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Ki-67/MIB-1 as a Prognostic Marker in Cervical Cancer - a Systematic Review with Meta-Analysis

  • Piri, Reza;Ghaffari, Alireza;Gholami, Nasrin;Azami-Aghdash, Saber;PourAli-Akbar, Yasmin;Saleh, Parviz;Naghavi-Behzad, Mohammad
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.6997-7002
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    • 2015
  • Background: In cervical cancer patients it has been reported that there in a significant Ki-67/MIB-1 expression is correlated with survival in cervical cancer patients. However, the prognostic value is still not well understood. Materials and Methods: In the present meta-analysis the prognostic value of Ki-67/MIB-1 with regard to overall survival (OS) and disease-free survival (DFS) in cervical cancer was investigated. The databases of PubMed, ISI Web of Science, Cochrane Central Register of Controlled Trials, EMBASE, Science Direct and Wiley Online Library were used to identify appropriate literature. Results: In order to explore the relationship between Ki-67/MIB-1 and cervical cancer, we have included 13 studies covering 894 patients in the current meta-analysis. The effect of Ki-67/MIB-1 on OS for pooled random effects HR estimate was 1.63 (95%confidence interval (CI) 1.09-2.45; P<0.05). The pooled HR for DFS was 1.26 (95%CI 0.58-2.73; P>0.05) and the subgroup analysis indicated Ki-67/MIB1 was associated with DFS (HR=3.67, 95%CI 2.65-5.09) in Asians. Conclusions: According to this meta-analysis, Ki-67/MIB-1 has prognostic value for OS in patients suffering from cervical cancer. For better evaluation of the prognostic role of Ki-67/MIB-1 on DFS, studies with larger numbers of patients are needed to validate present findings in the future.

Predictive V16alue of Thymidylate Synthase Expression in Gastric Cancer: A Systematic Review with Meta-analysis

  • Hu, Hua-Bin;Kuang, Lei;Zeng, Xiao-Min;Li, Bin;Liu, En-Yi;Zhong, Mei-Zuo
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.261-267
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    • 2012
  • Purpose: The relationship between thymidylate synthase (TS) expression and outcomes in gastric cancer (GC) patients remains controversial, although most studies reported poor survival and reduced response to fluoropyrimidine were related to high TS in tumors. We carried out a systematic review of the literature with meta-analysis to estimate the predictive value of TS expression from published studies. Methods: We indentified 24 studies analysing the outcome data in gastric cancer stratified by TS expression. Effect measures of outcome were hazard ratios (HRs) for overall survival (OS) and event-free survival (EFS), or the odds ratio (OR) for overall response rate (ORR). HRs and ORs from these eligible studies were pooled using random-effects meta-analysis. Results: Fifteen studies investigated outcomes in a total of 844 patients with advanced GC, and nine studies investigated outcomes in a total of 1,235 patients with localized GC undergoing adjuvant therapy. Meta-analysis of estimates showed high TS expression was significantly associated with poor OS in the advanced setting (HR: 1.43, 95%CI: 1.08 - 1.90), and poor EFS in the adjuvant setting (HR: 1.53, 95%CI: 1.01 - 2.32). Subgroup analysis demonstrated TS expression to haves even greater value in predicting OS, EFS and ORR in advanced GC patients treated with fluoropyrimidine monotherapy (HR for OS: 2.32, 95%CI: 1.53 - 3.50; HR for EFS: 1.76, 95%CI: 1.19 - 2.60; OR for ORR: 0.32, 95%CI: 0.11 - 0.95). Conclusion: High levels of TS expression were asssociated with a poorer OS for advanced GC patients compared with low levels. In the adjuvant setting, high TS expression was also associated with a worse EFS. Additional studies with consistent methodology are needed to define the precise predictive value of TS.

The Indepth Analysis of Plate Waste for DM Diet Served in General Hospital (종합병원 환자 당뇨식의 찬반에 대한 심층적 분석)

