• Title/Summary/Keyword: Median predictor

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Mitral Annular Tissue Velocity Predicts Survival in Patients With Primary Mitral Regurgitation

  • You-Jung Choi;Chan Soon Park;Tae-Min Rhee;Hyun-Jung Lee;Hong-Mi Choi;In-Chang Hwang;Jun-Bean Park;Yeonyee E. Yoon;Jin Oh Na;Hyung-Kwan Kim;Yong-Jin Kim;Goo-Yeong Cho;Dae-Won Sohn;Seung-Pyo Lee
    • Korean Circulation Journal
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    • v.54 no.6
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    • pp.311-322
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    • 2024
  • Background and Objectives: Early diastolic mitral annular tissue (e') velocity is a commonly used marker of left ventricular (LV) diastolic function. This study aimed to investigate the prognostic implications of e' velocity in patients with mitral regurgitation (MR). Methods: This retrospective cohort study included 1,536 consecutive patients aged <65 years with moderate or severe chronic primary MR diagnosed between 2009 and 2018. The primary and secondary outcomes were all-cause and cardiovascular mortality, respectively. According to the current guidelines, the cut-off value of e' velocity was defined as 7 cm/s. Results: A total of 404 individuals were enrolled (median age, 51.0 years; 64.1% male; 47.8% severe MR). During a median 6.0-year follow-up, there were 40 all-cause mortality and 16 cardiovascular deaths. Multivariate analysis revealed a significant association between e' velocity and all-cause death (adjusted hazard ratio [aHR], 0.770; 95% confidence interval [CI], 0.634-0.935; p=0.008) and cardiovascular death (aHR, 0.690; 95% CI, 0.477-0.998; p=0.049). Abnormal e' velocity (≤7 cm/s) independently predicted all-cause death (aHR, 2.467; 95% CI, 1.170-5.200; p=0.018) and cardiovascular death (aHR, 5.021; 95% CI, 1.189-21.211; p=0.028), regardless of symptoms, LV dimension and ejection fraction. Subgroup analysis according to sex, MR severity, mitral valve replacement/repair, and symptoms, showed no significant interactions. Including e' velocity in the 10-year risk score improved reclassification for mortality (net reclassification improvement [NRI], 0.154; 95% CI, 0.308-0.910; p<0.001) and cardiovascular death (NRI, 1.018; 95% CI, 0.680-1.356; p<0.001). Conclusions: In patients aged <65 years with primary MR, e' velocity served as an independent predictor of all-cause and cardiovascular deaths.

Metastatic Bone Disease as Seen in Our Clinical Practice - Experience at a Tertiary Care Cancer Center in Pakistan

  • Qureshi, Asim;Shams, Usman;Akhter, Azra;Riaz, Sabiha
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4369-4371
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    • 2012
  • Aim: Metastatic tumor of bone is the most common malignancy involving bone and is an important predictor of prognosis in advanced cancers. The prognosis depends upon the primary site of origin and the extent of disease. In current study, we present the pattern and distribution of metastatic bone disease seen in the leading cancer care center of Pakistan, Shaukat Khanum Cancer Hospital & Research Center (SKMCH & RC), Lahore. Materials & Methods: All cases of bony metastatic disease were included that presented in the Pathology Department, from Jan 2005 to July 2011. Patients of all ages and both sexes were included. Primary bone tumors, lymphomas, sarcomas and other malignancies were excluded. The data were recorded and analyzed with SPSS 16.0. Results: A total of 146 cases of metastatic bone disease were included in the study. Out of the total cases, 79 were male and 67 were female. Age range 25-82 years (median 52). Hip bone was the most frequent bone involved, with femur and vertebrae as second and third in the list. The commonest bone involved in males was vertebrae with 23 cases and in females was hip bone with 22 cases. Regarding primary site, cancers of breast, prostate and gastrointestinal tract were at the top of the list with prostate and breast being the most frequent primary sites of metastasis in males and females respectively. Conclusion: Bone metastasis is an important entity to consider in the differential diagnosis whenever a bony tumor especially carcinoma present in older age. Our data are comparable with international findings and the literature available regarding the site and distribution of skeletal metastatic lesions. A slight deviation noted was more common bony metastatic lesions with ovarian primaries in females and gastrointestinal tract cancers in males in our study.

