• Title/Summary/Keyword: SURVIVAL RATIO

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Risk Factors for Deliberate Self-extubation (기관 내 삽관환자의 의도적 자가발관 위험요인)

  • Cho, Young Shin;Yeo, Jung Hee
    • Journal of Korean Academy of Nursing
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    • v.44 no.5
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    • pp.573-580
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    • 2014
  • Purpose: This study was conducted to analyze intubation survival rates according to characteristics and to identify the risk factors affecting deliberate self-extubation. Methods: Data were collected from patients' electronic medical reports from one hospital in B city. Participants were 450 patients with endotracheal intubation being treated in intensive care units. The collected data were analyzed using Kaplan-Meier estimation, Log rank test, and Cox's proportional hazards model. Results: Over 15 months thirty-two (7.1%) of the 450 intubation patients intentionally extubated themselves. The patients who had experienced high level of consciousness, agitation. use of sedative, application of restraints, and day and night shift had significantly lower intubation survival rates. Risk factors for deliberate self-extubation were age (60 years and over), unit (neurological intensive care), level of consciousness (higher), agitation, application of restraints, shift (night), and nurse-to-patient ratio (one nurse caring for two or more patients). Conclusion: Appropriate use of sedative drugs, effective treatment to reduce agitation, sufficient nurse-to-patient ratio, and no restraints for patients should be the focus to diminish the number of deliberate self-extubations.

The Prognosis of Patients with Stage IV Gastric Carcinoma without Distant Metastasis (원격전이를 동반하지 않은 4기 위암 환자의 예후)

  • Lee Jun Ho;Noh Sung Hoon;Choi Seung Ho;Min Jin Sik
    • Journal of Gastric Cancer
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    • v.1 no.2
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    • pp.100-105
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    • 2001
  • Purpose: In the UICC staging system, stage IV contains not only those patients with distant metastasis but also patients with far advanced T and N status but without distant metastasis. We investigated the prognostic factors of stage IV gastric carcinoma patients without distant metastasis after curative resection. Materials and Methods: 190 stage IV gastric carcinoma patients without distant metastasis were reviewed after curative resection. Results: Male sex, distal third location, Borrmann type III, IV and histologically undifferentiated type were common. 5 year survival rate of the 190 patients was $22.2\%$. Depth of invasion and lymph node metastasis did not influence survival. The lymph node ratio (positive lymph node / retrieved lymph node) and combined resection affected survival by univariate and multivariate analysis. Conclusion: Combined resection and positive lymph node ratio were the independent prognostic factors in the patients with stage IV gastric carcinoma who underwent curative resection.

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Prognostic Value of the Anatomic Region of Metastatic Lymph Nodes in the Current TNM Staging of Gastric Cancer

  • Jeong, Oh;Jung, Mi Ran;Kang, Ji Hoon
    • Journal of Gastric Cancer
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    • v.21 no.3
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    • pp.236-245
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    • 2021
  • Purpose: The numeric N stage has replaced the topographic N stage in the current tumor node metastasis (TNM) staging in gastric carcinoma. However, the usefulness of the topographic N stage in the current TNM staging system is uncertain. We aimed to investigate the prognostic value of the topographic N stage in the current TNM staging system. Materials and Methods: We reviewed the data of 3350 patients with gastric cancer who underwent curative gastrectomy. The anatomic regions of the metastatic lymph nodes (MLNs) were classified into 2 groups: perigastric and extra-perigastric. The prognostic value of the anatomic region was analyzed using a multivariate prognostic model with adjustments for the TNM stage. Results: In patients with lymph node metastasis, extra-perigastric metastasis demonstrated significantly worse survival than perigastric metastasis alone (5-year survival rate, 39.6% vs. 73.1%, respectively, P<0.001). Extra-perigastric metastasis demonstrated significantly worse survival within the same pN stage; the multivariate analysis indicated that extra-perigastric metastasis was an independent poor prognostic factor (hazard ratio=1.33; 95% confidence interval=1.01-1.75). The anatomic region of the MLNs improved the goodness-of-fit (likelihood ratio statistics, 4.57; P=0.033) of the prognostic model using the TNM stage. Conclusions: The anatomic region of MLNs has an independent prognostic value in the numeric N stage in the current TNM staging of gastric carcinoma.

