• 제목/요약/키워드: Long-term prognosis

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임상가를 위한 특집 2 - 치주질환의 예후에 영향을 미치는 인자들 (Risk Factors for Periodontal Diseases)

  • 이재관
    • 대한치과의사협회지
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    • 제50권8호
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    • pp.465-473
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    • 2012
  • Prognosis is an anticipation of the probable response to periodontal therapy and a long-term prospect for maintaining a functional dentition. Hopeless cases or cases of simple gingivitis without systemic diseases generally have little problem to establish definite prognoses. However, it might become somewhat challenging to determine their prognoses in borderline cases. A risk factor for periodontal disease may be environmental, behavioral, or biologic factors that can be defined as an occurrence has been associated with destructive periodontitis. Some risk factors are modifiable, while others cannot be modified. Modifiable risk factors are environmental or behavioral in nature in contrast non-modifiable risk factors are usually intrinsic to the individual and therefore not easily changed. In this review, we will assess the various modifiable or non-modifiable risk factors for susceptibility 10 periodontal diseases.

Pediatric Acute Kidney Injury: Focusing on Diagnosis and Management

  • Cho, Myung Hyun
    • Childhood Kidney Diseases
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    • 제24권1호
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    • pp.19-26
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    • 2020
  • Acute kidney injury (AKI) is common in critically ill children, and is associated with increased mortality and long-term renal sequelae. The definition of pediatric AKI was standardized based on elevation in serum creatinine levels or decrease in urine output; accordingly, epidemiological studies have ensued. Although new biomarkers appear to detect AKI earlier and predict prognosis more accurately than traditional markers, they are not frequently used in clinical setting. There is no validated pharmacological intervention for AKI, so prevention and early detection are the mainstays of treatment. For high risk or early stage AKI patients, optimization of volume status and blood pressure, avoidance of nephrotoxins, and sufficient nutritional support are necessary, and have been demonstrated to be effective in preventing the occurrence of AKI and improving prognosis. Nevertheless, renal replacement therapy is needed when conservative care fails.

Prognostic Significance of Preoperative Blood Transfusion in Stomach Cancer

  • Kim, Seok-Hwan;Lee, Sang-Il;Noh, Seung-Moo
    • Journal of Gastric Cancer
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    • 제10권4호
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    • pp.196-205
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    • 2010
  • Purpose: We did a retrospective study to understand the prognostic effects of preoperative blood transfusions in stomach cancer surgery. Materials and Methods: Data for 1,360 patients who underwent gastrectomy for stomach cancer between 2001 and 2009 were retrospectively reviewed. We analyzed factors that affect preoperative transfusion and clinicopathologic features. We also analyzed 5-year and overall survival rates of the transfusion and non transfusion subgroups. Results: Sixty patients (4.4%) required blood transfusion within the preoperative period. The transfused group included patients who took aspirin or clopidogrel (P<0.001), with more advanced T stages (P<0.001), with more advanced nodal metastasis (P=0.00), and with more advanced stages (P=0.00) than the non transfusion group. On multivariate analysis, preoperative transfusion was a statistically significant negative influence on 5-year survival and overall survival rates (58.2% vs 79.9% (P=0.00), 58.2% vs 76.8% (P=0.00)). Applying Cox-regression analyses, blood transfusion did appear to have an effect on prognosis and on 5-year and overall survival rates. Conclusions: We found a direct negative relation between preoperative transfusion and long term prognosis in patients receiving gastric cancer surgery.

Upper gastrointestinal tract involvement of Crohn disease: clinical implications in children and adolescents

  • Kim, Eun Sil;Kim, Mi Jin
    • Clinical and Experimental Pediatrics
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    • 제65권1호
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    • pp.21-28
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    • 2022
  • Crohn disease (CD) is a multifactorial inflammatory disorder that can affect all segments of the gastrointestinal (GI) tract but typically involves the ileum and/or colon. To assess patient prognosis and choose appropriate treatment, it is necessary to accurately evaluate the factors influencing poor outcomes, including disease phenotype. Pediatric CD involving the upper GI (UGI) tract has become increasingly recognized with the introduction of routine upper endoscopy with biopsies for all patients and the increased availability of accurate small bowel evaluations. Most clinical manifestations are mild and nonspecific; however, UGI involvement should not be overlooked since it can cause serious complications. Although controversy persists about the definition of upper GI involvement, aphthoid ulcers, longitudinal ulcers, a bamboo joint-like appearance, stenosis, and fistula are endoscopic findings suggestive of CD. In addition, the primary histological findings, such as focally enhanced gastritis and noncaseating granulomas, are highly suggestive of CD. The association between UGI involvement and poor prognosis of CD remains controversial. However, the unstandardized definition and absence of a validated tool for evaluating disease severity complicate the objective assessment of UGI involvement in CD. Therefore, more prospective studies are needed to provide further insight into the standardized assessment of UGI involvement and long-term prognosis of CD. Our review summarizes the findings to date in the literature as well as UGI involvement in CD and its clinical implications.

