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PubMed1975

Prognosis of chronic glomerulonephritis in adult patients estimated on the basis of the Markov process.

The prognosis of chronic glomerulonephritis based on renal function was assessed using a statistical technique of the Markov process, where the absorbing state was assumed to be an uremic state, 194 adult patients with different types of disease were subjected to study. The 15 min value obtained in the intravenous PSP excretion test was divided into five states; SI (greater than 34%, normal), SII(25-34), SIII(15-24), SIV(5-14) and SV (greater than 5, uremic). The rates of SV with time were calculated with respect to several clinical characteristics. The prognosis of the patients with hypertension, distinct proteinuria and hematuria, or cellular cylindruria appeared to be relatively poor. The estimated number of years from each state to SV were also calculated. The results were similar to those already reported and gave us more exact information about the prognosis.

Adult↗
PubMed2000

[Expression of bcl-2 gene in relation to histologic type and grade, and prognosis of breast cancer].

OBJECTIVE: To ascertain whether bcl-2 gene expression is related to histologic type and grade, and prognosis of breast cancer and its prognosis. METHODS: Expression of bcl-2 protein was examined immunohistochemically in 85 cases of breast cancer patients with > or = 5 years of follow-up. RESULTS: Expression of bcl-2 protein was detectable in 68.2% of breast cancer specimens. It was not related to histologic type, but to histologic grade of the cancer. In grade I, bcl-2 was positive in 95.2% of the specimens which was significantly higher than that in grade II (64.6%) and grade III (25.0%)(P < 0.01). The positive rate of bcl-2 expression was 75.9% in patients who survived > or = 5 years as compared to that (51.6%) in patients survived < 5 years (P < 0.05). CONCLUSION: Expression of bcl-2 occurs more frequently in well differentiated breast cancer. It is associated with better prognosis of the patients.

Adult↗
PubMedDate not supplied

[Clinical course and long-term prognosis in patients with recurrent myocardial infarction].

UNLABELLED: Retrospective study was based on analysis of 881 patients treated in our ward in 1992-1996. Their fate was estimated through 2-6 years after the past myocardial infarction (MI). There were among of them 147 (16.7%) with second and 20 (2.3%) with third or next MI. Then we compared in-hospital course and long-term prognosis in patients with recurrent MI (group I, n = 167) to patients with the first MI (group II, n = 714). We have also evaluated influence of the time-period between the both episodes of myocardial infarctions on the prognosis. The chi-square test was applied to identify the significance of the difference between both groups. Using the Kaplan-Meier method, figures of survival curves were created. Patients in group I were about 4.9 year-older than in group II/(median age was 64.8 +/- 10.7 vs 59.9 +/- +/- 11.3 years p < 0.05). More popular were also diabetes (30.5% vs 18.5%, p < 0.001), advanced hypertension (31.7% vs 20.5% p < 0.01) and higher ratio of current smokers (51.5%) among risk factors in patients from group I. Second myocardial infarction had more serious in-hospital course than the first one. It could be the result of anterior location and more often cardiac complications like ventricular arrhythmias including VF, disturbances of intraventricular conductions, cardiogenic shock and pulmonary oedema with especially of first hours of acute myocardial infarction. Mortality rate in the group I was 2.2 times higher to compare with group II (24.0% vs 10.9%, p < 0.001). Significance higher mortality was in the first year of follow-up and among patients with recurrent myocardial infarction within 12 months after the first one. CONCLUSION: Previous myocardial infarction is significant risk factor that elevate in-hospital course and long-term mortality rate. We observed the higher mortality rate when the recurrent myocardial infarction occurred within 12 months after the first one. The longer time-period since the first myocardial infarction the better prognosis was observed in our analysis.

Age Distribution↗
PubMedDate not supplied

Clinical profile and prognosis of Addison's disease in India.

