• Asian Pacific Journal of Cancer Prevention
• /
• 제15권24호
• /
• pp.10729-10733
• /
• 2015

Background: Adjuvant androgen deprivation therapy (ADT) is a treatment option for prostate cancer (PC) patients after radical prostatectomy (RP). Although it can achieve a good progression-free survival rate, some patients still develop clinical metastasis. We here investigated risk factors of clinical metastasis in post-prostatectomy patients who received immediate adjuvant ADT. Materials and Methods: We identified 197 patients with non-metastatic PC who underwent RP at our institution between 2000 and 2012, followed by adjuvant ADT. The associations of various clinicopathologic factors with clinical metastasis (primary endpoint) and cancer-specific survival (secondary endpoint) were assessed. Multivariate analysis was conducted using a Cox proportional hazards model. Median follow-up was 87 months after RP. Results: Nine (4.6%) patients developed clinical metastasis and six (3.0%) died from PC. Eight of nine metastatic patients had a pathologic Gleason score (GS) 9 and developed bone metastasis, while the remaining one had pathologic GS 7 and developed metastasis only to para-aortic lymph nodes. On multivariate analyses, pathologic GS ${\geq}9$ and regional lymph node metastasis (pN1) were independent predictors of clinical metastasis and pathologic GS ${\geq}9$ was an independent predictor of cancer-specific death. Conclusions: Pathologic GS ${\geq}9$ and pN1 were independent predictors of clinical metastasis in post-prostatectomy patients who received immediate adjuvant ADT. Furthermore, pathologic GS ${\geq}9$ was an indispensable condition for bone metastasis, which may imply that patients with GS ${\leq}8$ on adjuvant ADT are unlikely to develop bone metastasis.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권14호
• /
• pp.5557-5563
• /
• 2014

Background: This study investigated the survival benefit of radiotherapy (RT) of the supra- and infraclavicular lymphatic drainage area in Chinese women with T1-2N1M0 breast cancer receiving mastectomy. Methods: A total of 593 cases were retrospectively reviewed from 1998 to 2007. The relationship between supra- or infraclavicular fossa relapse (SCFR) and post-operative RT at the supra-/infraclavicular lymphatic drainage area was evaluated. Results: The majority of patients (532/593; 89. 8%) received no RT while 61 patients received RT. The median follow-up was 85 months. Among patients without RT, 54 (10. 2%) developed recurrence in the chest wall or ipsilateral SCFR. However, none of the 61 patients who underwent RT demonstrated SCFR. One patient who received RT (1. 6%) experienced recurrence in the chest wall. Univariate analysis revealed that age and molecular subtype (both P < 0. 05) were two prognostic factors related to supraclavicular and infraclavicular fossa relapse-free survival (SFRFS). Multivariate analysis revealed that only Her-2 positive status (P = 0. 011) was an independent predictor of SFRFS. RT had no influence on distant metastasis (P = 0. 328) or overall survival (P = 0. 541). SCFR significantly affected probability of distant metastasis (P < 0. 001) and overall survival (P < 0. 001). Conclusion: Although RT was not significantly associated with SFRFS, postoperative RT was significantly associated with a lower locoregional (i. e., supraclavicular/infraclavicular and chest wall) recurrence rate. SCFR significantly influenced distant metastasis-free survival, which significantly influenced the overall survival of T1-2N1M0 breast cancer patients after mastectomy. Thus, prophylactic RT is recommended in T1-2N1M0 breast cancer patients, especially those who have Her-2 positive lesions.

• Clinical and Experimental Pediatrics
• /
• 제50권8호
• /
• pp.757-760
• /
• 2007

목 적 : 열성 경련은 간질과는 구별되는 양성 질환이지만 복합 열성 경련에서는 간질의 발생이 더 많은 것으로 알려져 있다. 복합 열성 경련의 정의에 해당하는 환자에서 간질 이행의 발생률이 증가하는지 알아보기 위하여 본 연구를 시행하였다. 방 법 : 열성 경련으로 건양대학교 병원 소아과를 방문하였던 환자들을 대상으로 후향적 연구를 시행하였으며 환자의 정보는 의무 기록 분석과 부모와의 면담을 통하여 조사하였다. 결 과 : 2000년 3월부터 2003년 12월까지 열성 경련으로 본원을 내원한 환아는 314명이었으며, 이 중 복합 열성 경련으로 진단받은 환아는 63명(20.0%)으로 12개월 이상 추적 관찰은 44명(44/63, 70.0%)에서 가능했다. 평균 $34.2{\pm}11.6$개월의 추적 관찰 기간동안 10명에서 간질이 발생하였고, 부분 발작(57.1%)을 한 경우가 2회 이상(26.7%) 또는 15분 이상의 경련(24.1%)과 비교하였을때 더 높은 간질 발생률을 보였다. 결 론 : 복합 열성 경련이 있는 환자에서 첫 열성 경련의 양상이 부분 발작의 형태로 나타난 경우에 이후 간질 발생 빈도가 높음을 알 수 있었다.

