• Title/Summary/Keyword: prognosis

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Utility of the APACHE II Score as a Neurologic Prognostic Factor for Glufosinate Intoxicated Patients (Glufosinate 중독 환자의 신경학적 예후 인자로서 APACHE II Score의 유용성)

  • Yoo, Dae Han;Lee, Jung Won;Choi, Jae Hyung;Jeong, Dong Kil;Lee, Dong Wook;Lee, Young Joo;Cho, Young Shin;Park, Joon Bum;Chung, Hae Jin;Moon, Hyung Jun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.14 no.2
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    • pp.107-114
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    • 2016
  • Purpose: The incidence of glufosinate poisoning is gradually increasing, and it can be fatal if severe poisoning occurs. However, factors useful for predicting the post-discharge neurological prognosis of patients who have ingested glufosinate have yet to be identified. Our objective was to evaluate the utility of the acute physiology and chronic health evaluation (APACHE) II score measured in the emergency department for predicting the neurological prognosis. Methods: From April 2012 to August 2014, we conducted a retrospective study of patients who had ingested glufosinate. The outcome of the patients at discharge was defined by the Cerebral Performance Category Score (CPC). The patients were divided into a good prognosis group (CPC 1, 2) and a poor prognosis group (CPC 3, 4, 5), after which the APACHE II scores were compared. The Hosmer-Lemeshow test and the area under the receiver operating characteristic (ROC) curve from patients determined calibration and discrimination. Results: A total of 76 patients were enrolled (good prognosis group: 67 vs poor prognosis group: 9). The cut-off value for the APACHE II score was 12 and the area under the curve value was 0.891. The Hosmer and Lemeshow C statistic x2 was 7.414 (p=0.387), indicating good calibration for APACHE II. Conclusion: The APACHE II score is useful at predicting the neurological prognosis of patients who have ingested glufosinate.

Validation of a Palliative Prognostic Index to Predict Life Expectancy for Terminally Ill Cancer Patients in a Hospice Consultation Setting in Taiwan

  • Cheng, Wei-Hong;Kao, Chen-Yi;Hung, Yu-Shin;Su, Po-Jung;Hsieh, Chia-Hsun;Chen, Jen-Shi;Wang, Hung-Ming;Chou, Wen-Chi
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.6
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    • pp.2861-2866
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    • 2012
  • Background: The aim of our study was to assess the practical utility of the palliative prognostic index (PPI) as a prognostic tool used by nurse specialists in a hospice consultation setting in Taiwan. Methods: In total, 623 terminal cancer patients under hospice consultation care from one medical center in northern Taiwan were enrolled between January 1 and June 30, 2011. PPI was assessed by a nurse specialist at first hospice consultation and patients categorized into groups by prognosis (good, intermediate, poor). Patient survival was analyzed retrospectively to determine significance of between-group differences. Results: By PPI sum score, 37.2% of patients were in the good prognosis group, 18% in the intermediate prognosis group and 44.8% in the poor prognosis group. The death rates were 56%, 81.2% and 89.6% and median survivals were 76, 18 and 7 days, respectively. The hazard ratio was 0.19 (95% confidence interval [CI] 0.10-0.24, p<0.001) for the poor versus good prognosis group and 0.54 (95% CI 0.43-0.69, p<0.001) for the poor versus intermediate prognosis group. The sensitivity and specificity for the poor prognosis group was 66% and 71%; the positive predictive value and negative predictive value were 81% and 52%, respectively, to predict patient death within 21 days (area under the curve of the receiver operating characteristic was 0.68). Conclusions: Assessment by PPI can accurately predict survival of terminal cancer patients receiving hospice consultation care. PPI is a simple tool and can be administered by nurse members of hospice consultation teams.