BACKGROUND: The clinical presentation of primary adrenocortical insufficiency (Addison's disease) in India may differ from that in developed countries. We therefore studied the clinical profile and prognosis of Addison's disease, with special reference to patients with tuberculous infection. We also evaluated the utility of various clinical parameters in differentiating tuberculous from idiopathic Addison's disease. METHODS: In a retrospective and prospective study, 45 consecutive patients of Addison's disease (20 patients with tuberculous aetiology) were studied for their clinical features, autoantibody profile (adrenal cytoplasmic, thyroid microsomal and gastric parietal cell antibodies) and prognosis. RESULTS: A tuberculous aetiology was present in 47% of the patients and of these, 85% had enlargement of one or both adrenal glands. While patients with tuberculous Addison's disease had a higher prevalence of extra-adrenal tuberculosis (55% v. 9%, p = 0.001), a lower frequency of adrenal cytoplasmic antibodies (17% v. 50%, p = 0.03) and parietal cell or thyroid microsomal antibodies (11% v. 55%, p = 0.004), a considerable overlap was observed. Despite adverse circumstances, during a mean follow up of 3.3 years, only 2 (5%) patients died, neither of whom had tuberculous involvement. Five (13%) patients suffered from one or more episodes of Addisonian crises, though none of these resulted in mortality. CONCLUSION: Tuberculosis remains an important cause of Addison's disease in India. The presence of extra-adrenal tuberculosis, or lack of adrenal cytoplasmic antibodies, does not, with certainty, differentiate between a tuberculous and idiopathic aetiology. The prognosis of Addison's disease was good despite unfavourable circumstances.

Addison Disease↗
PubMed1997

The correlations of clinicopathologic features, hormone receptor level with the prognosis of breast cancer: report of 308 cases in elderly women.

OBJECTIVE: This study analyses the clinicopathologic features and hormone receptor level of breast cancer in aged patients (> or = 60 years) and explores the related factors of the prognosis. METHODS: For all patients, the clinical data and pathologic data were reviewed retrospectively. Follow-up data were available. Of the 308 cases, tumor specimens in 130 patients were subjected to hormone receptor analysis by a dextran-coated charcoal technique. RESULTS: Of the 308 cases, 82 cases were in stage I, 147 cases in stage II, 66 cases in stage III, and 13 cases in stage IV. Metastatic rate (axillary lymph nodes) was 35.7%. The overall postoperative 5- and 10-year survival rates were 70.8% and 50.5%, respectively. Estrogen receptor and progesterone receptor positive rates were 66.9% and 40.0%, respectively. The survival rate was decreased with the increasing grade of TNM (P < 0.01). The mortality rate of the breast cancer was related to the clinical stage and the hormone receptor level (P < 0.05). CONCLUSIONS: There was a relatively good prognosis in this series. The size of tumor, number of metastatic nodes and hormone receptor level were related to the prognosis.

Adenocarcinoma↗
PubMed2001

Low expression of p27(Kip1), a cyclin-dependent kinase inhibitor, is a marker of poor prognosis in synovial sarcoma.

BACKGROUND: Low expression of p27(kip1), a dominant cyclin-dependent kinase inhibitor involved in G1-S transition of the cell cycle, recently has been reported to be associated with aggressive tumor growth. It has been shown that active cell proliferation alludes to poor prognosis in patients with synovial sarcoma. However, to the authors' knowledge, little is known about the clinicopathologic significance of p27(kip1) in synovial sarcoma. METHODS: p27(kip1) expression was examined immunohistochemically in 55 cases of primary synovial sarcoma, and the relations between p27(kip1) expression and several cell proliferation markers, i.e., mitotic index (MI), Ki-67 labeling index (Ki-67 LI), and clinicopathologic parameters related to poor prognosis, were determined. Univariate and multivariate survival analyses were performed to evaluate the prognostic significance of p27(kip1) expression in synovial sarcomas. RESULTS: p27(kip1) labeling index (p27(kip1) LI) correlated inversely with MI (r = -0.44, P = 0.0007) and Ki-67 LI (r = -0.63, P < 0.0001). Of the clinicopathologic parameters examined, tumor necrosis (P = 0.019) and American Joint Committee on Cancer (AJCC) stage (P = 0.021) correlated significantly with p27(kip1) LI. Survival analysis showed that p27(kip1) LI was an independent prognostic factor for overall survival in patients with synovial sarcoma (P = 0.0031). CONCLUSIONS: The study results suggested that low expression of p27(kip1) may be useful as a marker of poor-prognosis synovial sarcoma.

Adolescent↗
PubMed2001

Tumor biology and prognosis in black breast cancer patients: a review.

American black women have a risk of developing breast cancer lower than that of American white women. but they have a worse prognosis when they do develop the disease. A major factor responsible for this discrepancy is a relatively high poverty level in the black population, with the consequent likelihood of delayed diagnosis and presentation with more advanced disease. However, breast cancer in black women also occurs at a younger age, more often is estrogen receptor-negative, and more frequently exhibits aggressive biological behavior as judged by histopathologic grade, high tumor cell proliferation rate, and altered p53 expression. Obesity, known to be associated with a poor prognosis primarily as a consequence of increased estrogen production and bioavailability, is more common in black than in white breast cancer patients. An additional factor may be an earlier age at first completed pregnancy for black women, which is associated with a reduced breast cancer risk but also a poorer prognosis. Both the epidemiologic features and the tumor biology of breast cancer in black women serve to stress the particular importance of developing effective, specifically tailored strategies for early diagnosis in this ethnic group.