Cross-generational Effect of Bisphenol A on the Harpacticoid Copepod Tigriopus west: A Full Life Cycle Toxicity Test

  • Bang, Hyun Woo
    • Korean Journal of Environmental Biology
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    • v.36 no.4
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    • pp.456-462
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    • 2018
  • The purpose of this study was to assess cross-generational effects of bisphenol A exposure in benthic copepods, Tigriopus west. Nauplii (<24 hours old) were exposed to graded concentrations of bisphenol A, and toxicity end-points such as survival, development, sex ratio, and fecundity were measured. $F_1$ generations were grown under innoxious conditions, and similarly assessed. Significant differences were observed in development of nauplii and copepodites, between exposed and non-exposed copepods; however, there were no differences in survival of nauplii or copepodites, sex ratio, or brooding rate in parental generation. In contrast, in the $F_1$ generation, there were significant differences between the control group and exposed group in survival and development of nauplii. Length, width, and biomass of parental and $F_1$ generations were reduced in the exposed group compared to the control group. In addition, some deformities, such as swelling of the prosome, abnormally shaped egg sac, and dwarfism were observed after exposure to bisphenol A. So, our study demonstrates that a cross-generation toxicity test and monitoring of morphological deformities in harpacticoid copepods, can be useful for development of potential bioindicators for environmental monitoring, and assessment of chemical impact.

Clinical Significance of Preoperative Inflammatory Parameters in Gastric Cancer Patients

  • Lee, Deuk Young;Hong, Seong Woo;Chang, Yeo Goo;Lee, Woo Yong;Lee, Byungmo
    • Journal of Gastric Cancer
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    • v.13 no.2
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    • pp.111-116
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    • 2013
  • Purpose: Chronic inflammation induces cancer and cancer induces local tissue damage with systemic inflammation. Therefore, the aim of this study is to investigate the potential relationship between the severity of inflammation and prognosis in cancer patients. Materials and Methods: This study enrolled 220 patients from January 2002 to December 2006 who underwent gastric surgery. We evaluated the relationship between preoperative inflammatory parameters (erythrocyte sedimentation rate, neutrophil-to-lymphocyte ratio) and other clinicopathological factors. Survival outcomes were compared according to the extent of inflammation. Results: Significant elevation of erythrocyte sedimentation rate was related with old age, increased neutrophil-to-lymphocyte ratio, decreased hemoglobin, increased carcinoembryonic antigen, increased tumor size and advanced TNM stage. Neutrophil-to-lymphocyte ratio was significantly correlated with old age, increased erythrocyte sedimentation rate and advanced TNM stage. In the univariate analysis, elevated erythrocyte sedimentation rate and increased neutrophil-to-lymphocyte ratio had significantly poorer survival than those without elevation (all P<0.05). However, the multivariate analysis failed to prove erythrocyte sedimentation rate and neutrophil-tolymphocyte ratio as independent prognostic factors. Conclusions: The elevation of erythrocyte sedimentation rate and neutrophil-to-lymphocyte ratio were correlated with poor prognosis in the univariate analysis and there was a strong correlation between inflammatory parameters (erythrocyte sedimentation rate and neutrophil- to-lymphocyte ratio) and tumor progression. Thus, erythrocyte sedimentation rate and neutrophil-to-lymphocyte ratio are considered useful as follow-up factors.

Clinico-Pathological Patterns and Survival Outcome of Colorectal Cancer in Young Patients: Western Saudi Arabia Experience

  • Elsamany, Shereef Ahmed;Alzahrani, Abdullah Saeed;Mohamed, Mervat Mahrous;Elmorsy, Soha Ali;Zekri, Jamal Eddin;Al-Shehri, Ahmed Saleh;Haggag, Rasha Mostafa;Alnagar, Ahmed Abdel-Reheem;El Taani, Hani Abdalla
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5239-5243
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    • 2014
  • Background: The prognosis of young colorectal cancer (CRC) patients has been addressed by several studies but with contradictory results. The aim of the present study was to evaluate the clinico-pathological features of young Saudi patients with CRC in addition to displaying their survival outcome. Materials and Methods: In this retrospective study, young CRC patients (${\leq}40$ years) diagnosed between 2007 and 2011 from 4 centres in western Saudi Arabia, were included. Clinico-pathological features, tumor markers, dates of disease relapse and death were collected. Survival parameters were compared with those of older Saudi patients, reported in previous studies. Results: One hundred and sixteen young patients with CRC were identified (32.2% rectal, 67.8% colon). Some 44% were metastatic while 32.7% had stage III at diagnosis. Patients with grade 3 tumors made up 29.4% of the total while 49.5% had positive lymphovascular invasion (LVI), 56% had a lymph node (LN) ratio ${\geq}0.2$ and 40.2% were K-ras mutant. Median disease-free survival (DFS) and overall survival (OS) in non-metastatic cases were 22.8 and 49.6 months respectively with better median DFS in K-ras wild compared to mutant patients (28.5 vs 20.9 months, p=0.005). In metastatic cases, median OS was 19.5 months. These survival outcomes are inferior compared to those of older Saudi patients reported in prior studies. Conclusions: Young CRC patients present more commonly with advanced stage and a high incidence of adverse prognostic factors such as LVI and high LN ratio. Young CRC patients seem to have worse survival compared to older Saudi patients.

