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At least 1,495 records · Page 83Linked to original sources
PubMed2002

Thallium scintigraphy for the prognosis of idiopathic dilated cardiomyopathy.

OBJECTIVES: This study evaluated the significance of perfusion defects demonstrated by thallium-201 and age in the prognosis of patients with idiopathic dilated cardiomyopathy. METHODS: Seventy-four dilated cardiomyopathy patients underwent thallium scintigraphy as well as clinical and hemodynamic examination. RESULTS: Abnormal perfusion defects were present in 23 of 38 patients aged < 60 years (61%) and in 26 of 36 elderly patients aged > or = 60 years (72%; NS). Univariate analysis showed that such perfusion defects were a significant predictor of cardiac death only in patients aged < 60 years (p = 0.015). Stepwise discriminant analysis also revealed that perfusion defects were a significant predictor in patients aged < 60 years (Wilks' lambda 0.499, chi-square test 20.2, p = 0.003). Perfusion defects were not more important than the history of syncope or stroke in elderly dilated cardiomyopathy patients. Twenty-one patients died of disease-related causes during 58 +/- 43 months. The five-year survival rate was better in patients aged < 60 years without than in those with perfusion defects (100% vs 58.4%, respectively), but not affected in patients aged > or = 60 years (66.7% vs 62.2%). CONCLUSIONS: Thallium scintigraphy is valuable for the prognosis of patients with dilated cardiomyopathy aged < 60 years who are usually candidates for heart transplantation. Absence of thallium perfusion defects may indicate good long-term prognosis.

Cardiomyopathy, Dilated↗
PubMed2002

[Relationship between p27 expression and prognosis of colorectal carcinoma].

BACKGROUND & OBJECTIVE: It has been reported that p27 is associated with prognosis of some tumor. This study was designed to investigate the relationship between expression of p27 and prognosis of colorectal carcinoma. METHODS: The expression of p27 in 82 colorectal carcinoma specimens was detected by immunohistochemical method. The relationship between the expression of p27 and clinicopathological characteristics or survival time was analyzed by chi 2 test or log rank test, respectively, while univariate and multivariate prognostic analyses were performed by using Cox regression model. RESULTS: High p27 expression rate in colorectal carcinoma was 53.66% (44/82), while low expression rate was 46.34% (38/82). Low p27 expression in colorectal carcinoma was significantly associated with late Dukes stage, high incidence of lymph metastasis, and distant metastasis. Long rank test showed that the p27 expression was positively correlated to survival time and Cox regression indicated that the p27 was an prognostic marker of colorectal carcinoma. CONCLUSION: Low p27 expression in colorectal carcinoma was significantly associated with late Dukes stage, high incidence of lymph metastasis, and distant metastasis, poor prognosis, and short survival time. p27 is an prognostic marker of colorectal carcinoma.

Adolescent↗
PubMed2002

[Predictive factors of prognosis in rheumatoid arthritis].

Rheumatoid arthritis leads the patients to severe physical disability and the mortality is significantly worse than general population. To predict the prognosis at first visit in hospital is difficult but there are several factors influence on the prognosis; disease activity and it's duration, high titer of rheumatoid factor, male and vasculitis. The most important factor is disease activity and it's duration. Recent advance of the treatment of RA improve the prognosis of either disability or mortality. Adverse effects of drugs for RA may threaten the life but their use leads statistically significant improvement of mortality.

Arthritis, Rheumatoid↗
PubMed2000

[The relationship between clinical prognosis and classification of the isoforms of fuse gene in acute promyelocytic leukemia].

To check the anti-apoptosis gene bcl-2 protein/mRNA expression in 28 acute promyelocytic leukemia (APL), by immunohistochemistry and in situ hybridization, and to analyse the relationship among the bcl-2 gene expressions, clinical prognosis and classification of the isoforms of fuse gene in APL. The result shows the two types of isoforms of PML-RAR alpha have no significance in bcl-2 protein/mRNA expression, indexes of clinical prognosis. This shows that the classification of PML-RAR alpha isoform has no influence on clinical prognosis.

Adolescent↗
PubMed2002

[Single factor study of prognosis from 520 cases with chronic severe hepatitis].