Black or African American↗
PubMed2000

[Comparative estimation of the prognosis methods for an early recurrency of hemorrhage of ulcerative genesis].

There were revealed the occurrence risk factors for an early recurrence of hemorrhage of ulcer etiology, the method of mathematical prognosis was suggested with 78.8% authenticity. The programm of computeric prognosis, basing on "neuronic nets" with 91% authenticity was elaborated. It was established that computeric prognosis is more authentic and perspective method in comparison with mathematic one.

Algorithms↗
PubMed2000

[The significance of lowered ejection fraction on prognosis after myocardial infarction ].

The subject of this study was a group of 757 patients hospitalized because of acute myocardial infarction in years 1992-1996, who survived the in-hospital course and were under observation for 2-6 years after the infarction. During the 14-18th day of the hospital stay they were made an echocardiographic test, including the ejection fraction (EF). The aim of this study was to define the influence of the ejection fraction value lowered below 40% on the long-term prognosis in patients after acute myocardial infarction. We compared two groups of patients; group I, consisting of 130 (17.2%) patients with EF lowered below 40% and group II, which included 627 patients with EF over 40%. To estimate the statistic significance we used the chi-square and t-Student test. The morbidity curves were made with the Kaplan-Meier method. The course of the myocardial infarction was much more grave in group I than in group II, what is confirmed by a more often anterior ventricular infarction and the quantity of dangerous complications which occurred during the in-hospital phase. The multi-factor regressive analysis showed that the ejection fraction lowered below 40% raises 2.47 times (95% confidence interval 1.50-4.07) (p < 0.001) the risk of death during the first year after myocardial infarction and nearly two times during the 5 year follow-up, compared to patients with a higher EF value. The influence of the EF value lowered below 40% on the creation of an infarction was not significant. The EF value lowered below 40% in patients after acute myocardial infarction was a significant risk factor in the long-term prognosis. More than 40% of deaths during the long-term prognosis in this group were caused by heart failure.

Confidence Intervals↗
PubMed2001

Expression of hypoxia-inducible factor 1alpha in epithelial ovarian tumors: its impact on prognosis and on response to chemotherapy.

PURPOSE: To investigate the impact of expression of hypoxia-inducible factor (HIF)-1alpha on prognosis and on response to chemotherapy in epithelial ovarian tumors. EXPERIMENTAL DESIGN: Expression of HIF-1alpha protein was studied by immunohistochemistry in 102 specimens of epithelial ovarian cancers, in 50 borderline tumors, and in 20 cystadenomas. Results were correlated with p53, p21, and bcl-2 expression, microvessel density (MVD), apoptotic rate of tumor cells, and survival. RESULTS: In 68.6% of ovarian cancers and 88% of borderline tumors, expression of HIF-1alpha was observed. There was a significant correlation of HIF-1alpha protein expression and MVD (P < 0.001). HIF-1alpha overexpression alone and MVD showed no impact on survival of cancer patients. Furthermore, the response to platinum-based chemotherapy was independent from HIF-1alpha expression. Expression of HIF-1alpha correlated with apoptotic rate in the majority of cases, especially in low malignant potential tumors. In contrast, in cancer patients with strong expression of HIF-1alpha and p53 protein overexpression, not only a significantly increased MVD (P = 0.032, Mann-Whitney test) but also a significantly shorter overall survival was observed (P < 0.0001, Cox regression). The apoptotic rate was very low in these tumors. CONCLUSIONS: HIF-1alpha protein overexpression alone has no impact on the prognosis of ovarian cancer. The combination of HIF-1alpha protein overexpression with nonfunctional p53, however, indicates a dismal prognosis.

Cell Survival↗
PubMed2001

[Prognosis of mitral commissurotomy. Study of 1134 mitral patients 20 years later].

