• Asian Spine Journal
• /
• v.12 no.6
• /
• pp.981-986
• /
• 2018

Study Design: Retrospective case series. Purpose: Cauda equina syndrome (CES) is associated with etiologies such as lumbar disc herniation (LDH) and lumbar canal stenosis (LCS). CES has a prevalence of 2% among patients with LDH and exhibits variable outcomes, even with early surgery. Few studies have explored the factors influencing the prognosis in terms of bladder function. Therefore, we aimed to assess the factors contributing to bladder recovery and propose a simplified bladder recovery classification. Overview of Literature: Few reports have described the prognostic clinical factors for bladder recovery following CES. Moreover, limited data are available regarding a meaningful bladder recovery status classification useful in clinical settings. Methods: A single-center retrospective study was conducted (April 2012 to April 2015). Patients with CES secondary to LDH or LCS were included. The retrieved data were evaluated for variables such as demographics, symptom duration, neurological symptoms, bladder symptoms, and surgery duration. The variable bladder function outcome during discharge and at follow-up was recorded. All subjects were followed up for at least 2 years. A simplified bladder recovery classification was proposed. Statistical analyses were performed to study the correlation between patient variables and bladder function outcome. Results: Overall, 39 patients were included in the study. Majority of the subjects were males (79.8%) with an average age of 44.4 years. CES secondary to LDH was most commonly seen (89.7%). Perianal sensation (PAS) showed a significant correlation with neurological recovery. In the absence of PAS, bladder function did not recover. Voluntary anal contraction (VAC) was affected in all study subjects. Conclusions: Intactness of PAS was the only significant prognostic variable. Decreased or absent VAC was the most sensitive diagnostic marker of CES. We also proposed a simplified bladder recovery classification for recovery prognosis.

• The Korean journal of internal medicine
• /
• v.39 no.4
• /
• pp.625-639
• /
• 2024

Background/Aims: Intensive care unit (ICU) quality is largely determined by the mortality rate. Therefore, we aimed to develop and validate a novel prognostic model for predicting mortality in Korean ICUs, using national insurance claims data. Methods: Data were obtained from the health insurance claims database maintained by the Health Insurance Review and Assessment Service of South Korea. From patients who underwent the third ICU adequacy evaluation, 42,489 cases were enrolled and randomly divided into the derivation and validation cohorts. Using the models derived from the derivation cohort, we analyzed whether they accurately predicted death in the validation cohort. The models were verified using data from one general and two tertiary hospitals. Results: Two severity correction models were created from the derivation cohort data, by applying variables selected through statistical analysis, through clinical consensus, and from performing multiple logistic regression analysis. Model 1 included six categorical variables (age, sex, Charlson comorbidity index, ventilator use, hemodialysis or continuous renal replacement therapy, and vasopressor use). Model 2 additionally included presence/absence of ICU specialists and nursing grades. In external validation, the performance of models 1 and 2 for predicting in-hospital and ICU mortality was not inferior to that of pre-existing scoring systems. Conclusions: The novel and simple models could predict in-hospital and ICU mortality and were not inferior compared to the pre-existing scoring systems.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.5
• /
• pp.2253-2255
• /
• 2012

Objective: The objective of our present study was to assess the role of serum amyloid A (SAA) in stages and prognosis of renal cell carcinoma. Material and Methods: It was a hospital based retrospective study carried out in the Department of Medicine and Biochemistry of Manipal Teaching Hospital, Pokhara, Nepal between $1^{st}$ January 2008 and $31^{st}$ December 2011. The variables collected were SAA, CRP. Approval for the study was obtained from the institutional research ethical committee. Quantitative analysis of human SAA and C-reactive protein (CRP) was performed by radial immune diffusion (RID) assay for all cases. Results: Of the 422 total cases of renal cell carcinoma, 218 patients had normal and 204 abnormal SAA. SAA levels were grossly elevated in T3 stage ($122.3{\pm}SD35.7$) when compared to the mean for the T2 stage ($84.2{\pm}SD24.4$) (p value: 0.0001). Similarly, SAA levels were grossly elevated in M1 stage ($190.0{\pm}SD12.7$) when compared to the M0 stage ($160.9{\pm}SD24.8$) (p: 0.0001). There was no significant association with elevated CRP levels ($209.1{\pm}SD22.7$, normal $199.0{\pm}SD19.5$). Conclusion: The validity of SAA in serum as being of independent prognostic significance in RCC was demonstrated with higher levels in advanced stage disease.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.5
• /
• pp.2805-2809
• /
• 2013