• 한국환경보건학회지
• /
• 제27권2호
• /
• pp.127-137
• /
• 2001

Polychlorinated biphenyls(PCBs) are halogenated aromatic compounds with the empirical formula $C_{12}$ $H_{10-n}$C $l_{n}$(n=1~10), and are a mixture of possible 209 different chlorinated congeners. PCBs were widely used as dielectric fluids for capacitors and transformers, plasticizers, lubricant inks and paint addirives. Once released into the environment, PCBs persist for years because they are so resistant to degradation. In addition to their persistence in the environment, PCBs in ecological food chains undergo biomagnification because of their high degree of lipophilicity. In 1970s, the worldwide production of PCBs was ceased and the import of PCBs was prohibited since 1983 in Korea. In spite of these actions, many PCBs seems to be still in use. The environmental load of PCBs will continue to be recycled through air, land, water, and the biosphere for decades to come. This study was conducted to measure the concentrations of PCBs in the serum samples of 112 women by GC/MSD and GC/ECD. The main results of this study were as follows. 1. PCBs were detected in all samples. The mean $\pm$SD levels of PCBs in the serum were 3.613$\pm$0.759 ppb, and median were 3.828 ppb. 2. The correlation coefficients of the concentrations of 13 PCB congeners were from minimum, 0.7913 to maximum, 0.9985, and all was significant(p=0.0001). The correlation coefficient between the concentrations of PCBs and p,p'-DDE was 0.9641(p=0.0001). 3. There was a positive association between age and PCBs' concentrations (simple linear regression ; $R^2$=0.86, $\beta$=0.08023, p<0.001). 4. There was a positive association between total lipids in the serum and PCBs' concentrations (simple linear regression ; $R^2$=0.7058, $\beta$=0.00486, p<0.001). 5. For possible predictors of PCBs and p,p' -DDE levels in the serum, age adjusted model (Y=$\beta$$_{0}$+$\beta$$_1$age+ $B_2$X) was applied. For BMI, major residential area, wether to eat caught fish by angling, where to eat caught fish by angling(by parents in the past), fish consumption, meat consumption, meat consumption, and dairy consumption, there was no association. For total conception frequency and lactation frequency and lactation period, there was negative association.ion.

• Journal of Chest Surgery
• /
• 제44권1호
• /
• pp.44-50
• /
• 2011

Background: Cardiovascular complications are major causes of morbidity and mortality following non-cardiac thoracic operations. Recent studies have demonstrated that elevation of N-Terminal Pro-B-type natriuretic peptide (NT-proBNP) levels can predict cardiac complications following non-cardiac major surgery as well as cardiac surgery. However, there is little information on the correlation between lung resection surgery and NT-proBNP levels. We evaluated the role of NT-proBNP as a potential marker for the risk stratification of cardiac complications following lung resection surgery. Material and Methods: Prospectively collected data of 98 patients, who underwent elective lung resection from August 2007 to February 2008, were analyzed. Postoperative adverse cardiac events were categorized as myocardial injury, ECG evidence of ischemia or arrhythmia, heart failure, or cardiac death. Results: Postoperative cardiac complications were documented in 9 patients (9/98, 9.2%): Atrial fibrillation in 3, ECG-evidenced ischemia in 2 and heart failure in 4. Preoperative median NT-proBNP levels was significantly higher in patients who developed postoperative cardiac complications than in the rest (200.2 ng/L versus 45.0 ng/L, p=0.009). NT-proBNP levels predicted adverse cardiac events with an area under the receiver operating characteristic curve of 0.76 [95% confidence interval (CI) 0.545~0.988, p=0.01]. A preoperative NT-proBNP value of 160 ng/L was found to be the best cut-off value for detecting postoperative cardiac complication with a positive predictive value of 0.857 and a negative predictive value of 0.978. Other factors related to cardiac complications by univariate analysis were a higher American Society of Anesthesiologists grade, a higher NYHA functional class and a history of hypertension. In multivariate analysis, however, high preoperative NT-proBNP level (>160 ng/L) only remained significant. Conclusion: An elevated preoperative NT-proBNP level is identified as an independent predictor of cardiac complications following lung resection surgery.

