The diagnostic value of membrane glycolipid biochemistry index, the lipid-bound sialic acid (LSA) and total sialic acid (TSA) in cerebrospinal fluid (CSF) was evaluated in 30 intracranial and 65 gastrointestinal tumors. The plasma LSA, TSA and red cell membrane sialic acid (R-SA) in were determined according to the method of Sevenmerhulm. Our results showed that the levels of LSA and TSA in CSF of intracranial tumor patients was higher than that of normal group(p<0.01). The concentration of TSA and LSA in patients with malignant glioma was higher than that of benign meningioma patients(P<0.01). No significance was found between intracranial halmatoma patients and normal control group for levels of membrane glycolipids (p>0.05). Results also found that the plasma LSA, TSA and R-SA of gastric carcinoma were significantly higher than those of control group (p<0.05); while no significant difference was found in the plasma LSA, TSA and R-SA levels between chronic gastritis, gastrohelcoma and normal control group (p>0.05). Plasma LSA, TSA and R-SA levels of gastric carcinoma patient were significantly higher than those of chronic gastritis patients and gastrohelcoma patients(p<0.05). It was also found that plasma LSA, TSA and R-SA contents were significantly higher in large intestine carcinoma patients than in benign in stestine tumor patients (p<0.05) while no significant difference was found between intestine benign tumor and normal control group (p>0.05). The levels of LSA, TSA and R-SA were obviously higher in the patients with metastasis than in the ones without (p<0.05.) The membrane glycolipid biochemistry index LSA and TSA in CSF are sensive markers for diagnosing intracranial tumors. For gastrointestinal malignant tumors the plasma LSA TSA and red blood cell membrane SA may be considered as auxiliary indicators for diagnosis. They can be used for distinguishing benign from malignant tumors.
Purpose: There are no detailed reports on the incidence of venous thromboembolism (VTE) in pelvic and acetabular fractures in the Asian population. The purpose of this study was to investigate the incidence of VTE in pelvic and acetabular fractures in the Korean population. Methods: The cases of 67 Korean patients with pelvic and acetabular fractures treated at our hospital from January 2009 to February 2012 were analyzed retrospectively. Until May 2010, VTE screening was performed by contrast-enhanced computed tomography (CT) or ultrasonography (US) when the D-dimer value did not decline predictably, still exceeded $20{\mu}g/ml$ at 5 days after trauma and surgery, or increased to greater than $20{\mu}g/ml$ after a period of decline. After May 2010, contrast-enhanced CT and US were performed routinely irrespective of the D-dimer value. Physical prophylaxis was performed on all patients. The effects of the presence of a pelvic and/or acetabular fracture, and the effects of fracture type, accompanying injuries, and screening strategies on the incidences of VTE were investigated. Results: Overall, 26 patients(38.8%) were diagnosed with VTE and PTE in 14(20.9%). All were asymptomatic. Significantly higher incidences of VTE and PTE were observed in trauma patients with pelvic and acetabular fractures than in trauma patients without pelvic and acetabula fractures treated during the same period. No significant differences were observed in the incidences of VTE and PTE between patients with pelvic fractures, and patients with acetabular fractures or between patients with and without accompanying injuries. Compared with the previous screening strategy, the detection rates for VTE and PTE were higher for the newer screening strategy; however, the difference did not reach statistical significance. Conclusion: In the Korean population, we should be vigilant for a high incidence of VTE, especially PTE, in patients with pelvic and acetabular fractures.
Jeong, Oh;Jung, Mi Ran;Park, Young Kyu;Ryu, Seong Yeob
Journal of Gastric Cancer
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v.17
no.2
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pp.162-172
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2017
Purpose: Previous studies indicated conflicting results regarding the prognosis of gastric cancer with a family history (FHX). This study aimed to determine the clinicopathological features and survival of patients with gastric cancer with a FHX. Materials and Methods: We reviewed 2,736 patients with gastric cancer who underwent surgery between 2003 and 2009. The prognostic value of a FHX was determined in the multivariate model after adjusting for variables in the Asian and internationally validated prognostic models. Results: Of the patients, 413 (15.1%) had a FHX of gastric cancer. The patients with a FHX were younger (58.1 vs. 60.4 years; P<0.001) than the patients without a FHX. There were no significant differences in the histopathological characteristics between the 2 groups. A FHX was associated with a better overall survival (OS) rate only in the stage I group (5-year survival rate, 95% vs. 92%; P=0.006). However, the disease-specific survival (DSS) rate was not significantly different between the 2 groups in all stages. The multivariate model adjusted for the variables in the Asian and internationally validated prognostic models revealed that FHX has no significant prognostic value for OS and DSS. Conclusions: The clinicopathological features and survival of the patients with gastric cancer with a FHX did not significantly differ from those of the patients without a FHX.