Prognosis in the Patients with Prolonged Extracorporeal Membrane Oxygenation

  • Kim, Tae-Hun;Lim, Cheong;Park, Il;Kim, Dong-Jin;Jung, Yo-Chun;Park, Kay-Hyun
    • Journal of Chest Surgery
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    • v.45 no.4
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    • pp.236-241
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    • 2012
  • Background: Prolonged usage of extracorporeal membrane oxygenation (ECMO) may induce multi-organ failure. This study is aimed to evaluate prognostic factors in the patients with ECMO. Also, the prognosis of ECMO with Kidney Injury Network Scoring system is studied. Materials and Methods: From May 2005 to July 2011, 172 cases of ECMO were performed. The cases of perioperative use of ECMO were excluded. Renal failure patient and younger than 15 years old one were also excluded. As a result, 26 cases were enrolled in this study. Male patients were 15 (57.7%), and mean age was $56.57{\pm}17.03$ years old. Demographic data, ECMO parameters, weaning from ECMO, and application of continuous renal replacement therapy are collected and Acute Kidney Injury Network (AKIN) scores were evaluated just before ECMO and day 1, day 2 during application of ECMO. Results: Venoarterial ECMO was applied in 22 cases (84.6%). The reasons for applications of ECMO were cardiac origin in 21 (80.8%), acute respiratory distress syndrome in 4, and septic shock in 1 case. Successful weaning from ECMO was achieved in 15 cases (57.7%), and survival discharge rate was 9 cases (34.6%). Mean duration of application of ECMO was $111.39{\pm}54.06$ hours. In univariate analysis, myocarditis was independent risk factors on weaning failure. Using the receiver operating characteristic curve, level of hemoglobin on 24 hours after ECMO, and base excess on 48 hours after ECMO were showed more than 0.7. AKIN score was not matched the prognosis of the patients with ECMO. Conclusion: In our study, the prognosis of the patients with myocarditis was poor. Hemoglobin level at first 24 hours, and degree of acidosis at 48 hours were useful methods in relating with prognosis of ECMO. AKIN scoring system was not related with the prognosis of the patients. Further study for prognosis and organ injury during application ECMO may be needed.

Distinctions Between Clinicopathological Factors and Prognosis of Alpha-fetoprotein Negative and Positive Hepatocelluar Carcinoma Patients

  • Xu, Jia;Liu, Chang;Zhou, Lei;Tian, Feng;Tai, Ming-Hui;Wei, Ji-Chao;Qu, Kai;Meng, Fan-Di;Zhang, Ling-Qiang;Wang, Zhi-Xin;Zhang, Jing-Yao;Chang, Hu-Lin;Liu, Si-Nan;Xu, Xin-Shen;Song, Yan-Zhou;Liu, Jun;Zhang, Peng
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.2
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    • pp.559-562
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    • 2012
  • Serum alpha-fetoprotein (AFP) is a significant marker for clinical diagnosis and prognosis evaluation in hepatocellular carcinoma (HCC) patients. However, some proportion of liver cancer patients are AFP-negative (AFP ${\leq}$20ng/ml). In order to study the differences between clinicopathological factors and prognosis of alpha-fetoprotein negative and positive patients, a total of 114 cases (41 AFP-negative and 73 AFP-positive) were selected for our research. By systematically statistical analysis, the results demonstrated that compared with AFP-negative patients, AFP-positive examples were more likely to feature cirrhosis nodules, non-complete neoplasm capsules, and a poor Edmondson-steiner grade. Furthermore, AFP-negative patients demonstrated a favorable long-term prognosis. By univariate analysis and multivariate analysis with Cox's proportional hazards model, multiple tumors were found to be independent risk factors for worse survival of AFP negative patients; however, less tumor-free margins, multiple tumors and Edmondson-steiner grades III/IV, proved to be independent risk factors leading to a poor prognosis of AFP positive cases. Finally, we can infer that high levels of AFP signify a highly malignant tumor and unfavorable prognosis.

CD4+, IL17 and Foxp3 Expression in Different pTNM Stages of Operable Non-small Cell Lung Cancer and Effects on Disease Prognosis