Objective: This study aimed at investigating whether the orphan nuclear receptor NR4A2 is significantly associated with clinicopathologic features and overall survival of patients with nasopharyngeal carcinoma (NPC). Methods: Immunohistochemistry was performed to determine NR4A2 protein expression in 84 NPC tissues and 20 non-cancerous nasopharyngeal (NP) tissues. The prognostic significance of NR4A2 protein expression was evaluated using Cox proportional hazards regression models and Kaplan-Meier survival analysis. Results: We did not find a significant association between total NR4A2 expression and clinicopathological variables in 84 patients with NPC. However, we observed that high cytoplasmic expression of NR4A2 was significantly associated with tumor size (T classification) (P = 0.006), lymph node metastasis (N classification) (P = 0.002) and clinical stage (P = 0.017). Patients with higher cytoplasmic NR4A2 expression had a significantly lower survival rate than those with lower cytoplasmic NR4A2 expression (P = 0.004). Multivariate Cox regression analysis analysis suggested that the level of cytoplasmic NR4A2 expression was an independent prognostic indicator for overall survival of patients with NPC (P = 0.033). Conclusions: High cytoplasmic expression of NR4A2 is a potential unfavorable prognostic factor for patients with NPC.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.7
• /
• pp.3575-3581
• /
• 2016

Background: Cancer survival analysis is an essential indicator for effective early detection and improvements in cancer treatment. This study was undertaken to document colorectal cancer survival and associated prognostic factors in Malaysians. Materials and Methods: All data were retrieved from the National Cancer Patient Registry-Colorectal Cancer. Only cases with confirmed diagnosis through histology between the year 2008 and 2009 were included. Retrieved data include socio-demographic information, pathological features and treatment received. Survival curves were plotted using the Kaplan-Meier method. Univariate analysis of all variables was then made using the Log-rank test. All significant factors that influenced survival of patients were further analysed in a multivariate analysis using Cox' regression. Results: Total of 1,214 patients were included in the study. The overall 3- and 5-year survival rates were 59.1% and 48.7%, respectively. Patients with localized tumours had better prognosis compared to those with advanced stage cancer. In univariate analysis, staging at diagnosis (p<0.001), primary tumour size (p<0.001), involvement of lymph nodes (p<0.001) and treatment modalities (p=0.001) were found to be predictors of survival. None of the socio-demographic characteristics were found to exert any influence. In Cox regression analysis, staging at diagnosis (p<0.001), primary tumour size (p<0.001), involvement of lymph nodes (p<0.001) and treatment modalities (p<0.001) were determined as independent prognostic factors of survival after adjusted for age, gender and ethnicity. Conclusions: The overall survival rate for colorectal cancer patients in Malaysia is similar to those in other Asian countries, with staging at diagnosis, primary tumor size, involvement of lymph node and treatment modalities having significant effects. More efforts are needed to improve national survival rates in future.

• Journal of Chest Surgery
• /
• v.27 no.9
• /
• pp.785-792
• /
• 1994

In this study, the authors analyzed the prognostic value of four clinical variables[age and sex of patients, association with myasthenia gravis and clinical stage] and histological type in 30 consecutive patients with thymoma, histologically classified as cortical[10],medullary[5] and mixed[15]type according to Marino and Muller-Hermelink classification. There were significant differences between the histological types in the frequency of the different tumor stages and myasthenia gravis and prognosis.Most of the cortical thymomas were at stage III and all of the medullary and most of the mixed tumors at stage I or II.Myasthenia gravis occurred more commonly in patients with cortical[30%] and mixed thymoma[60%] than in patients with medullary thymoma[10%]. Follow-up was conducted in 30 patients,with follow-up range from 3 months to 120 months[mean,47.3months]. 5 year actuarial survival was 100% for medullary thymoma, 73% for mixed thymoma, and 47% for cortical thymoma.The overall survival curve shows that 87.6% of the patients are alive at 2 years and 72.8% at 5 years. And 7 patients was dead during follow-up periods.By Kaplan-Meier technique, we found that the patients who had myasthenia gravis had better prognosis[P<0.05]. Medullary thymoma is a comparatively rare, benign tumor, and usually not associated with myasthenia gravis. Cortical thymoma must be regarded as malignant. Mixed thymoma is intermediate in its behavior between medullary and cortical thymoma. But these tumors should be considered potentially malignant despite of presence as stage I of II disease. Also, the patients with stageI,II had good prognosis and the patients with total resection had good prognosis[P<0.05].