Prognostic value of neutrophil-to-lymphocyte ratio in locally advanced non-small cell lung cancer treated with concurrent chemoradiotherapy

  • Park, Eun Young;Kim, Yeon-Sil;Choi, Kyu Hye;Song, Jin Ho;Lee, Hyo Chun;Hong, Sook-Hee;Kang, Jin-Hyoung
    • Radiation Oncology Journal
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    • v.37 no.3
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    • pp.166-175
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    • 2019
  • Purpose: This study aimed to investigate neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as prognostic factors in patients with locally advanced non-small cell lung cancer (NSCLC) who received concurrent chemoradiotherapy (CCRT). Materials and Methods: We retrospectively analyzed 66 patients with locally advanced NSCLC treated with definitive CCRT. Among these patients, 95% received paclitaxel/carboplatin or docetaxel/cisplatin. The median radiation dose was 66 Gy in 33 fractions. The NLR and PLR before/after CCRT were evaluated. The maximally selected log-rank test was used to obtain the cutoff values related to the overall survival (OS). Results: Patients with high post-CCRT NLR (>3.12) showed worse OS, locoregional progression-free survival (LRPFS), and distant metastasis-free survival (DMFS) than those with low NLR (2-year OS: 25.8% vs. 68.2%, p < 0.001; 2-year LRPFS: 12.9% vs. 33.8%, p = 0.010; 2-year DMFS: 22.6% vs. 38.2%, p = 0.030). Patients with high post-CCRT PLR (>141) showed worse OS and LRPFS than those with low PLR (2-year OS: 37.5% vs. 71.1%, p = 0.004; 2-year LRPFS: 16.5% vs. 40.3%, p = 0.040). Patients with high NLR change (>1.61) showed worse OS and LRPFS than those with low NLR change (2-year OS: 26.0% vs. 59.0%, p < 0.001; 2-year LRPFS: 6.8% vs. 31.8%, p = 0.004). The planning target volume (hazard ration [HR] = 2.05, p = 0.028) and NLR change (HR = 3.17, p = 0.025) were the significant factors for OS in the multivariate analysis. Conclusion: NLR change after CCRT was associated with poor prognosis of survival in patients with locally advanced NSCLC. An elevated NLR after CCRT might be an indicator of an increased treatment failure risk.

Effects of Viability of Canine Oocytes Vitrified-Warmed by the EDS and EDT Methods

  • Park, Ji-Hoon;Abe, Yasuyuki;Kim, Sang-Keun
    • Reproductive and Developmental Biology
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    • v.32 no.4
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    • pp.245-248
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    • 2008
  • In the present studies, we have intended to compare the EDS (20% EG + 20% DMSO + 0.4 M sucrose + 10% FCS) and EDT (20% EG + 20% DMSO + 0.3 M trehalose 10% FCS) methods for vitrification of canine oocytes, in order to improve the vitrification methods. The survival rate of vitrified-thawed oocytes using the EDS method was $15.1{\pm}1.8%$ (p<0.05), which was lower than that of the control group $(66.7{\pm}2.5%)$. About $45{\sim}55%$ of the vitrified-warmed oocytes showed normal morphology, as assessed by PI staining. However, the ratio of survival rate of oocytes showed lower than that of normal morphology in comparison between EDS method and control group. The survival and developmental rates of vitrified-warmed oocytes by the EDS and EDT methods were $16.7{\pm}1.4%\;and\;11.1{\pm}0.8%$ and $8.3{\pm}1.4%\;and\;4.4{\pm}1.8%$, respectively (p<0.05). The results were significantly lower than the control group $(66.7{\pm}2.5%\;and\;16.7{\pm}3.7%)$. However, the survival rate of vitrified-warmed oocytes using EDS method showed higher than that in the ETS group.