Background: Some patients with special needs exhibit intellectual disability, including deficits in cognitive skills and decreased quality of life. The purpose of this study was to retrospectively compare changes in body composition and hemodynamics during general anesthesia in patients with and without special needs. Methods: The backgrounds of patients who underwent oral maxillofacial surgery under general anesthesia were recorded from medical records. Intracellular water (ICW), extracellular water (ECW), stroke volume variation (SVV), and heart rate (HR) were recorded for 3 h after the start of anesthesia. Categorical data were compared using an unpaired t-test, and a P-value of less than 0.05 was regarded as significant. Numerical data were compared using the Bonferroni correction, and a P-value of less than 0.0125 was regarded as significant. Results: A total of 21 patients were included in the study: 10 patients without special needs (non-S-group) and 11 patients with special needs (S-group). There were no significant differences in patients' backgrounds, except with regard to height (P = 0.03). In both groups, ICW and ECW were maintained, although they were lower in the S-group compared to the non-S-group. SVV was maintained in both groups, although it was higher in the S-group than the non-S-group. HR was significantly lower in the S-group 1 h after induction of anesthesia (P < 0.003). Conclusions: Changes in hemodynamics due to body fluid imbalance should be monitored during general anesthesia, especially for patients with special needs.
Zekri, Abdel-Rahman;Youssef, Amira Salah El-Din;Bakr, Yasser Mabrouk;Gabr, Reham Mohamed;El-Rouby, Mahmoud Nour El-Din;Hammad, Ibtisam;Ahmed, Entsar Abd El-Monaem;Marzouk, Hanan Abd El-Haleem;Nabil, Mohammed Mahmoud;Hamed, Hanan Abd El-Hafez;Aly, Yasser Hamada Ahmed;Zachariah, Khaled S.;Esmat, Gamal
Asian Pacific Journal of Cancer Prevention
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v.16
no.3
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pp.1281-1287
/
2015
Background: Early detection of hepatocellular carcinoma using serological markers with better sensitivity and specificity than alpha fetoprotein (AFP) is needed. Aims: The aim of this study was to evaluate the diagnostic value of serum sICAM-1, ${\beta}$-catenin, IL-8, proteasome and sTNFR-II in early detection of HCC. Materials and Methods: Serum levels of IL-8, sICAM-1, sTNFR-II, proteasome and ${\beta}$-catenin were measured by ELISA assay in 479 serum samples from 192 patients with HCC, 96 patients with liver cirrhosis (LC), 96 patients with chronic hepatitis C (CHC) and 95 healthy controls. Results: Serum levels of proteasome, sICAM-1, ${\beta}$-catenin and ${\alpha}FP$ were significantly elevated in HCC group compared to other groups (P-value<0.001), where serum level of IL-8 was significantly elevated in the LC and HCC groups compared to CHC and control groups (P-value <0.001), while no significant difference was noticed in patients with HCC and LC (P-value=0.09). Serum level of sTNFR-II was significantly elevated in patients with LC compared to HCC, CHC and control groups (P-value <0.001); also it was significantly higher in HCC compared to CHC and control groups (P-value <0.001). ROC curve analysis of the studied markers between HCC and other groups revealed that the serum level of proteasome had sensitivity of 75.9% and specificity of 73.4% at a cut-off value of $0.32{\mu}g/ml$ with AUC 0.803 sICAM-1 at cut off value of 778ng/ml, the sensitivity was 75.8% and the specificity was 71.8% with AUC 0.776. ${\beta}$-catenin had sensitivity and specificity of 70% and 68.6% respectively at a cut off value of 8.75ng/ml with an AUC of 0.729. sTNFR-II showed sensitivity of 86.3% and specificity of 51.8% at a cut off value of 6239.5pg/ml with an AUC of 0.722. IL-8 had sensitivity of 70.4% and specificity of 52.3% at a cut off value of 51.5pg/ml with AUC 0.631. Conclusions: Our data supported the role of proteasome, sICAM-1, sTNFR-II and ${\beta}$-catenin in early detection of HCC. Also, using this panel of serological markers in combination with ${\alpha}FP$ may offer improved diagnostic performance over ${\alpha}FP$ alone in the early detection of HCC.