성대결절 환자에서 음성치료 효과를 예측할 수 있는 인자에 대한 연구 (A Clinical Study of Predicable Factors of Voice Therapy Effect in Vocal Nodule Patients)

  • 우주현;백민관;김동영
    • 대한후두음성언어의학회지
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    • 제20권1호
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    • pp.52-56
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    • 2009
  • Background and Objectives : Vocal nodule is common inflammatory vocal cord lesion which could be improved by voice rest or voice therapy. But some patients, who do not have any improvement after voice therapy, should take laryngomicorsurgery or additional long-term voice therapy. So we try to find prognostic factors which affect the results of voice therapy. Materials and Methods: There are 36 patients (response group) whose symptoms improved after initial voice therapy and 16 patients (no response group) whose symptoms did not improve at all. We compared clinical features (durations of symptoms, voice abuse, laryngopharyngeal reflux), GRBAS scale, acoustic analysis, aerodynamic analysis and voice handicap index between the two groups from January, 2006 to June, 2008. Results: Response group underwent voice therapy 4.5 times (ave.) and no response group underwent 6.7 times (ave.). No response group has longer duration of symptoms, higher GRBAS scale score, higher NIH ratio, and higher MFR than those of response group. Conclusion : This study found that the prognosis of voice therapy in patients who have longer duration of symptoms, high NIH ratio, and bad perceptional test result is not likely to be good. In those cases, we should recommend earlier surgery, voice therapy after surgery, and inform about the necessity of long-term voice rehabilitation or voice therapy in order to get favorable compliance.

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Success and Failure of Surgical Endodontic Treatment in Molar Teeth

  • Geum, Yun-Seon;Lee, Jang-Ryeol;Kim, Hyeon-Cheol;Lee, Sang-Cheol;Kim, Yeong-Uk
    • Journal of Korean Dental Science
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    • 제3권2호
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    • pp.12-19
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    • 2010
  • Despite the latest advancement made in its techniques and devices/apparatuses and the resulting rising expectation in the field of dental surgery, apicoectomy performed in the molar teeth remains a technical challenge and lacks evidence substantiated by long-term follow-up studies. This study sought to investigate the treatment outcomes and post-operative success rate in the root-end resected molar teeth accompanied by a high level of surgical risks due to their close proximity to the mandibular canal and maxillary sinus. A total of 68 patients who received treatment at Livingwell Dental Hospital between 2004 and 2010 and underwent apical surgery in the maxillary or mandibular molar area were enrolled in this study. A total of 160 roots collected from 75 molar teeth were subjected to surgical endodontic treatment and subsequently evaluated clinically as well as radiographically. Based on the results of the study, the clinical success rate was found to be 78.8% in cases involving radiological healing. Likewise, 90.7% of the roots recorded a robust clinical survival rate, but with incomplete healing as shown by radiography. The results indicate that the apical procedure involving molar teeth is a prognosis-friendly method that promises positive outcomes and higher success rate based on long-term follow-up observations.

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Combination syndrome 예방을 고려한 flexible IARPD 증례 (Flexible IARPD considering the prevention of combination syndrome: a case report)

  • 김소연
    • 대한치과보철학회지
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    • 제60권4호
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    • pp.347-353
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    • 2022
  • 상악 완전 무치악과 하악 양측 후방 무치악 상태의 환자에서 전통적인 의치를 제작하는 방법은 흔히 볼수 있는 치료 방법이다. 그러나 장기적으로 볼 때 이와 같은 구강내 환경에서는 복합증후군(Combination syndrome)이라는 합병증이 발생할 수 있다. 이때 임플란트를 동반한 국소의치(Implant Assisted Removable Partial Denture, IARPD)의 적용으로 치조골 보존과 함께 Combination syndrome의 예방을 도모할 수 있다. 본 증례에서는 무치악 부위에 임플란트의 추가 식립 시 국소의치의 움직임에 의해 최후방 지대치에 가해지는 응력을 줄일 수 있으므로 금속이 아닌 레진 클라스프를 계획하였고 flexible 의치 레진을 사용하였다. 상악 총의치, 하악 flexible IARPD를 계획하여 최소한의 비용과 수술로서 심미적, 기능적인 장기적 예후를 얻어 보고하고자 한다.