OBJECTIVE: To further understand chronic severe hepatitis (CSH) and to improve the level of diagnosis and treatment and to explore the methods to reduce the fatality rate of CSH through analysing the factors related to prognosis of CSH. METHODS: The factors related to prognosis from 520 cases with CSH were analyzed by SPASS and STATA software. RESULTS: 1. The fatality rate in cases with age > or = 40 years was higher than that in cases with age <40 years (P<0.001), there was no significant difference (P>0.05) in sex and pathogenic basis of CSH; 2. The fatality rate rose in cases with WBC > or = 10.0 x 10(9) per liter or platelet <100 x 10(9) per liter; 3. The fatality rate increased gradually with the ratio of aspartic aminotransferase to alanine aminotransferase (AST/ALT) and serum total bilirubin (TBil), appearance of deviation of TBil and ALT, decrease in prothrombin activity (PTA), total cholesterol (TC), cholinesterase and albumin (Alb) (P<0.001). 4. The fatality rate increased with appearance of complications such as ascites, electrolyte disturbance, spontaneous peritonitis and so on (P<0.001). CONCLUSIONS: The important factors related to prognosis were age, > or = 40 years, WBC 10.0 x 10(9) per liter or platelet <100 x 10(9) per liter; the ratio of AST/ALT, TBil, Tc, cholinesterase, Alb and complication, to monitor dynamically laboratory indexes such as TBil, PTA, Tc, cholinesterase and so on and to prevent and cure various complications are important measures to reduce the fatality rate of CSH.

Adolescent↗
PubMed2003

CD4+ and CD8+ T cells cooperate to improve prognosis of patients with esophageal squamous cell carcinoma.

The purpose of this study is to clarify the roles of immune cell types, both individually and synergistically, in esophageal squamous cell carcinoma (ESCC). One hundred and twenty-two patients (105 males and 17 females; mean age, 62.3 years) with primary ESCC underwent surgical tumor resection at the Department of Surgical Oncology, School of Medicine, Hokkaido University and two affiliated hospitals between 1989 and 1999. Immunohistochemical analyses were performed for CD4, CD8, and CD57 (surface markers for natural killer cells). Patient prognosis was found to correlate with the number of CD4(+) and CD8(+) T cells in the stroma and the number of CD8(+) T cells within the cancer cell nest. Furthermore, the number of CD8(+) T cells in the stroma and within the cancer cell nest was found to be correlated [correlation coefficient (r) = 0.790; P < 0.0001). However, no correlation was observed between the number of natural killer cells and patient prognosis. Patients were classified into the following four groups based on CD4(+) and CD8(+) T-cell count: CD4/8(+/+), CD4/8(+/-), CD4/8(-/+), CD4/8(-/-). For the general patient pool, as well as for selected p-stage III and IV cases (n = 48), the survival rate for CD4/8(+/+) patients was significantly higher than that for the other three groups (log-rank test, P = 0.0012 and 0.0088, respectively). Multivariate analysis identified CD4/8(+/+) status, T classification, and N classification as independent prognostic factors. In conclusion, cooperation between CD4(+) and CD8(+) T cells correlates strongly with ESCC patient prognosis.

CD4 Lymphocyte Count↗
PubMed2003

Significance of low-dose dobutamine stress echocardiography for the prediction of the long-term prognosis for patients with acute myocardial infarction.

OBJECTIVES: Detection of stunned myocardium using low-dose dobutamine stress echocardiography is a good predictor of improvement of cardiac function in patients with acute myocardial infarction during short hospital stays. The present study evaluated the detection of stunned myocardium as a predictor of the long-term prognosis for patients with acute myocardial infarction. METHODS: One hundred and two patients (83 males, 19 females, mean age 61.5 years) with initial myocardial infarction underwent successful reperfusion therapy (direct percutaneous transluminal coronary angioplasty or stent) in the acute stage. Within 7 days, low-dose dobutamine was administered by intravenous drip and improvement of wall motion of the infarct area was evaluated by echocardiography. The patients were divided into two groups, the viable group that showed one grade or more improvement (61 patients), and the non-viable group that showed no improvement (41 patients). These groups were compared to determine the differences in clinical findings such as remodeling of the left ventricle measured by two-dimensional echocardiography, physical work capacity during serial multi-step exercise testing, and the prognosis. RESULTS: The viable group showed greater improvement in hemodynamics and wall motion of the infarct areas than the non-viable group. After discharge, the physical work capacity was significantly increased and there was no recognizable enlargement of the left ventricle in the viable group. No sudden cardiac death or heart failure occurred in the viable group, in contrast to incidences of 6% and 9%, respectively, in the non-viable group. Unstable angina and nonfatal re-infarction occurred more frequently in the viable group. CONCLUSIONS: The presence of stunned myocardium is a predictor of the prognosis for patients with acute myocardial infarction.

