• 제목/요약/키워드: Prognostic outcome

검색결과 459건 처리시간 0.027초

Ultrasonography for Facial Nerve Palsy: A Systematic Review and Meta-Analysis Protocol

  • Seojung Ha;Bo-In Kwon;Joo-Hee Kim
    • Journal of Acupuncture Research
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    • 제41권1호
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    • pp.63-68
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    • 2024
  • Background: Facial nerve palsy presents a significant healthcare challenge, impacting daily life and social interactions. This systematic review investigates the potential utility of ultrasonography as a diagnostic tool for facial nerve palsy. Methods: Electronic searches will be conducted across various databases, including MEDLINE, EMBASE, CENTRAL (Cochrane Central register of Controlled Trials), CNKI (China National Knowledge Infrastructure), KMBASE (Korean Medical Database), ScienceON, and OASIS (Oriental Medicine Advanced Searching Integrated System), up to February 2024. The primary outcome will focus on ultrasonography-related parameters, such as facial nerve diameter and muscle thickness. Secondary outcomes will encompass clinical measurements, including facial nerve grading scales and electrodiagnostic studies. the risk of bias in individual study will be assessed using the Cochrane Risk of Bias assessment tool, while the grading of recommendations, assessment, development, and evaluations methodology will be utilized to evaluate the overall quality of evidence. Conclusion: This study aims to review existing evidence and evaluate the diagnostic and prognostic value of ultrasonography for peripheral facial nerve palsy.

외상성 지주막하 출혈의 예후와 임상적 의의 (Prognosis and Clinical Significance of Traumatic Subarachnoid Hemorrhage)

  • 김근욱;이경석;윤석만;도재원;배학근;윤일규;최순관;변박장
    • Journal of Korean Neurosurgical Society
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    • 제29권2호
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    • pp.210-216
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    • 2000
  • Objectives : Head injury is one of the common causes of death in the industrialized countries, and it is a common cause of subarachnoid hemorrhage. Recently, traumatic subarachnoid hemorrhage(TSAH) has been considered as a major prognostic factor. Some suggested that a certain vasodilating agent may be effective to treat or prevent the secondary brain injury due to vasospasm from TSAH. The role of TSAH is not yet fully solved. The prognosis and clinical significance of the TSAH was evaluated. Methods : A retrospective study was performed. A total of 573 consecutive patients with head injury admitted to our institute from January 1996 to December 1997 were examined with respect to outcome and clinical features. In all patients, computerized tomographic scanning was done within 2 days after the injury. Results : TSAH was found in 68 patients(11.9%). The outcome at discharge of the patients without TSAH was favorable(good recovery and moderate disability) in 84.8%, unfavorable(severe disability and vegetative state) in 8.6%, and the mortality rate 6.7%. However, the outcome was favorable in 51.5%, unfavorable in 20.6%, and the mortality rate 27.9% in patients with TSAH. Although the outcome of the patients with thick TSAH was worse than that of the patients with scanty TSAH, the difference was not statistically significant. The difference of the outcome in patients with TSAH according to the location also lacked statistical significance. TSAH was more common in patients with age of 40 years or more, and patients with low Glasgow coma scores. Patients with TSAH had abnormal pupillary responses, diffuse axonal injuries, intubations and operative interventions more frequently than patients without TSAH. Conclusion : These results strongly suggest that the TSAH per se did not worsen the prognosis. However, it represented the injury to be more severe.

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The Clinical Impact of β-Blocker Therapy on Patients With Chronic Coronary Artery Disease After Percutaneous Coronary Intervention