With a test sample (n = 323), consisting of the answers to an inquiry about the patients with operated mitral stenosis (n = 1134), between 1952 and 1978, in "Hospital Pulido Valente", Lisbon, we compared the group of survivors with the decreased in the relation to sex, age, valvular lesion, type of surgery, valvular area before and after surgery and existence of incompetence. We concluded that mitral stenosis was more frequent in females (4/1), but it had a worse prognosis in males. The lower the age at the time of surgery the better long time prognosis. Digital and instrumental valvulotomy had similar mortality. Valvular incompetence had a worse prognosis and is associated with larger valvular area.

Adolescent↗
PubMed1999

[WT1 gene expression in leukemia patients and its correlation with prognosis and multidrug resistance].

OBJECTIVE: To evaluate the value of expression of WT1 gene in predicting the prognosis of leukemia patients, and explore the relationship between WT1 gene expression and multidrug resistance and cell apoptosis. METHODS: Expressions of WT1, MRP and mdr1 were measured in 68 leukemia patients by RT-PCR method. Expression of bcl-2 was measured in 32 AML patients by immunofluorescence flow cytometry. RESULTS: Expression of WT1 was revealed in 36 of 68 leukemia patients and none of 23 normal controls. Complete remission rate (59.46%) was lower in WT1 positive patients than that (87.10%, P = 0.011) in WT1 negative patients. The rate of MRP expression was also higher in patients with WT1 expression (58.33%), than in those without WT1 expression (32.26%, P = 0.033). Thirty-two AML patients were divided into high-, intermediate-, and low-risk groups according to the expression of WT1 and bcl-2. CR rates were significantly different among these 3 groups (33.33% for high-, 47.37% for intermediate-, and 100% for low-risk group, P < 0.05). CONCLUSION: The expression of WT1 can predict the treatment outcome and the prognosis for leukemia patients. Expression of WT1 is the most important risk factor, and the coexpression of WT1 and bcl-2 predicts poor prognosis of AML patients.

Adult↗
PubMed1975

Factors related to long-term prognosis following acute myocardial infarction. Importance of left ventricular function.

Factors related to 2-year and 4-year prognosis after acute myocardial infarction were studied in a series of 158 men. Stepwise multiple discriminant analysis was applied to findings recorded during hospital admission and to results of an exercise test carried out 6-8 weeks after the infarction. The best indicators for predicting a poor prognosis in the course of the following 2 years were a low systolic blood pressure on exercise and a palpable paradoxical cardiac pulsation. During the 4-year follow-up an abnormality of P terminal force in the ECG, which reflects left atrial overload, was the main predictor of poor prognosis.

Blood Pressure↗
PubMedDate not supplied

Proliferating cell nuclear antigen, p53, and c-erbB-2 expression in relation to clinicopathological variables and prognosis in cancer of the ampulla of Vater.

BACKGROUND/AIMS: Various clinicopathological factors have been thought to influence the prognosis of ampullary cancers. Recent advances in molecular biology should provide much useful information on the prognostic factors of ampullary carcinomas. METHODOLOGY: PCNA (proliferating cell nuclear antigen), p53, and c-erbB-2 were immunohistochemically evaluated in 30 resectable ampullary carcinomas. PCNA, p53, and c-erbB-2 expression, 6 clinicopathological variables, and prognosis were studied and correlations among these factors were investigated. RESULTS: The mean PCNA-positive rate was 39.1%. The percentages of cases positive for p53 and c-erbB-2 were 53% and 23%, respectively. No correlation was seen between PCNA, p53, or c-erbB-2 expression and clinicopathological variables. The optimum cut-off of PCNA indices influencing recurrence was decided as 40% by receiver operator characteristic curves. The cumulative disease-free survival rate of patients from the > or = 40% PCNA positive rate group was significantly poorer than that of the < 40% PCNA positive rate group (P < 0.01). p53 accumulation and c-erbB-2 expression were not correlated with prognosis. Multivariate analysis revealed that the PCNA positive rate and lymph node metastasis independently contributed to survival (P < 0.05). CONCLUSIONS: PCNA expression is a useful prognostic marker; however, p53 and c-erbB-2 overexpression are not useful as biomarkers for ampullary cancers.

Adult↗
PubMed2001

[Expression of vascular endothelial growth factor in primary esophageal squamous cell carcinoma and its significance in angiogenesis and prognosis of the tumor].

