• Title/Summary/Keyword: Poor prognosis

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Complement Receptor 1 Expression in Peripheral Blood Mononuclear Cells and the Association with Clinicopathological Features And Prognosis of Nasopharyngeal Carcinoma

  • He, Jian-Rong;Xi, Jing;Ren, Ze-Fang;Qin, Han;Zhang, Ying;Zeng, Yi-Xin;Mo, Hao-Yuan;Jia, Wei-Hua
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.6527-6531
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    • 2012
  • Purpose: Complement receptor 1 (CR1) is induced by Epstein-Barr virus (EBV) and may be a potential biomarker of nasopharyngeal carcinoma (NPC). We conducted the present study to evaluate the association of CR1 expression with clinicopathological features and prognosis of NPC. Methods: We enrolled 145 NPC patients and 110 controls. Expression levels of CR1 in peripheral blood mononuclear cells (PBMCs) were detected using quantitative real-time PCR and associations with clinicopathological features and prognosis were examined. Results: CR1 levels in the NPC group [3.54 (3.34, 3.79)] were slightly higher than those in the controls [3.33 (3.20, 3.47)] (P<0.001). Increased CR1 expression was associated with histology classification (type III vs. type II, P=0.002), advanced clinical stage (P=0.003), high T stage (P=0.017), and poor overall survival (HR, 4.89; 95% CI, 1.23-19.42; P=0.024). However, there were no statistically significant differences in CR1 expression among N or M stages. Conclusion: These findings indicate that CR1 expression in PBMCs may be a new biomarker for prognosis of NPC and a potential therapeutic target.

Role of Diffusion-Weighted Imaging as a Prognostic Indicator in Acute Hypoxic Encephalopathy (급성 저산소뇌병증의 예후 예측인자로서 확산강조영상의 역할)

  • Kim, Jin-Soo;Noh, Won-Young;Lim, Jae-Sung;Kim, Seon-Jeong;Yun, Chang-Ho;Park, Seong-Ho
    • Annals of Clinical Neurophysiology
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    • v.15 no.2
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    • pp.42-47
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    • 2013
  • Background: Diffusion-weighted image (DWI) might be useful to predict the prognosis of acute hypoxic encephalopathy. The aim of our study was to test whether the early change and extent of DWI abnormalities can be an indicator of the clinical outcome of hypoxic encephalopathy. Methods: Forty-four patients who were diagnosed as hypoxic encephalopathy due to the cardiorespiratory arrest were retrospectively identified. Clinical variables were determined, and the DWI abnormalities were counted by four areas: cortex, subcortical white matter, cerebellum and deep grey matter, and were divided into three groups by the extent of lesions. Prognosis was classified as 'poor' (Glasgow coma scale (GSC) at 30 days after arrest <9 or death) and 'good' (GSC at 30 days after arrest ${\geq}9$). Results: GCS at day 3 (p<0.001), presence of seizure (p=0.01), and presence of lesion (p<0.001) were significantly different in prognosis, but statistically there is no association with the extent of lesions and prognosis (p=0.26). Conclusions: Presence of early DWI changes could predict the clinical outcome of hypoxic encephalopathy after cardiorespiratory arrest.

Prognostic factors for outcome of surgical treatment in medication-related osteonecrosis of the jaw

  • Shin, Woo Jin;Kim, Chul-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.44 no.4
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    • pp.174-181
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    • 2018
  • Objectives: The number of patients with medication-related osteonecrosis of the jaw (MRONJ) is increasing, but treatment remains controversial. Published papers and systematic reviews have suggested that surgical treatment is effective in patients with MRONJ. The purpose of this study was to determine whether preoperative University of Connecticut Osteonecrosis Numerical Scale (UCONNS), other serologic biomarkers, and size of necrosis are prognostic factors for outcome of surgical treatment in MRONJ. Materials and Methods: From January 2008 to December 2016, 65 patients diagnosed with MRONJ at the Department of Oral and Maxillofacial Surgery in College of Dentistry, Dankook University who required hospitalization and surgical treatment were investigated. Patient information, systemic factors, and UCONNS were investigated. In addition, several serologic values were examined through blood tests one week before surgery. The size of osteolysis was measured by panoramic view and cone-beam computed tomography in all patients. With this information, multivariate logistic regression analysis with backward elimination was used to examine factors affecting postoperative outcome. Results: In multivariate logistic analysis, higher UCONNS, higher C-reactive protein (CRP), larger size of osteolysis, and lower serum alkaline phosphate were associated with higher incidence of incomplete recovery after operation. This shows that UCONNS, CRP, serum alkaline phosphate, and size of osteolysis were statistically significant as factors for predicting postoperative prognosis. Conclusion: This study demonstrated that CRP, UCONNS, serum alkaline phosphate, and size of osteolysis were statistically significant factors in predicting the prognosis of surgical outcome of MRONJ. Among these factors, UCONNS can predict the prognosis of MRONJ surgery as a scale that includes various influencing factors, and UCONNS should be used first as a predictor. More aggressive surgical treatment and more definite surgical margins are needed when the prognosis is poor.