Dobutamine↗
PubMed2003

Hodgkin's lymphoma in the elderly with special reference to type and intensity of chemotherapy in relation to prognosis.

BACKGROUND AND OBJECTIVES: In general, elderly patients with Hodgkin's lymphoma (HL) have a less favorable prognosis than do younger ones. Inadequate therapy, often due to decreased tolerance to treatment, contributes to the poor outcome. This study was undertaken to evaluate potential clinical factors of importance for prognosis with special reference to relative dose intensity (RDI) of chemotherapy (CT). DESIGN AND METHODS: Eighty-eight consecutive elderly (>60 years) HL patients diagnosed between 1973-1994 who received up-front CT+/-radiotherapy (RT) were included (median age 72 years, range 60-92; median follow-up time 78 months, range 49-206). The calculations of RDI of CT were based on Hryniuk's model. RESULTS: The 5-year overall (OS) and cause-specific (CSS) survival was 39% and 51%, respectively, in patients who received CT+/-RT. Nine of the 14 patients who only received 1 cycle of CT died within 6 months from diagnosis without achieving complete remission (CR). However, the remaining 5 patients in this group survived 14-97+ months. Patients with a RDI >65% had a significantly better OS (p=0.029) and CSS (p=0.024) than those with a RDI 65%. Patients who received ABVD-based CT with a RDI >65% had a significantly better OS (p=0.0011) than those who were treated with ABVD-based CT with a RDI 65%, or MOPP-like therapy, irrespective of received RDI. INTERPRETATION AND CONCLUSIONS: Prognosis remains heterogeneous and the significance of established prognostic factors is limited in elderly HL patients. Patients who received a low RDI of CT and those receiving non-ABVD-based treatment fared worse. However, also elderly patients can enjoy long-standing complete remission following minimal treatment.

Aged↗
PubMed2003

Intratumoral lymphatics are essential for the metastatic spread and prognosis in squamous cell carcinomas of the head and neck region.

Head and neck squamous cell carcinomas (HNSCCs) frequently disseminate to regional lymph nodes. To investigate the possible mechanisms involved, we studied the expression of cancer cell adhesion molecules together with lymphatic vascular and blood vascular markers in a panel of 97 primary HNSCC tumors and correlated expression levels with conventional clinicopathological parameters and with long-term prognosis. In particular, we measured the density of intratumoral and peritumoral lymph vessels as assessed with the marker lymphatic vessel endothelial hyaluronan receptor 1 (LYVE-1) and the density of tumor CD44, a receptor up-regulated in many metastatic cancers. Intratumoral LYVE-1(+) lymphatic vessels were clearly associated with a higher risk for local relapse as well as with poor disease-specific prognosis (P = 0.02 and 0.0009, respectively). In contrast, a high density of peritumoral LYVE-1(+) vessels was a sign of favorable survival (P = 0.05). Strong primary tumor CD44 expression was associated with a poor prognosis, an increased risk of local recurrence (P = 0.03 and 0.02, respectively), and an increase in resistance to radiation therapy (P = 0.03). CD44 was the only factor with an independent prognostic value for the disease-specific overall survival (P = 0.04). Our results suggest that intratumoral lymphatics play a greater role than peritumoral lymphatics in nodal metastasis of HNSCC and that tumor CD44 levels can predict sensitivity to radiation therapy. These parameters may be useful predictive and prognostic tools in the clinical management of HNSCC.

Adult↗
PubMed2003

Impact of genetic polymorphisms on heart failure prognosis.

Recent progress in genomic applications have led to a better understanding of the relationship between genetic background and cardiovascular diseases such as heart failure. The broad variability in heart failure patient outcome is in part secondary to modifier genes, i.e. genes that are not involved in the genesis of a disease but modify the severity of the phenotypic expression once the disease has developed. The strategy most commonly used to identify modifier genes is based on association studies between the severity of the phenotype and the sequence variation(s) of selected candidate gene(s). Using this strategy, several polymorphisms of the beta 1 and beta 2-adrenergic receptors genes and the angiotensin converting enzyme gene have been correlated to the prognosis of patients with heart failure. Recently, we have applied an experimental strategy, known as genome mapping, for the identification of heart failure modifier genes. Genome mapping has previously been used with success to identify the genes involved in the development of both monogenic and multifactorial diseases. We have shown that the prognosis of heart failure mice, induced through calsequestrin overexpression, is linked to two Quantitative Trait Loci localized on chromosomes 2 and 3. Using both strategies (candidate gene and genome mapping) should allow us to identify a number of modifier genes that may provide a more rational approach to identify patients with the worst prognosis and to predict their response to therapy.