OBJECTIVE: To study the expression of vascular endothelial growth factor (VEGF) and microvessel density (MVD) in primary esophageal squamous cell carcinoma and to clarify the association of VEGF expression with the angiogenesis and prognosis of this tumor. METHODS: VEGF expression and MVD in 82 specimens of primary esophageal squamous cell carcinoma, resected from Jan 1981 through May 1994, were examined by immunohistochemistry staining (SP method), using anti-VEGF polyclonal antibody and anti-factor VIII monoclonal antibody. The relationship between VEGF expression and MVD and postoperative survival of patient was analyzed. RESULTS: Fifty-two out of the eighty-two specimens of esophageal squamous cell carcinoma (63.4%) showed positive expression of VEGF. The median of MVD in tumor was 37/mm2 (9-150/mm2). There was a close correlation between MVD and VEGF expression (P = 0.001). The survival rate of patients with high MVD in the tumor was significantly lower than that of patients with low MVD (P = 0.017). The higher the level of expression of VEGF in tumor, the poorer prognosis for the patients (P = 0.000). CONCLUSION: In primary esophageal squamous cell carcinoma, angiogenesis is mediated mainly by VEGF. VEGF is associated with tumor progression and may increase the malignancy via angiogenesis. It may be used as an independent indicator for prognosis of esophageal squamous cell carcinoma.

Adult↗
PubMed2001

[The incidence of gallbladder cancer in Sweden has decreased. The poor prognosis can possibly be improved by radical surgery].

Gallbladder cancer is a rare disease with poor prognosis and short survival time. The condition is usually associated with gallstones and predominantly affects women. We have taken data from the National Cancer Register and the Cause of Death Register in Sweden and studied the annual incidence of and mortality due to gallbladder cancer from 1988 to 1997. Incidence has declined during this period, which may be explained by a high rate of cholecystectomies in Sweden between 1950 and 1970. Prognosis has traditionally been poor, with a median survival time of 3.5 months, which might be explained by the fact that the disease usually is diagnosed at an advanced stage. Epidemiological figures show that prognosis may have improved during the past decade. In several retrospective studies, mainly from Japan, better results with longer survival times are reported after extended surgery. In a small group of 11 patients with gallbladder cancer, Nevin grade II-V, who underwent extended surgery at The University Hospital in Linköping, there are no signs of recurrent disease in 10 patients after a follow-up of 1-8 years.

Aged↗
PubMed2001

[Differentiated thyroid carcinoma. Prognosis and therapy].

BACKGROUND: We have conducted retrospective analysis of 90 cases of Differentiated Thyroid Cancer (DTC) operated between 1978 and 1998. The aim of this study was to verify the most widely used prognostic factors and to try to identify differences in the development of these tumors. METHODS: The DTCs, selected from the histopathologic reports of the Institute of Pathologic Anatomy, were divided into high, intermediate and low malignancy tumors according to the classification of Carcangiu and Rosai. RESULTS: We found that age >45 years associated with a cancer larger than 1.5 cm and intermediate malignancy was related to the most dismal prognosis. Ten of the 90 cases had a dismal prognosis; 6/10 (60%) had disease recurrence. Four of those six patients died; one has disease recurrence 5 months after surgery, and one patient with disease recurrence after one year was lost to follow-up. The identification of metastases at the primary operation is of course an unfavourable prognostic factor. In fact, all of the six cases with metastases had disease recurrence after the treatment: three patients have died; two survive (one have a disease period of 5 months and the other a disease period of 2 years); one patient with disease recurrence one year after surgery was lost to follow-up. CONCLUSIONS: The most significant negative factors for prognosis purposes were the higher degrees of T, the presence of metastases at diagnosis or their appearance at follow-up, age greater than 45, male sex and areas of dedifferentiation within the histological pattern. Total thyroidectomy remains the treatment of choice.

Adult↗
PubMed1998

[Expression of nitric oxide synthase in squamous cell carcinoma of tongue and its prognosis].

OBJECTIVE: To study the expression of nitric oxide synthase (NOS) in squamous cell carcinoma of tongue and its prognosis. METHODS: The NOSI, NOSII and NOSIII of 55 cases of squamous cell carcinoma of tongue were detected by immunohistochemistry. RESULTS: The expressive rates of NOSI, NOSII and NOSIII were 30.9%, 40.0% and 38.2% respectively. There were significant differences between the patients with and without neck nodal metastasis, and between the patients survival more than 5 years and less than 5 years (P < 0.01), There were differences between G1, G2 and G3 and the clinical stages in NOSII (P < 0.05). CONCLUSION: The expression of the NOSI, NOSII and NOSIII in squamous cell carcinoma of tongue is raleted to its prognosis and the NOSII plays a more important role in growth, differentiation, metastatic capability and prognosis of the tumor.

Adult↗