  • Jiesuck Park;Jung-Kyu Han;Jeehoon Kang;In-Ho Chae;Sung Yun Lee;Young Jin Choi;Jay Young Rhew;Seung-Woon Rha;Eun-Seok Shin;Seong-Ill Woo;Han Cheol Lee;Kook-Jin Chun;DooIl Kim;Jin-Ok Jeong;Jang-Whan Bae;Han-Mo Yang;Kyung Woo Park;Hyun-Jae Kang;Bon-Kwon Koo;Hyo-Soo Kim
    • Korean Circulation Journal
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    • 제52권7호
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    • pp.544-555
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    • 2022
  • Background and Objectives: The outcome benefits of β-blockers in chronic coronary artery disease (CAD) have not been fully assessed. We evaluated the prognostic impact of β-blockers on patients with chronic CAD after percutaneous coronary intervention (PCI). Methods: A total of 3,075 patients with chronic CAD were included from the Grand Drug-Eluting Stent registry. We analyzed β-blocker prescriptions, including doses and types, in each patient at 3-month intervals from discharge. After propensity score matching, 1,170 pairs of patients (β-blockers vs. no β-blockers) were derived. Primary outcome was defined as a composite endpoint of all-cause death and myocardial infarction (MI). We further analyzed the outcome benefits of different doses (low-, medium-, and high-dose) and types (conventional or vasodilating) of β-blockers. Results: During a median (interquartile range) follow-up of 3.1 (3.0-3.1) years, 134 (5.7%) patients experienced primary outcome. Overall, β-blockers demonstrated no significant benefit in primary outcome (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.63-1.24), all-cause death (HR, 0.87; 95% CI, 0.60-1.25), and MI (HR, 1.25; 95% CI, 0.49-3.15). In subgroup analysis, β-blockers were associated with a lower risk of all-cause death in patients with previous MI and/or revascularization (HR, 0.38; 95% CI, 0.14-0.99) (p for interaction=0.045). No significant associations were found for the clinical outcomes with different doses and types of β-blockers. Conclusions: Overall, β-blocker therapy was not associated with better clinical outcomes in patients with chronic CAD undergoing PCI. Limited mortality benefit of β-blockers may exist for patients with previous MI and/or revascularization.

뇌동맥류의 조기수술 전 재출혈 방지를 위한 항섬유소용해제 투여의 효과 (The Effect of Antifibrinolytic Therapy in Prevention of Rebleeding before Early Aneurysm Surgery)

  • 이창영;임만빈;이장철;손은익;김동원;김인홍
    • Journal of Korean Neurosurgical Society
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    • 제30권9호
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    • pp.1065-1071
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    • 2001
  • 파열된 뇌동맥류의 조기수술이 계획된 환자에서 수술전까지 단기간에 걸친 항섬유소용해제 투여의 효과를 알아보기 위해 뇌동맥류성 지주막하출혈 환자 137례에 대하여 60례를 AMCA 투여군으로, 77례를 비 투여군으로 분류하여 재출혈, 증상적 혈관연축, 뇌수두증의 발생빈도 및 전체적인 치료성적을 비교, 분석하였다. 재출혈의 발생빈도는 AMCA 비 투여군에 비해 투여군에서 통계학적으로 유의하게 낮게 나타났고 AMCA의 장기투여에서 증가를 보인 증상적 혈관연축과 뇌수두증의 발생빈도는 양군에서 유의한 차이를 보이지 않았으며 전체적인 치료성적은 AMCA 투여군에서 비 투여군에 비해 보다 양호한 결과를 보였다. 따라서 조기수술이 계획된 뇌동맥류성 지주막하출혈 환자에서 AMCA의 단기간 투여는 재출혈율을 감소시켜 전체적인 치료결과를 향상시키는데 도움이 될 것으로 생각된다.

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Prognostic Significance of CYFRA21-1, CEA and Hemoglobin in Patients with Esophageal Squamous Cancer Undergoing Concurrent Chemoradiotherapy