Efficacy and Safety of Selumetinib Compared with Current Therapies for Advanced Cancer: a Meta-analysis

  • Shen, Chen-Tian;Qiu, Zhong-Ling;Luo, Quan-Yong
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2369-2374
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    • 2014
  • Background and Aim: Selumetinib is a promising and interesting targeted therapy agent as it may reverse radioiodine uptake in patients with radioiodine-refractory differentiated thyroid cancer. We conduct this metaanalysis to compare the efficacy and safety of selumetinib with current therapies in patients with advanced cancer. Methods: An electronic search was conducted using PubMed/ Medicine, EMBASE and Cochrane library databases. Statistical analyses were carried out using either random-effects or fixed-effects models according to the heterogeneity of eligible studies. Results: Six eligible trials involved 601 patients were identified. Compared with current therapies, treatment schedules with selumetinib did not improve progression free survival (hazard ratio, 0.91; 95%CI 0.70-1.17, P= 0.448), but did identify better clinical benefits (odds ratio, 1.24; 95%CI 0.69-2.24, P = 0.472) and less disease progression (hazard ratio, 0.72; 95%CI 0.51-1.00, P = 0.052) though its impact was not statistically significant. Sub-group analysis resulted in significantly improved progression free survival (hazard ratio, 0.61; 95%CI 0.49-0.57, P = 0.00), clinical benefits (odds ratio, 3.04; 95%CI 1.60-5.77, P = 0.001) and reduced disease progression (hazard ratio, 0.35; 95%CI 0.18-0.67, P = 0.001) in patients administrated selumetinib. Dermatitis acneiform (risk ratio, 9.775; 95%CI 3.143-30.395, P = 0.00) and peripheral edema (risk ratio, 2.371; 95%CI 1.690-3.327, P = 0.00) are the most frequently observed adverse effects associated with selumetinib. Conclusions: Compared with current chemotherapy, selumetinib has modest clinical activity as monotherapy in patients with advanced cancer, but combinations of selumetinib with cytotoxic agents in patients with BRAF or KRAS mutations hold great promise for cancer treatment. Dermatitis acneiform and peripheral edema are the most frequently observed adverse effects in patients with selumetinib.

Prognostic Value of a Single Center Nutrition Screening Tool in Patients with Metastatic Cancer (전이암 환자에서 단일기관 영양검색 도구의 예후 가치)

  • Yoon, Sung Soo;Kim, Min Jin;Kim, Eun Hye;Lee, Jee Young;Yoon, Seong Woo
    • Journal of Korean Traditional Oncology
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    • v.24 no.2
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    • pp.1-11
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    • 2019
  • Objectives : We investigated whether a single center nutrition screening tool (Kyunghee Neo Nutrition Risk Screening, KNNRS) can predict survival in patients with metastatic cancer. Methods : We retrospectively reviewed data of inpatients with metastatic cancer from April 2016 to August 2019. Data on demographic and clinical parameters were collected from electronic medical records, and overall survival was estimated using the Kaplan-Meier method. Stepwise Cox regression analysis was used to determine factors associated with survival. Patients with a KNNRS score of 0 to 3 were classified as "no-risk", 4 to 10 as "low-risk", and 11 to 20 as "high-risk". Results : Total 105 patients were included in the study. According to nutritional screening at baseline, 25 patients (23.8%, median age 57.0) were classified as ""no risk"" group; 80 patients (76.2%, median age 68.5) as "low risk" group; No patients as "high risk" group. Predictors of survival were Eastern Cooperative Oncology Group Performance Status score of 3 or 4 (hazard ratio [HR] = 1.93; 95% confidence interval [CI] = 1.21-3.10), hemoglobin less than 10 g/dL (HR = 1.97; 95% CI = 1.25-3.10) and C-reactive protein more than 1.0 mg/dL (HR = 1.95; 95% CI = 1.21-3.13). Kaplan-Meier survival analysis showed significant differences in the survival between KNNRS groups: ""no risk"" group: 6.1 ± 1.4 months (95% CI = 3.37-8.83); ""low risk"" group: 3.4 ± 0.9 months (95% CI = 1.5-5.37). Conclusions : Nutritional status according to KNNRS wasn't significant predictor of survival for patients with metastatic cancer. Improvement of KNNRS score thresholds is needed.