• The Korean journal of internal medicine
• /
• 제33권6호
• /
• pp.1093-1102
• /
• 2018

Background/Aims: The aim of this study was to investigate parameters that predict radiation-induced liver disease (RILD) following stereotactic body radiotherapy (SBRT) in patients with hepatocellular carcinoma (HCC) and to identify the clinical significance of RILD. Methods: We retrospectively reviewed the medical records of 117 HCC patients who were treated by SBRT from March 2011 to February 2015. RILD was defined as elevated liver transaminases more than five times the upper normal limit or a worsening of Child-Pugh (CP) score by 2 within 3 months after SBRT. All patients were assessed at 1 month and every 3 months after SBRT. Results: Median follow-up was 22.5 months (range, 3 to 56) after SBRT. RILD was developed in 29 of the 117 patients (24.7%). On univariate analysis, significant predictive factors of RILD were pretreatment CP score (p < 0.001) and normal liver volume (p = 0.002). Multivariate analysis showed that CP score was a significant predictor of RILD (p < 0.001). The incidence of RILD increased above a CP score of 6 remarkably. The rate of recovery from RILD decreased significantly above a CP score of 8. Survival analysis showed that CP score was an independent prognostic factor of overall survival (p = 0.001). Conclusions: CP score is a significant factor to predict RILD in patients with chronic liver disease. RILD can be tolerated by patients with a CP score ${\leq}7$. However, careful monitoring of liver function is needed for patients with a CP score 7 after SBRT.

• Korean Circulation Journal
• /
• 제48권11호
• /
• pp.1002-1011
• /
• 2018

Background and Objectives: The prognostic impact of left axis deviation (LAD) on clinical outcomes in acute heart failure syndrome (AHFS) with left bundle branch block (LBBB) is unknown. The aim of this study was to determine the prognostic significance of axis deviation in acute heart failure patients with LBBB. Methods: Between March 2011 and February 2014, 292 consecutive AHFS patients with LBBB were recruited from 10 tertiary university hospitals. They were divided into groups with no LAD (n=189) or with LAD (n=103) groups according to QRS axis <-30 degree. The primary outcome was all-cause mortality. Results: The median follow-up duration was 24 months. On multivariate analysis, the rate of all-cause death did not significantly differ between the normal axis and LAD groups (39.7% vs. 46.6%, adjusted hazard ratio, 1.01; 95% confidence interval, 0.66, 1.53; p=0.97). However, on the multiple linear regression analysis to evaluate the predictors of the left ventricular ejection fraction (LVEF), presence of LAD significantly predicted a worse LVEF (adjusted beta, -3.25; 95% confidence interval, -5.82, -0.67; p=0.01). Right ventricle (RV) dilatation was defined as at least 2 of 3 electrocardiographic criteria (late R in lead aVR, low voltages in limb leads, and R/S ratio <1 in lead V5) and was more frequent in the LAD group than in the normal axis group (p<0.001). Conclusions: Among the AHFS with LBBB patients, LAD did not predict mortality, but it could be used as a significant predictor of worse LVEF and RV dilatation (Trial registry at KorAHF registry, ClinicalTrial.gov, NCT01389843).