  • Zhang, Hai-Qin;Wang, Ren-Ben;Yan, Hong-Jiang;Zhao, Wei;Zhu, Kun-Li;Jiang, Shu-Mei;Hu, Xi-Gang;Yu, Jin-Ming
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권1호
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    • pp.199-203
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    • 2012
  • Purpose: To evaluate the prognostic value of serum CYFRA21-1, CEA and hemoglobin levels regarding long-term survival of patients with esophageal squamous cell carcinoma (ESCC) treated with concurrent chemoradiotherapy (CRT). Methods: Age, gender, Karnofsky Performance Status (KPS), tumor location, tumor length, T stage, N stage and serum hemoglobin, and CYFRA21-1 and CEA levels before concurrent CRT were retrospectively investigated and related to outcome in 113 patients receiving 5-fluorouracil and cisplatin combined with radiotherapy for ESCC. The Kaplan-Meier method was used to analyze prognosis, the log-rank to compare groups, the Cox proportional hazards model for multivariate analysis, and ROC curve analysis for assessment of predictive performance of biologic markers. Results: The median survival time was 20.1 months and the 1-, 2-, 3-, 5- year overall survival rates were 66.4%, 43.4%, 31.9% and 15.0%, respectively. Univariate analysis showed that factors associated with prognosis were KPS, tumor length, T-stage, N-stage, hemoglobin, CYFRA21-1 and CEA level. Multivariate analysis showed T-stage, N-stage, hemoglobin, CYFRA21-1 and CEA level were independent predictors of prognosis. By ROC curve, CYFRA21-1 and hemoglobin showed better predictive performance for OS than CEA (AUC= 0.791, 0.704, 0.545; P=0.000, 0.000, 0.409). Conclusions: Of all clinicopathological and molecular factors, T stage, N stage, hemoglobin, CYFRA21-1 and CEA level were independent predictors of prognosis for patients with ESCC treated with concurrent CRT. Among biomarkers, CYFRA21-1 and hemoglobin may have a better predictive potential than CEA for long-term outcomes.

Prognostic Significance of GSTP1, XRCC1 and XRCC3 Polymorphisms in Non-small Cell Lung Cancer Patients

  • Ke, Hong-Gang;Li, Jun;Shen, Yi;You, Qing-Sheng;Yan, Yu;Dong, Han-Xuan;Liu, Jun-Hua;Shen, Zhen-Ya
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권9호
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    • pp.4413-4416
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    • 2012
  • Aim: Individual differences in chemosensitivity and clinical outcome in non-small cell lung cancer (NSCLC) patients treatment with platinum-based chemotherapy may be due to genetic factors. Our study aimed to investigate the prognostic role of GSTP1, XRCC1 and XRCC3 in NSCLC patients treated with chemotherapy. Methods: A total of 460 cases were consecutively selected from The Affiliated Hospital of Nantong University between Jan. 2003 to Nov. 2006, and all were followed-up until Nov. 2011. Genotyping of GSTP1 Ile105Val, XRCC1 Arg194Trp, XRCC1 Arg399Gln and XRCC3 Thr241Met was conducted by duplex polymerase-chain-reaction with confronting-two-pair primer methods. Results: Patients with GSTP Val/Val exhibited a shorter survival time, and had a 1.89 fold greater risk of death than did those with the IIe/IIe genotype. For XRCC1 Arg194Trp, the variant genotype Trp/Trp was significantly associated with a decreased risk of death from NSCLC when compared with the Arg/Arg. Individuals carrying XRCC1 399Gln/Gln genotype had a longer survival time, with a lowered risk of death from NSCLC. Conclusion: This study indicated that GSTP1 Ile105Val, XRCC1 Arg194Trp and XRCC1Arg399Gln genes have a role in modifying the effect of platinum-based chemotherapy for NSCLC patients in a Chinese population. Our findings provide information for therapeutic decisions for individualized therapy in NSCLC cases.

Roles of Fibroblast Growth Factor-inducible 14 in Hepatocellular Carcinoma

  • Li, Nan;Hu, Wen-Jun;Shi, Jie;Xue, Jie;Guo, Wei-Xing;Zhang, Yang;Guan, Dong-Xian;Liu, Shu-Peng;Cheng, Yu-Qiang;Wu, Meng-Chao;Xie, Dong;Liu, Shan-Rong;Cheng, Shu-Qun
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권6호
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    • pp.3509-3514
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    • 2013
  • The prognostic value of the fibroblast growth factor-inducible 14 (Fn14) expression in hepatocellular carcinoma (HCC) is unknown. Real-time PCR (RT-PCR), western blot assays and immunohistochemistry analysis were here performed in order to compare Fn14 expressios in paired liver samples of HCC and normal liver tissue. Most of the tumor tissues expressed significantly higher levels of Fn14 compared to adjacent non-tumor tissues, with Fn14High accounting for 54.6% (142/260) of all patients. The Pearson ${\chi}^2$ test indicated that Fn14 expression was closely associated with serum alpha fetal protein (AFP) (P=0.002) and tumor number (p=0.019). Univariate and multivariate analyses revealed that along with tumor diameter and portal vein tumor thrombosis (PVTT ) type, Fn14 was an independent prognostic factor for both overall survival (OS) (HR=1.398, p=0.008) and recurrence (HR=1.541, p=0.001) rates. Fn14 overexpression HCC correlated with poor surgical outcome, and this molecule may be a candidate biomarker for prognosis as well as a target for therapy.

