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At least 667 records · Page 37Linked to original sources
PubMed2006

[Estimation of life expectancy for selecting surgical procedure and predicting prognosis of extradural spinal metastases].

BACKGROUND & OBJECTIVE: Clinically, whether and how to make a surgical interventional decision for the patients with spinal metastases is still controversial. Life expectancy is a significant determinant in the selection of surgical procedure for spinal metastases. This study was to evaluate Tomita and Tokuhashi scoring systems in selecting surgical procedure and predicting prognosis of extradural spinal metastases. METHODS: A total of 169 patients with spinal metastases, treated in the Spine Unit of Aarhus University Hospital, Denmark, from Jan. 2001 to Apr. 2004, were enrolled. The life expectancy was scored according to both Tomita system and Tokuhashi system before operation, the spinal metastases were classified according to Tomita system, and the patients underwent surgery accordingly. Follow-up was done 6, 12, and 24 months after operation. The precise of Tomita system and Tokuhashi system in estimating "death within 3 months", "death within 6 months", and "death within 12 months" was compared using Receiver Operating Characteristic curves (ROC curves). The mean survival time of the patients was calculated by Kaplan-Meier method. RESULTS: ROC curves of "death within 3 months", "death within 6 months", and "death within 12 months" showed no significant difference between Tomita score and Tokuhashi score in each group (P = 0.16, P = 0.47, and P = 0.38, respectively). Kaplan-Meier survival curves showed that Tomita system overestimated the prognosis in scores from 4 to 7, and Tokuhashi system underestimated the prognosis in scores from 0 to 8. CONCLUSIONS: Both Tomita and Tokuhashi scoring systems could be used to predict prognosis of spinal metastases after operation. Tokuhashi scoring system can predict early death more accurately, which can be used to avoid major operation for these patients.

Adult↗
PubMedDate not supplied

[Use of magnetic resonance imaging in the diagnosis and prognosis of multiple sclerosis].

Multiple sclerosis is an autoimmune disease characterized by demyelination and axonal loss. Conventional magnetic resonance imaging allows the demonstration of spatial and temporal dissemination of multiple sclerosis lesions earlier than is possible from clinical assessments. A variety of conventional magnetic resonance imaging protocols, in conjunction with clinical assessment, are now routinely used to increase the accuracy of diagnosis and long-term prognosis of multiple sclerosis. T2-weighted hyperintense lesions are related primarily to increased water content and thus cannot distinguish between inflammation, edema, demyelination, Wallerian degeneration, and axonal loss, whereas the contrast gadolinium-enhanced lesions on T1-weighted images reflect increased blood-brain barrier permeability associated with active inflammatory activity. Conventional magnetic resonance imaging metrics are not sufficiently sensitive to detect invisible brain damage in the normal appearing brain tissue, and they do not show a reliable correlation with clinical measures of disability. However, numerous studies showed that they can improve accuracy in the diagnosis and prognosis of multiple sclerosis. Recently, non-conventional magnetic resonance imaging techniques have been introduced to increase the accuracy of diagnosis and prognosis of multiple sclerosis. Several studies have used brain atrophy, T1-hypointense lesion volume, magnetization transfer imaging, diffusion-weighted imaging and magnetic resonance spectroscopy to test whether the extent and severity of tissue loss in lesions and in normal appearing gray and white matter at the time of clinically isolated syndrome may have diagnostic and prognostic value. These magnetic resonance imaging techniques represent a powerful tool to non-invasively study different pathological substrates of lesions and microscopic tissue changes. Additional short- and long-term prospective studies are requested to establish their value in the diagnosis and prognosis of multiple sclerosis.

Brain↗
PubMed2007

Cell cycle regulating proteins p21 and p27 in prognosis of oral squamous cell carcinomas.