Circulating Tumor Cell Number Is Associated with Primary Tumor Volume in Patients with Lung Adenocarcinoma

  • Kang, Byung Ju;Ra, Seung Won;Lee, Kyusang;Lim, Soyeoun;Son, So Hee;Ahn, Jong-Joon;Kim, Byung Chul
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.1
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    • pp.61-70
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    • 2020
  • Background: Circulating tumor cells (CTCs) are frequently detected in patients with advanced-stage malignant tumors and could act as a predictor of poor prognosis. However, there is a paucity of data on the relationship between CTC number and primary tumor volume in patients with lung cancer. Therefore, our study aimed to evaluate the relationship between CTC number and primary tumor volume in patients with lung adenocarcinoma. Methods: We collected blood samples from 21 patients with treatment-naive lung adenocarcinoma and 73 healthy individuals. To count CTCs, we used a CTC enrichment method based on fluid-assisted separation technology. We compared CTC numbers between lung adenocarcinoma patients and healthy individuals using propensity score matching, and performed linear regression analysis to analyze the relationship between CTC number and primary tumor volume in lung adenocarcinoma patients. Results: CTC positivity was significantly more common in lung adenocarcinoma patients than in healthy individuals (p<0.001). The median primary tumor volume in CTC-negative and CTC-positive patients was 10.0 ㎤ and 64.8 ㎤, respectively. Multiple linear regression analysis showed that the number of CTCs correlated with primary tumor volume in lung adenocarcinoma patients (β=0.903, p=0.002). Further subgroup analysis showed a correlation between CTC number and primary tumor volume in patients with distant (p=0.024) and extra-thoracic (p=0.033) metastasis (not in patients with distant metastasis). Conclusion: Our study showed that CTC numbers may be associated with primary tumor volume in lung adenocarcinomas patients, especially in those with distant metastasis.

Expression and Prognostic Roles of TRPV5 and TRPV6 in Non-Small Cell Lung Cancer after Curative Resection

  • Fan, Hong;Shen, Ya-Xing;Yuan, Yun-Feng
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2559-2563
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    • 2014
  • Purpose: We investigated the expression of epithelial $Ca^{2+}$ channel transient receptor potential vanilloid (TRPV) 5 and 6 in non-small-cell lung cancer (NSCLC) and assessed their prognostic role in patients after surgical resection. Materials and Methods: From January 2008 to January 2009, 145 patients who had undergone surgical resection of NSCLCs were enrolled in the study. Patient clinical characteristics were retrospectively reviewed. Fresh tumor samples as well as peritumor tissues were analyzed for TRPV5/6 expression using immune-histochemistry (IHC) and quantitative reverse transcriptase-polymerase chain reaction (RT-PCR). Patients were grouped based on their TRPV5 and TRPV6 levels in the tumor tissues, followed up after surgery, and statistically analyzed to examine the prognostic roles of TRPV5 and TRPV6 on patients' survival after surgical resection of NSCLCs. Results: Using IHC, among the 145 patients who had undergone surgical resection of NSCLCs, strong protein expression (grade${\geq}2$) of TRPV5 and TRPV6 was observed in a lower percentage of primary tumor tissues than in non-tumor tissues of same patients. Similar findigns were obtained with the RT-PCR test for mRNA levels. Decreased overall mRNA levels of TRPV5 and TRPV6 were associated with a worse overall survival rate (p=0.004 and p=0.003 respectively) and shorter recurrence-free survival (p<0.001 and p<0.001 respectively). The combining effect of TRPV5 and TRPV6 on survival was further investigated using multivariate analysis. The results showed that a combination of low expression of TRPV5 and TRPV6 could be an independent predictor of poor recurrence-free survival (p=0.002). Conclusions: Decreased expression of TRPV5/6 in tumor tissues was observed in NSCLC patients and was associated with shorter median survival time after surgical resection. Combined expression of TRPV5 and TRPV6 in tumor tissues demonstrated promising prognostic value in NSCLC patients.

The Level of Squamous Cell Carcinoma Antigen and Lymph Node Metastasis in Locally Advanced Cervical Cancer