Laxative Choice and Treatment Outcomes in Childhood Constipation: Clinical Data in a Longitudinal Retrospective Study

  • Chanpong, Atchariya;Osatakul, Seksit
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제21권2호
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    • pp.101-110
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    • 2018
  • Purpose: Functional constipation (FC) is a common gastrointestinal (GI) problem affecting children's well-being and quality of life. Although polyethylene glycol (PEG) is recommended as the first line therapy, it is not always applicable in lower socioeconomic populations. Hence, this study aimed to compare clinical courses of FC in children treated with different medications in order to identify prognostic factors related to treatment outcomes. Methods: We reviewed the medical records of patients aged ${\leq}15$ years diagnosed with FC according to the Rome IV criteria from 2007 to 2015 at the GI clinic, Songklanagarind Hospital. Baseline characteristic, medical history, and treatment outcomes were collected at first and subsequent visits. Results: Exactly104 patients (median age at diagnosis, 2.8 years) were diagnosed with FC. The number of follow-up visits per patient ranged from 1 to 35. The median duration of follow-up was 18.0 months (range, 6.0-84.2 months). PEG was given to 21% of patients. During the follow up period, 76% of patients experienced first recovery with a median time to recovery of 9.8 months. There were no significant differences in time until first recovery and relapse between patients who received and those who did not receive PEG (p=0.99 and 0.06, respectively). Age >6 years, normal defecation frequency, no history of cow's milk protein allergy, and use of laxatives were associated with successful outcomes. Conclusion: Treatment outcomes between patients who had and never had PEG demonstrated no significant difference in our study. Hence, current practices in laxative prescriptive patterns may be effective.

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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    • 제15권6호
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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.

Outcomes of Malignant Ovarian Germ-Cell Tumors Treated in Chiang Mai University Hospital over a Nine Year Period

  • Neeyalavira, Vithida;Suprasert, Prapaporn
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권12호
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    • pp.4909-4913
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    • 2014
  • Malignant ovarian germ cell tumors (MOGCT) are rare neoplasms that most frequently occur in women at a young reproductive age. There have been limited data regarding this disease from Southeast Asian countries. We therefore conducted a retrospective study to analyze the clinical characteristics and the treatment outcomes of MOGCT treated at our institute between January, 2003 and December, 2012. Seventy-six patients were recruited from this period with the mean age of 21.6 years and 11.8% were pre-puberty. The two most common symptoms were pelvic mass and pelvic pain. Two-thirds of the studied patients presented at an early stage. The most common histology was immature teratoma (34.2%) followed by endodermal sinus tumor (28.9%), dysgerminoma (25%), mixed type (10.5%) and choriocarcinoma (1.3%). Over 80% of these patients received fertility sparing surgery and about 70% received adjuvant chemotherapy with the complete response rate at 73.3% and partial response at 11.1%. The most frequent chemotherapy was BEP regimen (bleomycin, etoposide, cisplatin). With the mean follow up time at 56.0 months, 12 patients (15.8%) developed recurrence and only an advanced stage was the independent prognostic factor. The ten year progression free survival (PFS) and overall survival rate of our study were 81.9% and 86.2%, respectively. In conclusion, MOGCT often occurs at a young age. Treatment with fertility sparing operations and adjuvant chemotherapy with a BEP regimen showed a good outcome. An advanced stage is a significant prognostic factor for recurrence.