Cyclin-dependent kinases (CDKs) and cyclin-dependent kinase inhibitors (CDKIs), such as p21 and p27, exert a direct control on the cell cycle. p21 and p27 are negative regulators of cyclin-dependent kinases and in this function they are negative check-point regulators of the cell cycle. We therefore aimed to evaluate p21 and p27 expression in oral squamous cell carcinomas (OSSC) to determine the value as a prognostic marker. One hundred and ninety-two patients with histologically proven, surgically treated squamous cell carcinoma of the oral cavity were eligible for the study and investigated for the expression of p21 and p27 by means of tissue microarrays (TMAs). Immunohistochemical screening under identical condition were carried out with antibodies against p21 and p27. Correlations between clinical features and the expression of the respective antibodies were evaluated statistically by Kaplan-Meier curves, log-rank and chi(2) tests. The expression of p21 correlated significantly with an increased prognosis in the log-rang test (p=0.01). No significant correlation was found between the expression of p27 and the overall survival rate. In multivariate Cox analysis, p27 was indicated as independent predictor of survival prognosis in the subgroup of nodal positive carcinomas, p27 positive tumours showed a significantly better survival prognosis (p=0.03). p21 and p27 in carcinoma of oral cavity seem to be predictive parameter in regulation and prognosis of squamous cell carcinomas. A p21 negative subgroup of OSCC may benefit from additional radio or radiochemotherapy.

Adult↗
PubMed1991

Flash visual-evoked potentials and flash electroretinography in the preoperative visual prognosis of eyes with cataracts.

This study evaluated the reliability of flash visual-evoked potentials and flash electroretinography in the prognosis of postoperative visual acuity after cataract extraction. We tested 94 patients with cataract in whom the preoperative visual acuity ranged from light perception to 3/10. On the basis of the electrophysiologic tests, we formulated three types of preoperative visual prognosis: high, intermediate, and poor. To assess the postoperative visual acuity, all subjects were followed for at least three months after cataract extraction. Visual acuity was subdivided in three arbitrary classes: less than or equal to 1/10, between 2/10 and 5/10, and between 6/10 and 10/10. Finally, we evaluated the reliability of our preoperative prognosis. Statistical analysis of our results (using the chi-square test) showed our predictions were highly significant for the total sample, revealing a strict correlation between our prognosis and the final visual acuity.

Adult↗
PubMed1991

[Relation of tumor size, lymph node status and prognosis in breast cancer].

Tumor size and the extent of axillary lymph node involvement are the two most important prognostic factors for breast cancer, but their relation is not clear. Data on 2189 cases of radical surgery from 1956-1985 showed a linear relation between tumor size and percentage of cases with positive lymph node involvement. A negative relation was noted between tumor size, the extent of lymph node involvement and prognosis. There was a significance difference in survival rate between one group, two group or more lymph nodes involve. The worst prognosis was seen in those patients with level 3 lymph nodes involve. Tumor size and lymph node status were found to be independent but additive prognostic indicators. If there was no lymph node involvement, the survival rate was decreased because of tumor size. In cases of 1-3 and 4-6 lymph nodes involved, the survival rate was not different when tumor size was less than 5 cm, but there was a significant difference when tumor size large than 5 cm. In cases of more than 7 nodes involved, the survival rate decreased regardless of tumor size. Lymph node metastasis was more important than tumor size in prognosis. The relation of different TNM combination with prognosis was investigated, and the importance of the treatment of internal mammary lymph node in breast cancer was emphasized.

Breast Neoplasms↗
PubMed1991

[Short-term and long-term prognosis of alcohol dependence: a follow-up study of Danshu-Kai (Alcohol Abstinence Club) members].