Chloride and lactate as prognostic indicators of calf diarrhea from eighty-nine cases

  • Gencay Ekinci;Emre Tufekci;Youssouf Cisse;Ilknur Karaca Bekdik;Ali Cesur Onmaz;Oznur Aslan;Vehbi Gunes;Mehmet Citil;Ihsan Keles
    • Journal of Veterinary Science
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    • 제25권3호
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    • pp.38.1-38.16
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    • 2024
  • Importance: Deaths due to neonatal calf diarrhea are still one of the most critical problems of cattle breeding worldwide. Determining the parameters that can predict diarrhea-related deaths in calves is especially important in terms of prognosis and treatment strategies for the disease. Objective: The primary purpose of this study was to determine mortality rates and durations, survival status, and predictive prognosis parameters based on vital signs, hematology, and blood gas analyses in neonatal diarrheic calves. Methods: The hospital automation system retrospectively obtained data from 89 neonatal diarrheic calves. Results: It was found that 42.7% (38/89) of the calves brought with the complaint of diarrhea died during hospitalization or after discharge. Short-term and long-term fatalities were a median of 9.25 hours and a median of 51.50 hours, respectively. When the data obtained from this study is evaluated, body temperature (℃), pH, base excess (mmol/L), and sodium bicarbonate (mmol/L) parameters were found to be lower, and hemoglobin (g/dL), hematocrit (%), lactate (mmol/L), chloride (mmol/L), sodium (mmol/L) and anion gap (mmol/L) parameters were found to be higher in dead calves compared to survivors. Accordingly, hypothermia, metabolic acidosis, and dehydration findings were seen as clinical conditions that should be considered. Logistic regression analysis showed that lactate (odds ratio, 1.429) and CI- (odds ratio, 1.232) concentration were significant risk factors associated with death in calves with diarrhea. Conclusions and Relevance: According to the findings obtained from this study, the determination of lactate and Cl- levels can be used as an adjunctive supplementary test in distinguishing calves with diarrhea with a good prognosis.

A Long-Term Survival Case of a Primary Malignant Intracerebral Nerve Sheath Tumor

  • Lee, Byung Sun;Kim, Young Gyu;Kim, Dong Ho;Lee, Mou Seop
    • Journal of Korean Neurosurgical Society
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    • 제54권3호
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    • pp.261-264
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    • 2013
  • We report a long-term survival case of a primary malignant intracerebral nerve sheath tumor (MINST) occurring in the right frontal lobe of a 13-year old boy. After the gross total resection (GTR), we have performed radiation therapy but it recurred 50 months after the surgery, so the second GTR was performed. Later, second tumor recurrence was found 4 months after the second surgery. Subsequently the third GTR, radiotherapy, and chemotherapy were carried out. At present, the patient has been remaining alive for 77 months without evidence of tumor recurrence. According to the previous reports, the primary MINST is very rare : there are only 8 cases reported. It is also a fast-growing, invasive tumor with poor outcome. This is the first case that had no recurrence for 50 months after the surgery among the reported cases that had been followed up for more than 5 years. It is supposed that a period of recurrence free survival after GTR and low mitotic activity are associated with the patient's prognosis. A GTR followed by adjuvant radiation therapy and chemotherapy will be recommended to patients of MINST.

Large Cell Neuroendocrine Carcinoma of the Thymus: A Two-Case Report

  • Yoon, Yong-Han;Kim, Jae-Ho;Kim, Kwang-Ho;Baek, Wan-Ki;Lee, Hyun-Kyu;Lee, Moon-Hee;Lee, Kyung-Hee;Kim, Lucia
    • Journal of Chest Surgery
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    • 제45권1호
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    • pp.60-64
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    • 2012
  • A large cell neuroendocrine carcinoma (LCNEC) of the thymus is a very rare malignant tumor that has a very poor prognosis. The detailed clinical features of LCNEC are still unknown, including the long term prognoses and the definitive modalities of the treatment for LCNEC of the thymus. We are reporting 2 cases of an enlarged LCNEC of the thymus, both of which were diagnosed and treated by surgical resection followed by postoperative adjuvant chemoradiation therapy. Although recurrences and metastases of the LCNEC were noticed 1 and 4 years postoperatively for each case, aggressive surgical resection and adjuvant chemoradiation therapy may be helpful for a patient's long term survival.