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.3
• /
• pp.1193-1196
• /
• 2016

Background: Colorectal cancer (CRC) is the commonest malignancy in the lower gastrointestinal tract in both men and women. It is the third leading cause of cancer-dependent death in the world. In Iran the incidence of colorectal cancer has increased during the last 25 years. Materials and Methods: In this article we analyzed the survival of 447 colorectal patients of Taleghani hospital in Tehran using parametric competing-risks models. The cancers of these patients were diagnosed during 1985 - 2012 and followed up to 2013. The purpose was to assess the association between survival of patients with colorectal cancer in the presence of competing-risks and prognostic factors using parametric models. The analysis was carried out using R software version 3.0.2. Results: The prognostic variables included in the model were age at diagnosis, tumour site, body mass index and sex. The effect of age at diagnosis and body mass index on survival time was statistically significant. The median survival for Iranian patients with colorectal cancer is about 20 years. Conclusions: Survival function based on Weibull model compared with Kaplan-Meier survival function is smooth. Iranian data suggest a younger age distribution compared to Western reports for CRC.

• 한국신재생에너지학회:학술대회논문집
• /
• 2008.10a
• /
• pp.274-277
• /
• 2008

To evaluate high-resolution wind resources for local and coastal area with complex terrain was attemped to combine the prognostic MM5 mesoscale model with CALMET diagnostic modeling this study. Firstly, MM5 was simulated for 1km resolution, nested fine domain, with FDDA using QuikSCAT seawinds data was employed to improve initial meteorological fields. Wind field and other meteorological variables from MM5 with all vertical levels used as initial guess field for CALMET. And 5 surface and 1 radio sonde observation data is performed objective analysis whole domain cells. Initial and boundary condition are given by 3 hourly RDAPS data of KMA in prognostic MM5 simulation. Geophysical data was used high-resolution terrain elevation and land cover(30 seconds) data from USGS with MM5 simulation. On the other hand SRTM 90m resolution and EGIS 30m landuse was adopted for CALMET diagnostic simulation. The simulation was performed on whole year for 2007. Vertical wind field a hour from CALMET and latest results of MM5 simulation was comparison with wind profiler(KEOP-2007 campaign) data at HAENAM site.

• Korean Journal of Psychosomatic Medicine
• /
• v.5 no.1
• /
• pp.82-88
• /
• 1997

Background : Patients with command hallucinations are commonly assumed to be at high risk for dangerous behavior. However the issue of whether command hallucinations hold any clinical relevance in schizophrenic patients has not been established. Method : The author analyzed the clinical and research records of schizophrenic patients with auditory hallucinations who participated in outpatient research follow-up for 9 months after discharge. Patients with auditory hallucinations were classified as experiencing or not experiencing command hallucinations based on clinical psychiatric assessment. Results : Of 63 patients with auditory hallucinations, 29(46%) reported the command hallucinations and these hallucinations often were violent in content(44.8%). Patients with command hallucinations were not significantly different from patients without command hallucinations on sociodemographic and clinical characteristics, and clinical or prognostic course variables, but patients with command hallucinations had significantly more short hospitalizations(less than one month) than patients without command hallucinations. 3 of the patients with command hallucinations who committed suicide during the follow up periods were died. Conclusion : Command hallucinations may be frequent, and in most cases they have minimal influence on the outcome of schizophrenia, but if the patients with command hallucinations have a history of suicide attempts before admission, the possibility of suicide attempts by command hallucinations should be considered.

• Tuberculosis and Respiratory Diseases
• /
• v.73 no.4
• /
• pp.224-230
• /
• 2012

Background: We evaluated the clinical outcomes and prognostic factors of patients requiring prolonged mechanical ventilation (PMV), defined as ventilator care for ${\geq}21$ days, who were admitted to the medical intensive care unit (ICU) of a university hospital in Korea. Methods: During the study period, a total of 2,644 patients were admitted to the medical ICU, and 136 patients (5.1%) were enrolled between 2005 and 2010. Results: The mean age of the patients was $61.3{\pm}14.5$ years, and 94 (69.1%) were male. The ICU and six-month cumulative mortality rates were 45.6 and 58.8%, respectively. There were 96 patients with tracheostomy placement after admission and their mean period from admission to the day of tracheostomy was $21.3{\pm}8.4$ days. Sixty-three patients (46.3%) were successfully weaned from ventilator care. Of the ICU survivors (n=74), 34 patients (45.9%) were transferred to other hospitals (not university hospitals). Two variables (thrombocytopenia [hazard ratio (HR), 1.964; 95% confidence interval (CI), 1.225~3.148; p=0.005] and the requirement for vasopressors [HR, 1.822; 95% CI, 1.111~2.986; p=0.017] on day 21) were found to be independent factors of survival on based on the Cox proportional hazard model. Conclusion: We found that patients requiring PMV had high six-month cumulative mortality rates, and that two clinical variables (measured on day 21), thrombocytopenia and requirement for vasopressors, may be associated with prognostic indicators.