  • 양일선;이해영;김정려;차지아
    • Journal of Nutrition and Health
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    • v.35 no.3
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    • pp.394-401
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    • 2002
  • The purpose of this study was to : (a) examine diabetic patients' sensory evaluation and food preferences, (b) analyze the portion sizes & plate wastes, (c) investigate the factors affecting plate wastes, and (d) determine the nutritional & mometary values of the plate wastes. A questionnaire for determining food preference and sensory evaluation was developed. Thirty-three diabetic patients who were hospitalized in Sanggye Paik hospital in Seoul were studied. Serving sizes and plate wastes were weighed by using an electric scale, and the CAN-Pro program was used to evaluate the nutritional value or the food consumed. The data were analyzed using the SAS package program for descriptive analysis, t-test, ANOVA, and the Pearson correlation. Using a five-point Likeu-type scale, the temperature s[ore ranged from 3.1 to 3.3 (1 : very poor, 5 : excellent), the preference store was 3.0-3.2 (1 : very dislike, 5:very like), the taste score was 2.9-3.2 (1 : very poor, 5 : excellent), and the amount of food served score was 2.8-3.0 (1 : too little, 5 : too much). Serving sizes were considered insufficient by patients because most of the DM diet was low in calories. Average plate waste for the DM diet was 26.2% of the total served, by weight, and was lower than that for patients consuming a normal diet, which was 30.3%, found in previous research. Those subjects who had been previously hospitalized and who wished to participate in a campaign for food waste reduction produced less plate waste than other groups (p<.05). Plate wastes of the DM diet were negatively correlated with taste, temperature, and preference, and were positively correlated with the amount served: however, these results were not statistically significant. It was found that diabetic patients consumed adequate levels of energy, protein, Ca, Fe, Vitamin B$_1$, Vitamin B$_2$, and niacin, but inadequate levels of Phosphorus, Vitamin A and Vitamin C. The plate wastes were calculated to be 26.2% of the total cost (₩ 3,489), which is ₩9l5. This represents a significant wastage of resources from the hospital. The results of this study could assist foodservice managers in both controlling food wastage, and improving the quality of hospital food services.

Bacterial profile of suction drains and the relationship thereof to surgical-site infections in prosthetic breast reconstruction

  • Yoon, Jeongmin;Chung, Jae-Ho;Hwang, Na-Hyun;Lee, Byung-Il;Park, Seung-Ha;Yoon, Eul-Sik
    • Archives of Plastic Surgery
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    • v.45 no.6
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    • pp.542-549
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    • 2018
  • Background Despite the increasing popularity of prosthetic breast reconstruction, scant data exist on the microbiological profile of drainage fluid from closed-suction drains and the relationship thereof to surgical-site infections (SSIs) in breast reconstruction surgery. This study aimed to determine whether bacteria isolated from drainage fluid were associated with the development of SSIs, and whether the bacterial profile of drainage fluid could be a clinically useful predictor of SSIs. Methods We performed a retrospective chart review of 61 women who underwent tissue expander/implant or direct-to-implant reconstructions. Patient demographics and culture studies of drainage fluid from suction drains collected on postoperative day 7 were evaluated. Results Sixteen patients (26.23%) were culture-positive, and 45 patients (73.77%) were culture-negative. The most frequently isolated bacteria were coagulase-negative staphylococci, followed by Staphylococcus aureus. SSIs were diagnosed in seven patients and were mostly resolved by systemic antibiotics; however, the tissue expander or implant was explanted in two patients. Positive culture of drainage fluid from closed-suction drains was significantly associated with the development of SSIs (P<0.05). The positive predictive value was 37.50%, and the negative predictive value was 97.78%. Conclusions To our knowledge, this study is the first to demonstrate a significant association between the microbiological profile of drainage fluid from closed-suction drains and the development of SSIs in patients with prosthetic breast reconstructions. The high negative predictive value suggests that microbial testing of drainage fluid from closed-suction drains may have clinical utility. Further prospective studies with larger sample sizes are required to confirm our findings.

Preoperative Weakness and Demyelination of the Corticospinal Tract in Meningioma Patients : Changes in Diffusion Parameters Using Diffusion Tensor Imaging

  • Kim, Myoung Soo;Chung, Chun Kee;Jung, Hee-Won;Park, Chul-Kee;Kim, Chi Heon;Kim, June Sic
    • Journal of Korean Neurosurgical Society
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    • v.55 no.5
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    • pp.267-272
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    • 2014
  • Objective : Differentiation of demyelination in white matter from axonal damage can be determined using diffusion tensor imaging (DTI). In this study using meningioma patients an attempt was made to evaluate the relationship between preoperative weakness and the changes of diffusion parameters in the corticospinal tract (CST) using DTI. Methods : Twenty-six patients with meningioma were enrolled in this study. Eleven of them suffered from objective motor weakness and were classified as Group 1. The remaining 15 patients did not present motor weakness and were classified as Group 2. Fiber tractography and CST diffusion parameters were obtained using DTIStudio. The ratios (lesion side mean value/contralateral side mean value) of CST diffusion parameters were compared with 1.0 as a test value using a one-sample t-test. Results : In Group 1, fractional anisotropy (FA), tensor trace (TT), and radial diffusivity (RD, ${\lambda}2$ and ${\lambda}3$) of the CST were significantly different between two hemispheres, but axial diffusivity (AD, ${\lambda}1$) of the CST was not significantly different between two hemispheres. In Group 2, FA and ${\lambda}3$ of CST did not differ significantly between the hemispheres. In Group 2, TT, ${\lambda}1$, and ${\lambda}2$ of CST in the ipsilateral hemisphere were significantly higher than those of the unaffected hemisphere. However, the differences were small. Conclusion : Motor weakness was related to a low FA and high TT resulting from increased RD of the CST fibers. CST diffusion changes in patients with weakness are similar to those for demyelination.