  • Lekskul, Navamol;Charakorn, Chuenkamon;Lertkhachonsuk, Arb-Aroon;Rattanasiri, Sasivimol;Ayudhya, Nathpong Israngura Na
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.11
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    • pp.4719-4722
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    • 2015
  • Background: This study aimed to determine the utility and a cut-off level of serum squamous cell carcinoma antigen (SCC-Ag) to predict lymph node metastasis in locally advanced cervical cancer cases. We also investigated the correlation between SCC-Ag level and lymph node status. Materials and Methods: From June 2009 to June 2014, 232 patients with cervical cancer stage IB2-IVA, who were treated at Ramathibodi Hospital, were recruited. Receiver operating characteristic (ROC) curves were used to identify the best cut-off point of SCC-Ag level to predict lymph node metastasis. Quantile regression was performed to evaluate the correlation between SCC-Ag levels and pelvic lymph node metastasis, paraaortic lymph node metastasis, and parametrial involvement as well as tumor size. Results: Pelvic lymph node metastasis and paraaortic lymph node metastasis were diagnosed in 46.6% and 20.1% of the patients, respectively. The median SCC-Ag level was 6 ng/mL (range, 0.5 to 464.6 ng/mL). The areas under ROC curves between SCC-Ag level and pelvic lymph node metastasis, paraaotic lymph node metastasis, parametrial involvements were low. SCC-Ag level was significantly correlated with paraaortic lymph node status (p=0.045) but not with pelvic lymph node status and parametrial involvement. SCC-Ag level was also related to the tumor diameter (p<0.05). Conclusions: SCC-Ag level is not a good predictor for pelvic and paraaortic lymph node metastasis. However, it is still beneficial to assess the tumor burden of squamous cell carcinoma of the cervix.

Hypersensitivity Reactions to Oxaliplatin: Clinical Features and Risk Factors in Koreans

  • Kim, Mi-Yeong;Kang, Sung-Yoon;Lee, Suh-Young;Yang, Min-Suk;Kim, Min-Hye;Song, Woo-Jung;Kim, Sae-Hoon;Kim, Yo-Jung;Lee, Keun-Wook;Cho, Sang-Heon;Min, Kyung-Up;Lee, Jong-Seok;Kim, Jee-Hyun;Chang, Yoon-Seok
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1209-1215
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    • 2012
  • Background and Aim: Oxaliplatin hypersensitivity is a well-known adverse reaction but the prevalence varies and data for frequency and clinical features have not been reported for Korea. Here we evaluates the prevalence and risk factors for hypersensitivity reactions to oxaliplatin after chemotherapy. Methods: Clinical information on all patients treated with oxaliplatin was retrospectively reviewed in electronic medical records between August 2009 and July 2010 in Seoul National University Bundang Hospital. Patients who experienced hypersensitivity reactions to oxaliplatin were compared with those who did not. Results: A total of 393 patients received oxaliplatin, with 42 (10.7%) experiencing hypersensitivity reactions including three cases of anaphylaxis. Median cycle of the first hypersensitivity reaction was 8. Reactions correlated with lower dexamethasone doses. Other variables were not significant. Conclusions: The prevalence of hypersensitivity reactions was 10.7%, symptoms being mostly mild and cutaneous. Lower dexamethasone doses could be a predictor for hypersensitivity reactions to oxaliplatin.

The Neutrophil to Lymphocyte Ratio has a High Negative Predictive Value for Pathologic Complete Response in Locally Advanced Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

  • Eryilmaz, Melek Karakurt;Mutlu, Hasan;Salim, Derya Kivrak;Musri, Fatma Yalcin;Tural, Deniz;Coskun, Hasan Senol
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7737-7740
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    • 2014
  • Background: The neutrophil-to-lymphocyte ratio (NLR) is a strong predictor of mortality in patients with pancreatic, colorectal, lung, gastric cancer and renal cell carcinoma. The aim of this study was to determine the relationship between pathological complete response (pCR) and pretreatment NLR values in locally advanced breast cancer (BC) patients receiving neoadjuvant chemotherapy (NACT). Materials and Methods: Datawere collected retrospectively from the Akdeniz University School of Medicine Database for locally advanced BC patients treated with NACT between January 2000-December 2013. Results: A total of 78 patients were analyzed. Sixteen (20%) patients achieved pCR. Estrogen receptor (ER) positivity was lower in pCR+ than pCR-cases (p=0.011). The median NLR values were similar in both arms. The optimum NLR cut-off point for BC patients with PCR+ was 2.33 (AUC:0.544, 95%CI [0.401-0.688], p=0.586) with sensitivity, specificity, positive predictive value and negative predictive value (NPV) of 50%, 51,6%, 21,1%, and 80%, respectively. Conclusions: This study showed no relationship between the pCR and pretreatment NLR values. Because of a considerable high NPV, in the patients with higher NLR who had luminal type BC in which pCR is lower after NACT, such treatment may not be recommended.