595 alcohol dependent cases had been enrolled in the Mie Danshu-Shinsei-Kai (The Alcohol Abstinence Club in Mie) since its establishment in Jan. 1972 by Oct. 1984 when this study started. 163 cases of them, who had been practising abstinence at least for 6 months when the first observation was made in Oct. 1984, were selected for the follow-up study. Relapses in these cases were checked twice, 2.5 years later in 1987 and 5 years later in 1989. The results obtained were summarized as follows: It was observed that 64% of those who had practised abstinence for 2 years sustained abstinence successfully at least for the next 5 years, and 74% of those who had kept non-drinking for 3 years continued abstinence for the next 5 years. Those who had practised abstinence for shorter than 2 years just before the first observation showed that the closer the term of abstinence approached to 2 years, the more sharply the following 5 year abstinence rate increased. It was noticed among those who had kept abstinence for longer than 3 years that the longer the abstinence period became, the more slowly the next 5 year abstinence rate increased, eventually reaching to as high as 81%. A turning point from sharp increase to slow increase was found in between 2 and 3 years of abstinence. From the observation mentioned above, the period of abstinence can be classified into three categories in view of prognosis: shorter than 2 years, 2 to 3 years, and longer than 3 years, which stand for "unstable," "intermediate," and "stable" period respectively. The intermediate period is considered to be critically important in terms of prognosis and treatment of alcohol dependence. It would be reasonable therefore to prospect prognosis in the short term or in the long term basis according to the period of abstinence. The object and contents of treatment might become different before and after the intermediate period. The major factors which affect the prognosis can be classified into 5 categories; 1) the degree of insight into his or her drinking, 2) biological condition, 3) financial problems like "debt," 4) tendency toward multiple addiction, and 5) problems of "co-dependency." It was noticed that although all of these factors remained unresolved in most cases of unstable period, factors 1), 2) and 3) were mostly successfully resolved in a stable period. Factors 4) and 5) are found in not rarely even in a stable period.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1991

[Clinical course and prognosis in SLE patients with pulmonary hypertension: a comparative study with primary pulmonary hypertension].

Recently pulmonary hypertension (PH) has been recognized as one of life threatening complications which determine the prognosis of patients with systemic lupus erythematosus (SLE). Clinical aspects and pathology in patients with SLE complicated by PH (SLE-PH) have been reported to have a close similarity to those in patients with primary pulmonary hypertension (PPH), the prognosis of which is very poor in general. However, the long-term prognosis for patients with SLE-PH is not clear yet. Mainly because of some technical limitations for determining the severity of the PH, long-term follow-up studies have been inconclusive. In this study, 7 patients with SLE-PH and 6 patients with PPH were studied by using two-dimensional echocardiography. The interventricular septal curvature (R) was measured from the parasternal short axis view and the reciprocal value (1/R) was applied as a severity index of the PH. In 4 patients with SLE-PH and 6 with PPH, pulmonary arterial pressure was measured by cardiac catheterization concomitantly. There were no significant differences in 1/R and pulmonary arterial pressure between the two groups when PH was diagnosed for the first time. In the PPH group, the mean period of follow-up study was 25.3 months and all of the patients died during that period. In SLE-PH group, the mean period of follow-up study was 50.6 months, and only 3 patients (43%) died during that period. No patients in the PPH group showed improvement in 1/R, but 3 patients with SLE-PH improved in 1/R during a long follow-up period (60, 96 and 103 months respectively). Thus, the prognosis for SLE-PH was better than that for PPH, and there were some differences in the course and worsening behavior of PH in SLE-PH compared with that in PPH during the long-term follow-up study with reference to the echocardiographic investigation using 1/R value.

Adolescent↗
PubMed1991

[The ultrastructural factors of the individual prognosis in rectal cancer in patients following radical surgical treatment].

Multifactorial analysis of the prognostic diagnosis of 39 main clinical, morphological and ultrastructural traits in 109 patients with rectum carcinoma is performed on the basis of computer EC-1045/230 program and algorithmic complex. The optimal complex of the traits is established possessing the maximum information value for prognosis of the 2-, 3- and 5-year survival of patients with this tumour. Three rules are formed for the individual prognosis of a favourable and unfavourable issue of the disease after the radical surgery. The value (in %) of these rules for the prognosis was determined: 79,86 and 92% for the 2-, 3- and 5-year survival, respectively. This is the precision with which one or another prognosis can be predicted.