Pretreatment Neutrophil/Lymphocyte Ratio as a Prognostic Aid in Colorectal Cancer

  • Ozdemir, Yavuz;Akin, Mehmet Levhi;Sucullu, Ilker;Balta, Ahmet Ziya;Yucel, Ergun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2647-2650
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    • 2014
  • Background: Colorectal cancers(CRC) are the third most common cancer in the western world, with surgery preferred for management of non-metastatic disease and post surgical treatment usually arranged according to the TNM staging system. However, there is still prognostic variation between patients who have the same stage. It is increasingly recognized that variations within disease course and clinical outcome in colorectal cancer patients are influenced by not only oncological characteristics of the tumor itself but also host response factors. Recent studies have shown correlation between the inflammatory response and clinical outcomes in various cancers. The neutrophil/lymphocyte ratio (NLR) has been described as a marker for immune response to various stimuli including cancer. Material-Methods: Two hundred eighty-one CRC patients were included in our retrospective analysis, separated into two groups according to a cut-off value for the NLR. Patient data including age, gender, vertical penetration, anatomic location, and differentiation of the tumor, TNM stage, survival rate, and disease-free survival were analyzed for correlations with the NLR. Results: Using ROC curve analysis, we determined a cut-off value of 2.2 for NLR to be best to discriminate between patient survival in the whole group. In univariate analysis, high pretreatment NLR (p=0.001, 95%CI 1.483-4.846), pathologic nodal stage (p<0.001, 95%CI 1.082-3.289) and advanced pathologic TNM stage (p<0.001, 95%CI 1.462-4.213) were predictive of shorter survival. In multivariate analysis, advanced pathologic TNM stage (p=0.001, 95%CI 1.303-26.542) and high pretreatment NLR (p=0.005, 95%CI 1.713-6.378) remained independently associated with poor survival. Conclusions: High pre-treatment NLR is a significant independent predictor of shorter survival in patients with colorectal cancer. This parameter is a simple, easily accessible laboratory value for identifying patients with poorer prognosis.

A Study on the Relation between Occlusal Wear Area and Occlusal Contact Patterns (교모면적과 교합접촉양태 간의 관계에 대한 연구)

  • Se-Sook Kang;Kyung-Soo Han
    • Journal of Oral Medicine and Pain
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    • v.19 no.2
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    • pp.153-168
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    • 1994
  • The aim of the present study was to investigate a relation between occlusal wear area and occlusal contact patterns. For the purpose, occlusal wear area were measured in 58 dental students and in 129 patients with temporomandibular disorders(TMDs) from dental casts. Teeth used in this study were from canine to second molar on both sides in upper arch, totally ten. Occlusal wear area on casts was marked by pencil and photocopies, and then, the area was measured with planimeter. Occlusal relation was clinically examined with regard to Angle's classification, chewing side preference, lateral guidance pattern and bruxing and/or clenching habit. T-Scan, electronic occlusal contact analyzer, was used to record occlusal contact number, contact force, contact time and occlusal balance that is TLR(total left-right statistics) during tooth contact. All measurement were repeated 3 times and the average value was used for data processing. The obtained results were as follows : 1. Mean value of occlusal wear area did not differ significantly between dental students and patients. 2. There ws not significant difference in wear area between chewing side and non-chewing side in both groups. 3. Occlusal wear area was significantly increased with age in both groups. 4. Three subgroups divided by Angle's classification did not show any difference in occlusal wear area among them, but three subgroups divided by lateral guidance pattern showed slightly significant difference between canine guide subgroup and group function subgroup in patients. Occlusal wear ares\a in group function subgroup wear larger than canine guide subgroup. 5. Mean value of wear area in patients with bruxing and/or clenching habit did not differ from those in patients without such habit. 6. Correlationship among items related to occlusal contact pattern were highly consistent and significant in dental students and only one item significantly correlated with occlusal wear area was tooth contact time.