Survival of Cholangiocarcinoma Patients in Northeastern Thailand after Supportive Treatment

  • Thunyaharn, Nut;Promthet, Supannee;Wiangnon, Surapon;Suwanrungruang, Krittika;Kamsa-ard, Supot
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.7029-7032
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    • 2013
  • Background: Cholangiocarcinoma (CCA) is a very common cancer in Northeastern Thailand. Most CCA patients see a physician at a late stage when curative surgery is not possible. After diagnosis, they generally are treated by partial surgery/percutaneous drainage, chemotherapy and supportive treatment. Objective: This study aimed to assess the survival rates of CCA patients after supportive treatment. Methods: A retrospective cohort design was applied in this study. Data for 746 CCA patients were extracted from the hospital-based cancer registry of Srinagarind Hospital, Khon Kaen University. The patients were diagnosed (at least by ultrasonography) between 1 January, 2009 and 31 December, 2009 and then followed up for current status until 30 June, 2011. The cumulative survival rate was calculated by the Kaplan-Meier method, and independent prognostic factors were investigated using Cox regression. Results: The total follow-up time was 5,878 person-months, and the total number of deaths was 637. The mortality rate was therefore 10.8 per 100 person-year (95%CI : 10.1-11.7). The cumulative 3, 6, 9, 12 and 24 month survival rates were 59%, 39%, 31%, 24% and 14%, respectively. The median survival time after supportive treatment was 4 months. After adjusting for gender, age, stage, distant metastasis, histological grading and treatment, stage was a significant predictor of survival of CCA patients. Those in stage III and stage IV had a 6.78 fold higher mortality than the stage I and stage II cases (95% CI : 1.6-28.7). Conclusion: It is very important to encourage patients to see health personnel at an early stage.

An Efficient Partial Distortion Search Algorithm using the Spatial and Temporal Correlations for Fast Motion Estimation (고속 움직임 추정을 위한 시공간적 상관관계 기반의 효율적인 부분 왜곡 탐색 알고리즘)

  • Ha, Dong-Won;Cho, Hyo-Moon;Lee, Jong-Hwa
    • Journal of the Institute of Electronics Engineers of Korea SD
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    • v.47 no.1
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    • pp.79-85
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    • 2010
  • In video standards such as H.264/AVC, motion estimation (ME) / compensation (MC) is regarded as a vital component in a video coder as it consumes a large amount of computation resources. The full search technique, which is used in general video codecs, gives the highest visual quality but also has the problem of significant computational load. To solve this problem, many fast algorithm has benn proposed. Among them, NPDS show that can maintain its video quality very close to the full search technique while achieving computation reduction by using a halfway-stop technique in the calculation of block distortion measure. In this paper, we proposed algorithm by determining minimum distortion measure with predictive motion vector and using the new search order. As the result, we can check that the proposed algorithm reduces the computational load 95% in average compared to the full search, respectively with the PSNR lost about 0.04dB.

Seasonal Changes in Mood and Behavior and Associated Factors of Seasonality in Korean Bipolar Disorder Patients and Normal Controls (양극성 장애 환자와 정상인에서 계절성의 양상과 관련 요인 탐색)

  • Choi, Jungmi;Baek, Ji Hyun;Kim, Ji Sun;Choi, Ji Sun;Noh, Jihae;Nam, Hee Jung;Lee, Dongsoo;Hong, Kyung Sue
    • Korean Journal of Biological Psychiatry
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    • v.17 no.3
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    • pp.153-160
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    • 2010
  • Objectives : Recurrence of mood episodes associated with a specific season has been described in various mood disorders. Seasonal change in mood and behavior as a lifetime trait is also observed in healthy individuals. This study aimed at comparing the lifetime trait of seasonal variations of mood and behavior between bipolar disorder patients and controls as well as investigating associated factors of seasonality. Methods : Subjects were ninety-four clinically stable patients with bipolar disorder and 188 age- and sex-matched healthy controls. Seasonality of mood and behavior was assessed retrospectively on lifetime basis using Seasonal Pattern Assessment Questionnaire(SPAQ). Results : The patient group showed a higher median global seasonality score(GSS) of SPAQ and a higher rate of seasonal affective disorder(SAD) compared to the control group(p < 0.0001). For subjects showing prominent seasonality, the seasonal symptom profile and seasonal pattern was similar in both patient and control groups. In addition to the diagnosis, female gender was shown to be a predictor of seasonality in the multiple linear regression analysis(p = 0.045). Conclusion : This study suggests that lifetime trait of seasonality may be related to the susceptibility of bipolar disorder.