Adenocarcinoma↗
PubMed1991

[Treatment and prognosis of giant cell tumor in the sacrum--study of Bone Tumor Registry in Japan].

The prognosis of giant cell tumors arising in the sacrum is difficult to ascertain. Because of the low incidence in Japan there are scanty statistics. We selected 14 cases from the Bone Tumor Registry in Japan. Questionnaires were sent to hospitals which had submitted cases, regarding Enneking's staging, surgical approach, surgical procedure, radiotherapy, chemotherapy, complications and prognosis of this tumor. The results of the questionnaire show that surgery alone gives better results than combined surgery and radiotherapy. Good prognosis called for surgery alone. Curettage resulted in no evidence of disease (NED) in four cases. Bad prognosis called for combined surgery, radiotherapy and chemotherapy. If we surmise from the biological behavior of the giant cell tumor, that the tumor mass extends out extraosseously en-bloc excision with nerve roots is indicated. Extensive curettage will be adequate if the tumor is confined intraosseously. Radiotherapy should not be selected except for inoperative cases.

Adolescent↗
PubMed1991

Juvenile chronic arthritis: classification, differential diagnosis and prognosis.

Although the nomenclature and classification of juvenile chronic polyarthritis is not uniform, the division into systemic, polyarticular and pauciarticular forms is generally accepted. The characteristic symptoms, the division into subgroups according to age, clinical course and serology as well as the differential diagnostic considerations pertaining to each form are described. Most of the children with the pauciarticular form have a good prognosis; however, in 15% of these cases the disease changes into polyarticular JCA. The systemic form has the least favorable prognosis, while the prognosis of polyarthritic JCA depends upon the presence of the IgM-Rheuma factor. In seronegative patients the prognosis also depends on the age at onset of the disease and on the quality of the treatment of the joints during the acute phases.

Adolescent↗
PubMed1990

[Evaluation of short term prognosis of bronchopulmonary dysplasia].

Assessing the short-term prognosis of bronchopulmonary dysplasia (BPD) (duration of mechanical ventilation, of O2 therapy, and risk of death) is often uncertain at the early stages of the disease. From a retrospective study of 124 cases of BPD, we made a search for factors of poor prognosis which could be recognized early. Among the 124 BPD, 56 (45%) had a severe disease (mechanical ventilation for greater than 3 months and/or O2 for greater than 4 months), and 24 of them (20%) died. Two types of factors have been identified as linked to a poor prognosis (risk of evolution towards a severe disease in a proportion of 70 to 90%): some respiratory events (refractory hypoxemia, recurrent pneumothorax, interstitial emphysema, no improvement of hyaline membrane disease at 3-4 days of life in babies less than 32 weeks gestational age) and hemodynamic failures (cardiac failure due to persistent ductus arteriosus, collapse following infection or anoxia). We have also defined different values of a ventilatory index (I = mean airway pressure x FiO2) which allows the neonatologists to estimate the final prognosis of BPD during the first two months of life.

Airway Resistance↗
PubMed1990

[Smooth muscle tumors of gastrointestinal tract: a study on correlation between pathology and prognosis and histogenesis].

Seventy three cases of gastrointestinal smooth muscle tumors (GISMT) were collected and their correlation between pathology and prognosis and their histogenesis was studied, microscopically, the following parameters were evaluated: 1. cellularity; 2. grade of differentiation; 3. nuclear pleomorphism; 4. mitotic rate/10 HPF. All cases were followed up, but from only 47 information was elicited. To study the histogenesis, the technique of immunohistochemical staining to desmin, S-100 protein was used in all the cases and five were examined by EM. The results showed that the mitotic rate was the most important and reliable pathological parameter used to differentiate between benign and malignant tumors, and to evaluate the prognosis of a given tumor; in the cases which showed active mitosis, tumor size was important to evaluate the prognosis; the other histologic parameters of less, if any, significance in evaluation of prognosis. The authors supported the hypothesis that GISMT might mainly be derived from primary mesenchymal cells potentiated with smooth muscle cells differentiation. The hypothesis that GISMT are derived from nerve tissue waits for further evidence.

