal of Chest Surgery
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    • v.57 no.1
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    • pp.53-61
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    • 2024
  • Background: In the treatment of esophageal cancer, a gastric conduit is typically the first choice. However, when the stomach is not a viable option, the usual alternative is a colon conduit. This study compared the long-term surgical outcomes of gastric and colon conduits over the same interval and aimed to identify factors influencing the prognosis. Methods: A retrospective review was conducted of patients who underwent esophagectomy followed by reconstruction for primary esophageal cancer between January 2006 and December 2020. Results: The study included 1,545 patients, with a gastric conduit used for 1,429 (92.5%) and a colon conduit for 116 (7.5%). Using propensity-matched analysis, 116 patients were selected from each group for comparison. No significant difference was observed in longterm survival between the gastric and colon conduit groups, irrespective of anastomosis level and pathological stage. A higher proportion of patients in the colon conduit group experienced postoperative complications compared to the gastric conduit group (57.8% vs. 25%, p<0.001). Multivariable analysis revealed that age over 65 years, body mass index below 22.0 kg/m2, neoadjuvant therapy, postoperative anastomotic leakage, and renal failure were risk factors for overall survival in patients with a colon conduit. Regarding conduit-related complications, cervical nastomosis was the only significant risk factor among those with a colon conduit. Conclusion: Despite the association of colon conduits with high morbidity rates relative to gastric conduits, the long-term outcomes of colon conduits were acceptable. More consideration should be given perioperatively to the use of a colon conduit, particularly in cases involving cervical anastomosis.

Prognostic Value of Preoperative Serum CA 242 in Esophageal Squamous Cell Carcinoma Cases

  • Feng, Ji-Feng;Huang, Ying;Chen, Qi-Xun
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1803-1806
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    • 2013
  • Purpose: Carbohydrate antigen (CA) 242 is inversely related to prognosis in many cancers. However, few data regarding CA 242 in esophageal cancer (EC) are available. The aim of this study was to determine the prognostic value of CA 242 and propose an optimum cut-off point in predicting survival difference in patients with esophageal squamous cell carcinoma (ESCC). Methods: A retrospective analysis was conducted of 192 cases. A receiver operating characteristic (ROC) curve for survival prediction was plotted to verify the optimum cuf-off point. Univariate and multivariate analyses were performed to evaluate prognostic parameters for survival. Results: The positive rate for CA 242 was 7.3% (14/192). The ROC curve for survival prediction gave an optimum cut-off of 2.15 (U/ml). Patients with CA 242 ${\leq}$ 2.15 U/ml had significantly better 5-year survival than patients with CA 242 >2.15 U/ml (45.4% versus 22.6%; P=0.003). Multivariate analysis showed that differentiation (P=0.033), CA 242 (P=0.017), T grade (P=0.004) and N staging (P<0.001) were independent prognostic factors. Conclusions: Preoperative CA 242 is a predictive factor for long-term survival in ESCC, especially in nodal-negative patients. We conclude that 2.15 U/ml may be the optimum cuf-off point for CA 242 in predicting survival in ESCC.