  • Zhang, Guo-Qing;Han, Feng;Fang, Xin-Zhi;Ma, Xiao-Mei
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3955-3960
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    • 2012
  • Objective: To investigate the effects of $CD4^+$, IL17 and Foxp3 expression on prognosis of operable non-small cell lung cancer (NSCLC) with different pTNM stages. Methods: Expression of $CD4^+$, IL17 and Foxp3 in 102 cases of NSCLC tissues and adjacent cancer tissues was detected by immunohistochemistry and associations with prognosis with different pTNM stages were analyzed. The Chi-square test was used to compare count data. Survival differences were evaluated by Kaplan-Meier single factor analysis and the COX regression model was used to analyze the relationship between influential factors and the disease prognosis. The significance level was ${\alpha}$=0.05. Results: Expression of CD4, IL-17 and Foxp3 significantly varied in different pTNM stages of NSCLC tissues (P < 0.05). The same was true for CD4 expression (P < 0.05). The median survival time (MST) in the positive CD4 expression group was evidently higher than that in the negative group (25.8/23.9 months). Compared with stage III, the MST difference of stages I and II in the positive CD4 expression group were statistically significant (P < 0.05). The MST in positive IL-17 and Foxp3 expression groups was obviously lower than that in the corresponding negative group (P < 0.05) (25.6/35.1 months and 24/35.3 months, respectively). There was a significant difference of MST between any two of three stages of positive IL-17 expression group (P < 0.05), and it was the same with positive Foxp3 expression group. TNM stage, negative CD4 expression, and positive IL-17 and Foxp3 expression were the main risk factors for the prognosis of NSCLC. Conclusion: Surgical prognosis of NSCLC can be better assessed by the combination of clinical staging and expression of IL17 and Foxp3.

Relation between Serum S100β and Severity and Prognosis in Traumatic Brain Injury (외상성 뇌손상 환자에 있어서 S100β의 혈중 농도와 뇌손상의 정도 및 예후의 관계)

  • Kim, Oh Hyun;Lee, Kang Hyun;Yoon, Kap Jun;Park, Kyung Hye;Jang, Yong Su;Kim, Hyun;Hwang, Sung Oh
    • Journal of Trauma and Injury
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    • v.20 no.2
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    • pp.138-143
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    • 2007
  • Purpose: $S100{\beta}$, a marker of traumatic brain injury (TBI), has been increasingly focused upon during recent years. $S100{\beta}$, is easily measured not only in cerebrospinal fluid (CSF) but also in serum. After TBI, serum S 10019, has been found to be increased at an early stage. The purpose of this study was to evaluate the clinical correlations between serum $S100{\beta}$, and neurologic outcome, and severity in traumatic brain injury. Methods: From August 2006 to October 2006, we made a protocol and studied prospectively 42 patients who visited the emergency room with TBI. Venous blood samples for $S100{\beta}$, protein were taken within six hours after TBI and vital signs, as well as the Glasgow Coma Scale (GCS), were recorded. The final diagnosis and the severity were evaluated using the Abbreviated Injury Score (AIS), and the prognosis of the patients was evaluated using the Glasgow Outcome Score (GOS). Results: Thirty-eight patients showed a favorable prognosis (discharge, recovery, transfer), and four showed an unfavorable prognosis. Serum $S100{\beta}$, was higher in patients with an unfavorable prognosis than in patients with a favorable prognosis, and a significant difference existed between the two groups ($0.74{\pm}1.50\;{\mu}g/L$ vs $7.62{\pm}6.53\;{\mu}g/L$ P=0.002). A negative correlation existed between serum $S100{\beta}$, and the Revised Traumatic Score (R2=-0.34, P=0.03), and a positive correlation existed between serum $S100{\beta}$, and the Injury Severity Score (R2=0.33, P=0.03). Furthermore, the correlation between serum $S100{\beta}$, and the initial GCS and the GCS 24 hours after admission to the ER were negative (R2=-0.62, P<0.001; R2=-0.47, P=0.005). Regarding the GOS, the mean serum concentration of $S100{\beta}$, was $7.62\;{\ss}{\partial}/L$ (SD=${\pm}6.53$) in the expired patients, $1.15\;{\mu}g/L$ in the mildly disable patient, and $0.727\;{\mu}g/L$ (SD=${\pm}0.73$) in the recovered patients. These differences are statistically significant (p<0.001). Conclusion: In traumatic brain injury, a higher level of serum concentration of $S100{\beta}$, has a poor prognosis for neurologic outcome.