Adolescent↗
PubMed1990

[Factors influencing prognosis of tongue cancer: a retrospective study of 260 cases].

This paper is a retrospective study of prognostic factors involved the tongue cancers. The 3 and 5 year survival rates of the tongue cancer were 63.77% 61.2%, respectively. I. The prognosis in females was poorer than that of males II. The prognosis of oral tongue cancer was better than oropharyngeal tongue cancer. III. The larger the cancer, the poorer the prognosis. IV. Node involvement was an important factor influencing survival rate. V. Immediate repair of defect did not influence survival rate. VI. The main cause of death was recurrence of the primary site, which generally occurred within 3 years postoperatively. The authors suggest that I. The depth of the tumours infiltration should be an index for the evaluation of prognosis. II. The neck dissection, either functional or radical, should be carried out as a routine. III. The management of mandible will be determined according to the tumor infiltration. IV. immediate reconstruction is recommended.

Adolescent↗
PubMed1990

[The prognosis of convulsions in the newborn--the place of EEG in comparison with echoencephalography].

The routine-EEG in premature and term infants with cerebral seizures and its additional information are discussed in comparison to clinical and morphological findings. The clinical, electroencephalographic and echoencephalographic data to all 29 neonates that were treated during a four years period are presented. Three of those infants died, eight of them showed pathological results during developmental and neurological follow-up. EEG's were performed during or short by after seizures. A correlation could be shown between poor prognosis and suppression of background activity consisting in inactivity, burst-suppression pattern or moderate suppression. By contrast a normal or mildly suppressed EEG correlated with good longterm prognosis. Paroxysmal discharges in the EEG were helpful in diagnosing seizures and also for prognosis of cerebral convulsions later on. The echoencephalographic findings especially mild intracranial hemorrhages and increased periventricular echogenicity had less prognostic value. The echoencephalographic follow-up showed ventricular dilatation (e vacuo) in children who later on had developmental and neurological impairment. For assessment of prognosis in premature and term babies with cerebral seizures imaging procedures (echoencephalography and CT-scan) as well as electroencephalography are of mutual importance.

Echoencephalography↗
PubMedDate not supplied

[Immunologic tests in the prognosis of solid malignant tumors].

Survival at 6, 12 and 24 months was studied in relation to the immunological findings before treatment and its variations after treatment in 600 patient and its variations after treatment in 600 patients with solid malignant tumours. Any change in any of these tests is a sign of poor prognosis proportional to the degree of this change. The most precise prognosis is given by an association of these tests. These two year survival rate for tumours without apparent spread was 87% if the tests were normal, 43% if one group of tests was disturbed and 11% if two groups of tests were abnormal. With local or regional spread, the survival was 52% in cases with normal tests, 12% if one group was disturbed, and 4% if both groups of tests were abnormal. With multiple metastases, the survival rates were respectively 24%, 4% and 0%. Thus the prognosis is less unfavourable for a tumour with general spread and normal immunological tests (24%) than for a localised tumour with a disturbance of two groups of immunological tests (11%). These immunological tests carried out before any treatment are thus very valuable in prognosis, independant of the apparent extension of the tumour. This indications are important in deciding on treatment.

Follow-Up Studies↗
PubMed1990

[Study on prognosis of threatened abortion assessed by multivariate analysis].