Mandibular movement is composed of border movement and functional movement. Border movement such as maximal mouth opening, hinge opening ad lateral eccentric movement has good reproducibility, but functional movement such as chewing, swallowing and speech has also reproducibility. Especially for chewing movement, individual reproducibility has been confirmed by many studies. Study of chewing pattern is still in controversy. In new approach for raising the diagnostic value, numeric parameters and morphologic characteristics could be used for evaluation of chewing pattern. This study was performed to investigate the differences between chewing pattern in controls and in patients with temporomandibular disorders. Sixty-three patients with temporomandibular disorders participated in this study, and they were divided into unilaterally affected subjects or bilaterally affected subjects. Then unilaterally affected subjects were classified into closed lock group, disk displacement with reduction group, and degenerative joint disease group. For recording of chewing pattern, subjects were asked to chew one piece of presoftened chewing gum on both sides, and the chewing movement was recorded with the Electrognatho- Graphy(Bio-Research Associates Inc., U.S.A.). Tooth contact pattern for occlusal stability (Total left-right statistics )was also recorded with T-Scan(Tekscan Co., U.S.A.). The dta related to chewing pattern and total left-right statistics were statistically analyzed by SAS/stat program. The obtained results were as follows : 1. In patient group, mean value of A-P distance and the ratio of A-P distance to vertical distance were larger than control group, but the value of lateral distance in affected side and the closing velocity in unaffected side were smaller than that of control group, respectively. 2. In case of unilateral affected patients, chewing pattern of other side had tendency to restricted movement and slow velocity in closed lock group or degenerative joint disease group than control group or disk displacement with reduction group. 3. In bilateral degenerative joint disease patients, contralateral side had tendency to large range of motion and slow chewing velocity than preferred chewing side. 4. The patients with restricted mouth opening below than 35mm had higher value of total left-right statistics than patient group mouth opening above 35mm. Also closed lock group had higher total left-right statistics than disk displacement with reduction group, degenerative joint disease group and control group. 5. There was some difference in morphologic characteristics of chewing pattern between in control group and in affected side of unilateral patient group, but no difference between control group and unaffected side of unilateral patient group. 6. There were positive correlations between vertical distance and A-P distance, between vertical distance and chewing velocity, between A-P distance and chewing velocity, and between opening velocity and closing velocity in unilateral affected patients.
Background: The early detection of anthracycline- induced cardiotoxicity is very important since it might be useful in prevention of cardiac decompensation. This study was designed with the intent of assessing the usefulness of cardiac troponin T (cTnT) and NT- Pro BNP estimation in early prediction of anthracycline induced cardiotoxicity. Materials and Methods: In this prospective study histologically proven breast cancer patients who were scheduled to receive anthracycline containing combination chemotherapy as a part of multimodality treatment were enrolled. Baseline cardiac evaluation was performed by echocardiography (ECHO) and biomarkers like cardiac troponin T (cTnT) and N terminal- pro brain natriuretic peptide (NT- Pro BNP). All patients underwent cTnT and NT- Pro BNP estimation within 24 hours of each cycle of chemotherapy and were followed up after 6 months of initiation of chemotherapy. Any changes in follow up ECHO were compared to ECHO at baseline and cTnT and NT- Pro BNP levels after each cycle of anthracycline-based chemotherapy. Results: Initial data were obtained for 33 patients. Mean change in left ventricular diastolic diameter (LVDD) within 6 months was $0.154{\pm}0.433cms$ (p value=0.049). Seven out of 33 patients had an increase in biomarker cTnT levels (p value=0.5). A significant change in baseline and follow up LVDD was observed in patients with raised cTnT levels (p value=0.026) whereas no change was seen in ejection fraction (EF) and left atrial diameters (LAD) within 6 months of chemotherapy. NT- Pro BNP levels increased in significant number of patients (p value ${\leq}0.0001$) but no statistically significant change was observed in the ECHO parameters within 6 months. Conclusions: Functional monitoring is a poorly effective method in early estimation of anthracycline induced cardiac dysfunction. Estimation of biomarkers after chemotherapy may allow stratification of patients in various risk groups, thereby opening window for interventional strategies in order to prevent permanent damage to the myocardium.
Purpose: The aim of this study was to evaluate the prognostic value of the peripheral blood lymphocyte count before surgery in those patients with gastric cancer. Materials and Methods: The study group was comprised of a series of 1,054 patients who underwent curative gastrectomy. The appropriate lymphocyte count cutoff value was determined. The prognostic factors were evaluated by univariate and multivariate analyses. Results: The lymphocyte count cutoff value was 1,500/ul. The patients were classified into two groups: Group A had a lymphocyte count $\geq$ 1,500/ul (n=765) and Group B had a lymphocyte count <1,500/ul (n=289). There were statistically significant differences between the groups according to their age (P<0.001), the tumor stage (P=0.038) and the tumor size (P<0.001). The 5- and 10-year survival rates of Group A were 80.1% and 76.6%, respectively and those of Group B were 72.4% and 63.5%, respectively (P=0.002). When multivariate analysis was performed by the Cox proportional hazards model, the lymphocyte count was not an independent prognostic factor. Conclusion: Although the prognosis of patients with a high lymphocyte count was better than that of the patients with a low lymphocyte count, our results did not support using the preoperative peripheral blood lymphocyte count as an independent prognostic factor for patients with gastric cancer.