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Continuous Renal Replacement Therapy: A Survey of Practice in a Critical Care Unit (일 종합병원에서의 지속적 신대체요법 적용에 관한 실태)

  • Seo, Min-Jeong;Choi, Ang-Ja;Suh, Ji-Young;Cho, Yong-Ae;Sung, Young-Hee
    • Journal of Korean Critical Care Nursing
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    • v.2 no.1
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    • pp.58-68
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    • 2009
  • Purpose: The treatment effects and operation status of continuous renal replacement therapy (CRRT) for acute renal failure patients have been investigated. Method: Two expert nurses reviewed the records of 731 patients undergoing CRRT in an intensive care unit of a general hospital from Jan. 2002 to Dec. 2006 with the CRRT assessment sheet and situation sheet developed for this study. Results: The number of patients received CRRT increased from 90 in 2002 to 194 in 2006. The most common indication for CRRT was azotemia (40.0%). Before CRRT treatment, patients were 78.6 ($\pm55.5$) of BUN value and 5.0 ($\pm3.2$) of Cr. value. The standard values of BUN and Cr. were lowered. Compared the survival group with the death group, there were significant differences among the medical departments and the main diagnosis group. Their BUN and creatinine value, APACHE II score, mean blood pressure, and oliguria were significantly different (p<0.05). Conclusion: This survey demonstrates a trend that patients receiving CRRT has been increased. We suggest further studies are needed in some hospitals in order to generalize the results and to find how CRRT treatment affects patient’s survival and death rate.

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The Effects of Acupuncture Stimulation on Skin Conductance Response of Anxiety Patients and Normal Subjects (침자극이 불안 환자와 정상 성인의 피부전도도에 미치는 영향)

  • Jeong, Myeong-Suk;Choi, Woo-Jin;Lee, Kyung-Won;Lee, Seung-Gi;Kim, Ji-Eun;Lee, Jeong-Chan;Park, Kyung-Mo
    • Journal of Oriental Neuropsychiatry
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    • v.20 no.2
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    • pp.101-110
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    • 2009
  • Objectives : The purpose of this study was to investigate the effects of acupuncture on autonomic nervous system in anxiety patients and normal subjects by using SCR(Skin Conductance Response). Methods : The study group consists of 15 anxiety patients as the experimental group stimulated by verum acupuncture, 15 anxiety patients as the control group stimulated by sharm acupuncture, and 15 normal subjects stimulated by verum acupuncture. We measured GSR of experimental and control group, normal subjects during Working Memory Test and acupuncture stimulation. Results : 1. Measured value of SCR during Working Memory Test was significant different in control group, but it was not significant different in experimental group. 2. SCR value of three groups was significantly decreased during acupuncture stimulated. There was only significantly SCR value change during 0min.-5min, of first acupuncture. The section of the other groups was no significantly different. 3. STAI scores of experimental group and control group were significantly decreased. Conclusions : The study results suggest that acupuncture stimulation and sham acupuncture also effective on activity in the sympathetic nervous system and STAI scores.

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Prognostic value of FDG PET/CT during radiotherapy in head and neck cancer patients

  • Kim, Suzy;Oh, Sowon;Kim, Jin Soo;Kim, Yu Kyeong;Kim, Kwang Hyun;Oh, Do Hoon;Lee, Dong-Han;Jeong, Woo-Jin;Jung, Young Ho
    • Radiation Oncology Journal
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    • v.36 no.2
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    • pp.95-102
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    • 2018
  • Purpose: To evaluate the prognostic value of $^{18}F$-fluorodeoxyglucose positron-emission tomography (FDG PET) with computed tomography (CT) before and during radiotherapy (RT) in patients with head and neck cancer. Methods: Twenty patients with primary head and neck squamous cell carcinoma were enrolled in this study, of whom 6 had oropharyngeal cancer, 10 had hypopharyngeal cancer, and 4 had laryngeal cancer. Fifteen patients received concurrent cisplatin and 2 received concurrent cetuximab chemotherapy. FDG PET/CT was performed before RT and in the 4th week of RT. The parameters of maximum standardized uptake value, metabolic tumor volume, and total lesion glycolysis (TLG) of the primary tumor were measured, and the prognostic significance of each was analyzed with the Cox proportional hazards model. Results: Higher TLG (>19.0) on FDG PET/CT during RT was a poor prognostic factor for overall survival (OS) (p = 0.001) and progression-free survival (PFS) (p = 0.007). In the multivariate analysis, TLG during RT as a continuous variable was significantly associated with OS and PFS rate (p = 0.023 and p = 0.016, respectively). Tumor response worse than partial remission at 1 month after RT was another independent prognostic factor for PFS (p = 0.024). Conclusions: Higher TLG of the primary tumor on FDG PET/CT during RT was a poor prognostic factor for OS and PFS in patients with head and neck cancer.