• 대한영상의학회지
• /
• 제79권5호
• /
• pp.264-270
• /
• 2018

목적: 간기능이 보존된 간세포암 환자에서 간문맥 고혈압이 고주파열치료 후 종양 재발에 미치는 영향을 평가한다. 대상과 방법: 2010년 1월에서 2017년 3월 사이에 Milan criteria 및 Child-Pugh class A를 가진 신규 간세포암 환자 중 본원에서 고주파열치료를 시행한 환자가 본 연구에 포함되었다. 종양 재발에 대한 예측인자를 찾기 위해 Cox proportional hazard model을 이용한 단변량 및 다변량 분석을 수행하였다. 결과: 모두 178명의 환자가 본 연구에 포함되었다. 추적 관찰 기간의 중앙값은 42.8개월이었다. 국소 재발률은 문맥고혈압 여부에 따라 뚜렷한 차이를 유발하지 않았다(p = 0.195). 3년 및 5년 원위부 간내 종양 재발률은 문맥고혈압이 없는 환자의 경우 각각 29.5%와 53.7%, 그리고 문맥고혈압이 있는 환자의 경우 51.9%와 63.6%였으며 두 군 사이의 차이는 통계적으로 유의하였다(p = 0.011). 단변량 및 다변량 분석에서 문맥압항진은 원위부 간내 종양 재발에 대한 독립적인 예측 인자이었다(p = 0.008). 결론: Child-Pugh class A를 가진 간세포암 환자의 경우, 문맥고혈압은 종양 재발에 불량 예후인자로 작용하였다.

• 대한영상의학회지
• /
• 제82권4호
• /
• pp.876-888
• /
• 2021

목적 항암 치료를 진행하는 위암 간전이 환자에서 종양의 길이를 이용한 반응 평가와 비교하여 종양의 부피를 이용한 반응 평가가 환자의 생존율을 더 잘 예측할 수 있는지 알아보는 연구이다. 대상과 방법 항암 치료를 진행하는 위암 간전이 환자 43명을 연구에 포함하였다. 간전이 종양의 부피를 정량적으로 계산한 기준과 Response Evaluation Criteria in Solid Tumors 기준을 비교하였다. 카플란-마이어, 콕스비례위험 모형을 사용하여 일변량분석과 다변량분석을 통해 환자 생존율 및 연관된 인자를 알아보았다. 결과 저자들은 간전이 종양의 부피를 정량적으로 계산한 기준을 이용했을 때, 질환 반응군(23.6개월; 95% 신뢰구간, 8.63~38.57)과 질환 비반응군(7.6개월; 95% 신뢰구간, 3.78~11.42)간 생존율에 통계학적 유의한 차이를 확인하였다(p = 0.039). 질환 안정군과 질환 진행군을 부피를 이용한 반응 평가와 길이를 이용한 반응 평가로 구분할 경우 양군은 생존기간과 위험비에서 의미 있는 차이를 보였으나 두 반응 평가 방법 간 차이는 없었다(카플란-마이어 모형: p = 0.006; 콕스비례위험 모형: 위험비, 2.437, p = 0.008). 결론 항암 치료를 진행하는 위암 간전이 환자들에서 간전이의 부피 반응 평가는 환자들의 생존율을 예측하는 데 도움을 줄 수 있다.

• Korean Journal of Radiology
• /
• 제23권2호
• /
• pp.172-179
• /
• 2022

Objective: We aimed to evaluate the ostium of right coronary artery of anomalous origin from the left coronary sinus (AORL) with an interarterial course throughout the cardiac cycle on CT and analyze the clinical significance of the ostial findings. Materials and Methods: From January 2011 to December 2015, 68 patients (41 male, 57.3 ± 12.1 years) with AORL with an interarterial course and retrospective cardiac CT data were included. AORL was classified as high or low ostial location based on the pulmonary annulus in the diastolic and systolic phases on cardiac CT. In addition, the height, width, height/width ratio, area, and angle of the ostium were measured in both cardiac phases. After cardiac CT, patients were followed until December 31, 2020 for major adverse cardiac events (MACE). Clinical and CT characteristics associated with MACE were explored using Cox regression analysis. Results: During a median follow-up period of 2071 days (interquartile range, 1180.5-2747.3 days), 13 patients experienced MACE (19.1%, 13/68). Seven (10.3%, 7/68) had the ostial location change from high in the diastolic phase to low in the systolic phase. In the univariable analysis, younger age (hazard ratio [HR] = 0.918, p < 0.001), high ostial location (HR = 4.008, p = 0.036), larger height/width ratio (HR = 5.621, p = 0.049), and smaller ostial angle (HR = 0.846, p = 0.048) in the systolic phase were significant predictors of MACE. In multivariable cox regression analysis, younger age (adjusted HR = 0.917, p = 0.002) and high ostial location in the systolic phase (adjusted HR = 4.345, p = 0.026) were independent predictors of MACE. Conclusion: The ostial location of AORL with an interarterial course can change during the cardiac cycle, and high ostial location in the systolic phase was an independent predictor of MACE.