The serum concentrations of various hormones which included hPL, progesterone(P), estradiol(E2) and 17 alpha-hydroxyprogesterone (17P) in serum, and hCG in urine were measured simultaneously in patients with threatened abortion to evaluate the prognosis. Ultrasound scanning was also undertaken. One hundred and thirty-six patients at 5 to 8 weeks of gestation were divided into two groups retrospectively. Group A consisted of 99 patients with a good prognosis and group B consisted of 37 patients who aborted spontaneously. The mean concentrations of hormones, and ultrasound findings (GS, CRL and FHM) were not significantly different in both groups at 5 weeks. An attempt was made to apply the data to the computation in multivariate analysis. By discriminant analysis, 100% reliability was achieved in separating the two groups according to hormone levels only at this stage of pregnancy. At 6 weeks, the hCG, P and E2 values were statistically higher in group A than B. Because of the overlapping of the data, principal component analysis was attempted. Two groups were roughly separated. The values for factor loading indicated that GS, CRL and 17P effective in making the separation possible. At 7 and 8 weeks of gestation, the mean concentrations of hCG, hPL, P and E2 were significantly higher in A than B. The factor loading values indicated that ultrasound findings were essential in separating into two groups. These results suggested that hormonal analysis may be useful in assessing the prognosis in threatened abortion in the early stage of gestation (5 and 6 weeks), while ultrasound findings make an accurate prediction for the prognosis possible after 7 weeks of gestation.

Abortion, Threatened↗
PubMed1990

[The treatment, course and prognosis of sarcoidosis cases].

Sarcoidosis is a disorder with a highly variable prognosis. Although spontaneous cure is common, a small number of patients become progressively worse. In this study, we analysed 433 patients with sarcoidosis who presented to our institute. Twenty-seven patients (6.2%) of them developed serious morbidity. We studied the clinical course, prognosis and use of steroid therapy in those 27 patients. Eight (29.6%) of the 27 patients developed severe disability during their clinical course, in spite of their mild clinical symptoms and findings at first presentation. Therefore, clinical symptoms and findings, such as ocular disorders, ECG abnormalities, negative reaction to PPD, serum ACE values and lymphocyte count are not always useful markers for the prognosis of sarcoidosis. The relationship between maximum serum ACE values during the course and the duration of the active phase was investigated in 93 patients who were followed throughout their course of the disease. Improvement occurred more often within 5 years in the patients with DR5(+) HLA class II or DRw53(-) compared to patients with DR5(-) or DRw53(+). Using various combinations of specific antigens, the following 5 groups revealed good prognoses, frequently improving within 5 years, 1) DR5(+) and DR4(-), 2) DR5(+) and DRw53(-), 3) DR5(+), DR4(-) and DR8(-), 4) DR5(+), DR4(-) and DR9(-), 5) DR5(+), DR4(-), DR8(-) and DR9(-). HLA class II antigens may also play an important role in the prognosis of sarcoidosis. Since relapses almost always occurred after cessation of steroid therapy, the duration of treatment should be as long as possible and the dosage should also be tapered carefully.

Adolescent↗
PubMed1988

[Factors influencing on the prognosis in breast cancer].

TNM classification, tumor size, lymph node metastasis, histological type of primary tumor, ER status and biological tumor markers have been recognized as prognostic factors in breast cancer. The 673 breast cancer patients undergoing radical mastectomy at this department were analyzed for TNM classification influencing on the postoperative prognosis. Five-and ten- year survival rates were 93% and 89% in stage I, 83.9% and 75.5% in stage II, 67.3% and 60% in stage III. The most common histological type, namely, invasive ductal carcinoma, of primary breast cancer was classified into three types by Japan Mammary Cancer Society. The first type was papillotubular carcinoma, the second solid-tubular carcinoma, and the third scirrhous carcinoma. The prognosis of papillotubular carcinoma was best. Many investigators reported that the prognosis of ER positive breast cancer was good. But in the latest report, the opposite result is obtained. More study is necessary to evaluate the prognostic value of ER. The most common biological tumor markers were CEA, LDH and ALP. The CEA was the best prognosis-factor in biological tumor markers.

Adenocarcinoma, Scirrhous↗