Objectives Amyloid β positron emission tomography (Aβ PET) is widely used as a diagnostic tool in patients who have symptoms of cognitive impairment, however, this diagnostic examination is too expensive. Thus, predicting the positivity of Aβ PET before patients undergo the examination is essential. We aimed to analyze clinical predictors of patients who underwent Aβ PET retrospectively, and to develop a predicting model of Aβ PET positivity. Methods 468 patients who underwent Aβ PET with cognitive impairment were recruited and their clinical indicators were analyzed retrospectively. We specified the primary outcome as Aβ PET positivity, and included variables such as age, sex, body mass index, diastolic blood pressure, systolic blood pressure, education, dementia family history, Mini Mental Status Examination (MMSE), Clinical Dementia Rating (CDR), Clinical Dementia Rating-Sum of Box (CDR-SB), hypertension (HTN), diabetes mellitus (DM) and presence of apolipoprotein E (ApoE) E4 as potential predictors. We developed three final models of amyloid positivity prediction for total subjects, mild cognitive impairment (MCI) and Alzheimer's disease (AD) dementia using a multivariate stepwise logistic regression analysis. Receiver operating characteristic (ROC) curve analysis was performed and the area under curve (AUC) value was calculated for the ROC curve. Results Aβ PET negative patients were 49.6% (n = 232), and Aβ PET positive patients were 50.4% (n = 236). In the final model of all subjects, older age, female sex, presence of ApoE E4 and lower MMSE are associated with Aβ PET positivity. The AUC value was 0.296. In the final model of MCI subjects (n = 244), older age and presence of ApoE E4 are associated with Aβ PET positivity. The AUC value was 0.725. In the final model of AD subjects (n = 173), lower MMSE scores, the presence of ApoE E4 and history of HTN are associated with Aβ PET positivity. The AUC value was 0.681. Conclusions The cerebral amyloid positivity model, which was based on commonly available clinical indicators, can be useful for prediction of amyloid PET positivity in MCI or AD patients.
Sung Hyun Yoon;Eunhee Kim;Yongho Jeon;Sang Yoon Yi;Hee-Joon Bae;Ik-Kyung Jang;Joo Myung Lee;Seung Min Yoo;Charles S. White;Eun Ju Chun
Korean Journal of Radiology
/
v.21
no.9
/
pp.1055-1064
/
2020
Objective: To assess the incremental prognostic value of coronary computed tomography angiography (CCTA) in comparison to a clinical risk model (Framingham risk score, FRS) and coronary artery calcium score (CACS) for future cardiac events in ischemic stroke patients without chest pain. Materials and Methods: This retrospective study included 1418 patients with acute stroke who had no previous cardiac disease and underwent CCTA, including CACS. Stenosis degree and plaque types (high-risk, non-calcified, mixed, or calcified plaques) were assessed as CCTA variables. High-risk plaque was defined when at least two of the following characteristics were observed: low-density plaque, positive remodeling, spotty calcification, or napkin-ring sign. We compared the incremental prognostic value of CCTA for major adverse cardiovascular events (MACE) over CACS and FRS. Results: The prevalence of any plaque and obstructive coronary artery disease (CAD) (stenosis ≥ 50%) were 70.7% and 30.2%, respectively. During the median follow-up period of 48 months, 108 patients (7.6%) experienced MACE. Increasing FRS, CACS, and stenosis degree were positively associated with MACE (all p < 0.05). Patients with high-risk plaque type showed the highest incidence of MACE, followed by non-calcified, mixed, and calcified plaque, respectively (log-rank p < 0.001). Among the prediction models for MACE, adding stenosis degree to FRS showed better discrimination and risk reclassification compared to FRS or the FRS + CACS model (all p < 0.05). Furthermore, incorporating plaque type in the prediction model significantly improved reclassification (integrated discrimination improvement, 0.08; p = 0.023) and showed the highest discrimination index (C-statistics, 0.85). However, the addition of CACS on CCTA with FRS did not add to the prediction ability for MACE (p > 0.05). Conclusion: Assessment of stenosis degree and plaque type using CCTA provided additional prognostic value over CACS and FRS to risk stratify stroke patients without prior history of CAD better.
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