Prognosis after treatment with multiple dental implants under general anesthesia and sedation in a cerebral palsy patient with mental retardation: A case report

  • Hong, Young-Joon;Dan, Jung-Bae;Kim, Myung-Jin;Kim, Hyun Jeong;Seo, Kwang-Suk
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.2
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    • pp.149-155
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    • 2017
  • Cerebral palsy is a non-progressive disorder resulting from central nervous system damage caused by multiple factors. Almost all cerebral palsy patients have a movement disorder that makes dental treatment difficult. Oral hygiene management is difficult and the risks for periodontitis, dental caries and loss of multiple teeth are high. Placement of dental implants for multiple missing teeth in cerebral palsy patients needs multiple rounds of general anesthesia, and the prognosis is poor despite the expense. Therefore, making the decision to perform multiple dental implant treatments on cerebral palsy patients is difficult. A 33-year-old female patient with cerebral palsy and mental retardation was scheduled for multiple implant treatments. She underwent computed tomography (CT) under sedation and the operation of nine dental implants under general anesthesia. Implant-supported fixed prosthesis treatment was completed. During follow-up, she had the anterior incisors extracted and underwent the surgery of 3 additional dental implants, completing the prosthetic treatment. Although oral parafunctions existed due to cerebral palsy, no implant failure was observed 9 years after the first implant surgery.

Subsyndromal Bipolar Disorder (아증후군적 양극성 장애)

  • Kim, Moon-Doo;Jeon, Bong-Hee;Yoon, Bo-Hyun;Bhak, Won-Myong
    • Korean Journal of Biological Psychiatry
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    • v.18 no.4
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    • pp.217-224
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    • 2011
  • Subsyndromal bipolar symptoms are common during maintenance treatment and appear to be associated with relapse into an episode of the same polarity. This implies subsyndromal symptoms are an important problem in recurrent bipolar disorder and require more additive and infallible therapeutic intervention. Undetected, untreated subsyndromal states lead patients to have poor prognosis and quality of life. The combination of a long undetected illness and significant psychosocial impairment renders early identification and intervention vital for the treatment of bipolar disorders. Methods for early identification includes finding prodromes, using screening tools such as the HCL-32 (Hypomania Checklist-32) and the BSDS (bipolar spectrum diagnostic scale). Various augmentation treatment methods would be needed to reduce subsyndromal symptoms, especially, psychosocial treatment has the potential to help patients address the multiple psychosocial problems associated with this chronic illness. To overcome difficulties of diagnosing subsyndromal disorder and to treat it appropriately, a staging system was suggested by some researchers. It assumes that earlier stages have better prognosis and require simpler therapeutic regimens. Staging may assist in treatment planning and prognosis of bipolar disorder, and emphasize the importance of early intervention. Further research is required in this exciting and novel area.

Extensive and aggressive growth of adenoid cystic carcinoma in the lacrimal gland

  • Park, Jonghyun;Kim, Han Koo;Kim, Woo Seob;Bae, Tae Hui
    • Archives of Craniofacial Surgery
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    • v.21 no.2
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    • pp.114-118
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    • 2020
  • Adenoid cystic carcinoma (ACC) in the lacrimal gland is a very rare disease with poor overall prognosis. Its primary treatment is surgical excision, including orbital exenteration and radical orbitectomy, which is combined with radiotherapy and chemotherapy. Age, histopathologic type, bone invasion, and tumor extent are known factors that affect the prognosis of ACC. Furthermore, perineural invasion is highly associated with local tumor recurrence and tumor base invasion. Here, we report a rare case of ACC in the lacrimal gland with superior sagittal sinus invasion that repeatedly recurred after the surgical excision.