A CLINCO-RADIOGRAPHIC STUDY ON EFFECT OF HAP USED AFTER ODONTOGENIC CYST ENUCLEATION (치성 낭종 적출술후 사용된 HAP의 효과에 대한 임상적 방사선학적 연구)

  • Rim, Jae-Seok;Kim, Seong-Mun;Ryu, Jae-Jun;Kim, Hui-Jong;Lee, Sang-Eun;Cho, Min
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.12 no.3
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    • pp.57-62
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    • 1990
  • Many alloplastic materials have been used as the bony substitute in large bony defects caused by fracture, periodontitis, & cyst, etc. Nowadays Hydroxyapatite(HAP) is the most usable material as the bony substitute. The reasonable properties of HAP are nontoxic, biocompatible to host tissues & have osteoconductivity. Other bioceramic materials are recommended as the bony substitute with high success rate. We have studied the clinical use of HAP as the bony substitute in the defected area caused by cyst. The reasonalbe & successful results are obtained. The results were as followed. 1. Better prognosis was obtained in the case of HAP & bone mixed graft than HAP graft only. And the best prognosis was obtained in the case of iliac bone graft. 2. Better prognosis was obtained in Mx. than in Mn. 3. It seems that the soft tissue ingrowth into the HAP granule play an important role in the success of the HAP graft. 4. Though the flap covering the HAP granules was perforated, the relative good prognosis was obtained by re-suturing the perforeated site.

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An Event-Driven Failure Analysis System for Real-Time Prognosis (실시간 고장 예방을 위한 이벤트 기반 결함원인분석 시스템)

  • Lee, Yang Ji;Kim, Duck Young;Hwang, Min Soon;Cheong, Young Soo
    • Korean Journal of Computational Design and Engineering
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    • v.18 no.4
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    • pp.250-257
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    • 2013
  • This paper introduces a failure analysis procedure that underpins real-time fault prognosis. In the previous study, we developed a systematic eventization procedure which makes it possible to reduce the original data size into a manageable one in the form of event logs and eventually to extract failure patterns efficiently from the reduced data. Failure patterns are then extracted in the form of event sequences by sequence-mining algorithms, (e.g. FP-Tree algorithm). Extracted patterns are stored in a failure pattern library, and eventually, we use the stored failure pattern information to predict potential failures. The two practical case studies (marine diesel engine and SIRIUS-II car engine) provide empirical support for the performance of the proposed failure analysis procedure. This procedure can be easily extended for wide application fields of failure analysis such as vehicle and machine diagnostics. Furthermore, it can be applied to human health monitoring & prognosis, so that human body signals could be efficiently analyzed.

Postoperative Analysis of Prognostic Factors of Thymoma (흉선종의 술후 예후판정요인의 분석)

  • 박창권
    • Journal of Chest Surgery
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    • v.27 no.9
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    • pp.785-792
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    • 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].

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Tandem High-dose Chemotherapy and Autologous Stem Cell Transplantation in Children with Brain Tumors : Review of Single Center Experience

  • Sung, Ki Woong;Lim, Do Hoon;Shin, Hyung Jin
    • Journal of Korean Neurosurgical Society
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    • v.61 no.3
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    • pp.393-401
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    • 2018
  • The prognosis of brain tumors in children has improved for last a few decades. However, the prognosis remains dismal in patients with recurrent brain tumors. The outcome for infants and young children in whom the use of radiotherapy (RT) is very limited because of unacceptable long-term adverse effect of RT remains poor. The prognosis is also not satisfactory when a large residual tumor remains after surgery or when leptomeningeal seeding is present at diagnosis. In this context, a strategy using high-dose chemotherapy and autologous stem cell transplantation (HDCT/auto-SCT) has been explored to improve the prognosis of recurrent or high-risk brain tumors. This strategy is based on the hypothesis that chemotherapy dose escalation might result in improvement in survival rates. Recently, the efficacy of tandem HDCT/auto-SCT has been evaluated in further improving the outcome. This strategy is based on the hypothesis that further dose escalation might result in further improvement in survival rates. At present, the number of studies employing tandem HDCT/auto-SCT for brain tumors is limited. However, results of these pilot studies suggest that tandem HDCT/auto-SCT may further improve the outcome. In this review, we will summarize our single center experience with tandem HDCT/auto-SCT for recurrent or high-risk brain tumors.