Pulmonary Carcinosarcoma within Bronchogenic Cyst (Pulmonary Carcinosarcoma within Bronchogenic Cyst: 1례 보고)

  • 권오춘
    • Journal of Chest Surgery
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    • v.18 no.2
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    • pp.341-344
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    • 1985
  • Carcinosarcoma is an unusual and rarest neoplasm in man, consisting of carcinomatous parenchyme and sarcomatous stroma. Two clinical types of carcinosarcoma were present. One type of tumor was centrally located [endobronchial type], infrequent metastasis, and better prognosis than parenchymal type. The other type was peripherally located [parenchymal type], frequent metastasis, and poor prognosis. The histogenesis of carcinosarcoma is many hypothesis, but controversial; 1] sarcomatous degeneration of stroma, 2] intermingling of simultaneously arising carcinoma & sarcoma, 3] multiple primary tumor, 4] blastomatous changes in hamartoma, 5] stromal reaction to squamous cell carcinoma, 6] true & collision carcinosarcoma. In this case, 52 year-old male patient was hospitalized due to intermittent hemoptysis & known pulmonary lesions. Since 1968, chest PA showed round haziness within cyst & multiple cyst on RUL & RLL. Radical pneumonectomy was performed and histopathology showed carcinosarcoma, surrounded by bronchial epithelium. The patient maintain general well-being without clinical evidence of recurrence till now.

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Animal Models of Arthritis: Pharmacological Intervention

  • Ryn, Joanne van
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 2001.11a
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    • pp.41-76
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    • 2001
  • Rheumatoid arthritis is an incurable chronic inflammatory and destructive arthopathy that affects 1% of the population world-wide. It has substantial personal, social and economic costs. The long-term prognosis is poor: 80 percent of affected patients will become disabled within 20 years after onset of disease. Medical costs of rheumatoid arthritis average ∼$ 6000 (US) per patient (1), Current antirheumatic drugs have limited efficacy and many side effects and more importantly they do not improve the long-term prognosis of rheumatoid arthritis (2). After a decade of few notable advances in therapy, several biological response modifiers that target pathophysiological processes in the disease have now emerged in the clinic. These new drugs are termed biological agents, and although information about their use in the clinic is still limited to short term treatment, they appear to have the ability to modify disease progress. In addition, COX-2 selective agents have now been approved that have comparable efficacy with standard NSAIDs, but fewer gastrointestinal side effects (3). Thus today many more therapeutic options are suddenly open to patients that even five years ago had little hope of relief from chronic pain and inflammation.

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Clinical Application of $^{18}F-FDG$ PET in Malignant Mesothelioma (악성중피종에서 $^{18}F-FDG$ PET의 임상응용)

  • Lee, Eun-Jeong
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.sup1
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    • pp.157-161
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    • 2008
  • Malignant pleural mesothelioma (MPM) has a poor prognosis and a strong association with exposure to asbestos. Although there are not generally accepted guidelines for treatment of MPM, recent reports suggest that multi modality therapy combining chemotherapy, radiotherapy, and surgery can improve the survival of patients with MPM. Therefore exact staging is required to decide the best treatment option. However, it is well known that there are many difficulties in determining precise preoperative stage, predicting prognosis, and monitoring response to therapy with conventional imaging modalities such as CT and MRI in MPM. Recently PET with $^{18}F-FDG$ comes into the spotlight as an important staging method. There is increasing evidence that PET is superior to other conventional imaging modalities in diagnosis and staging of MPM. Particularly PET/CT improves the diagnostic and staging accuracy over PET or CT alone in MPM because it provides anatomic imaging data as well as functional information. PET and PET/CT are also useful for monitoring response to therapy and SUV is reported as a prognostic factor in MPM.

$^{18}F-FDG-PET/CT$ in Endometrial Carcinoma (자궁내막암에서 $^{18}F-FDG-PET/CT$)

  • Jeon, Tae-Joo
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.sup1
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    • pp.110-112
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    • 2008
  • Endometrial carcinoma is one of the most common gynecologic malignancies and which is predominant in postmenopausal women. Clinically many patients are hospitalized in early stage due to clinical sign and symptom such as vaginal bleeding and in this case, patient's prognosis is known to be good. However, considerable number of patients with advanced and relapsed disease reveal poor prognosis. Therefore, exact staging work up is essential for proper treatment as is primary lesion detection. $^{18}F-FDG-PET$ has been widely used for the evaluation of gynecologic malignancies such as cervical carcinoma and ovarian cancer. In contrast, FDG PET application to endometrial carcinoma is limited until now and there is no sufficient data to validate the usefulness of FDG PET for this disease yet. However, several studies showed promising results that FDG PET is sensitive and specific in detection of recurrent or metastatic lesions. Therefore further active investigation in this field can facilitate the use of FDG PET for endometrial carcinoma.