AMP Deaminase↗
PubMed2003

[Correlation between prognosis and cell proliferation, apoptosis in squamous cell carcinoma of tongue].

OBJECTIVE: To study the correlation between prognosis and cell proliferation, apoptosis in squamous cell carcinoma (SCC) of tongue. METHODS: Using TdT-mediated dUTP biotin nick end labeling (TUNEL) for cell apoptosis and immunohistochemical staining for proliferating cell nuclear antigen (PCNA), Bcl-2 and Bax protein expression. RESULTS: In SCC of tongue, the positive rates of apoptosis index (AI), Bcl-2, Bax and PCNA were 55.8%, 65.4%, 73.1% and 100.0% respectively. In the univariate Kaplan-Meier analysis, low expression of Bax, high expression of PCNA, Bcl-2/Bax expression ratio > 1 and high staging were all associated with lower survival rate (Log-rank test, P < 0.05, respectively), AI was only correlated with grading. Bcl-2 did not show a significant association with all features. CONCLUSIONS: The levels of Bax and PCNA expression and Bcl-2/Bax expression ratio have independent prognosis value in squamous cell carcinoma of the tongue. Comprehensive analysis of these parameters can be helpful to identify biological behavior and predict more accurately the prognosis of patients of tongue squamous cell carcinoma.

Adult↗
PubMed2003

[Therapeutics indications and prognosis of eclampsia at Dakar University Teaching Hospital].

OBJECTIVE: To study the factors of risk of complications and evaluate the quality of medical and obstetrical management of eclampsia. METHODOLOGY: We performed a retrospective analysis of all cases of eclampsia recorded during the ante- or per partum period from January 1, 2000 to December 31, 2001 at the gynecological and obstetrical clinic at Dakar University Teaching Hospital. RESULTS: Eclampsia had concerned 78 patients, with an incidence of 8 per 1000 childbirth. The epidemiological profile was primipara (68%), young (average age: 20 years), 36 weeks pregnancy or more (60,3%), evacuation in a state of post critical coma (74.3%), on average after 2 seizures, without medical assistance (64%) with an average diastolic blood pressure of 100 mm Hg. Examinations with strong prognosis value like blood count, creatininemia, coagulation, hepatic transaminases and uricemia were not available in emergency (only 24% of all cases). Medicines prescribed included, nicardipine (63%) and magnesia sulfate (53%); this medical treatment was satisfactory in 34.6% of the cases. Cesarean section was performed in 50%. The prognosis was marked by 17.9% maternal mortality and a perinatal mortality of 359 per 1000 births. The principal risk factors of maternal and perinatal complications were early-onset eclampsia, large number of seizures and late obstetrical treatment. CONCLUSION: Prehospital treatment and availability of early cesarean section must be better organized to improve the prognosis of eclampsia.

Adolescent↗
PubMed2003

[The effect of therapeutic intervention with corticosteroids on outcome and prognosis of sarcoidosis].

OBJECTIVE: To evaluate the effects of corticosteroids on the prognosis of sarcoidosis. METHOD: There were analysis and comparison on the prognosis of natural course and corticosteroids therapy of 133 patients with sarcoidosis diagnosed by biopsy pathologic histology follow-up over 4 years. RESULTS: Six of the 7 patients with ocular sarcoidosis were cured by oral prednisone (PRED), and 1 patient receiving intraocular dexamethasone lost his sight. In patients with extra-pulmonary sarcoidosis who were not treated, 33 of the 38 cases underwent spontaneous remission, but another 5 cases progressed. Twenty-two of the 26 patients with stage I pulmonary disease underwent spontaneous remission, 3 progressed, with only one case cured by PRED therapy. In the 55 patients with stage II pulmonary sarcoidosis who received PRED therapy, the chest roentgenogram and lung function were back to normal in 45 cases, but 10 cases failed. One patient with stage II pulmonary disease without treatment progressed to stage IV. Three patients with stage III pulmonary sarcoidosis were cured by PRED therapy, but III patients with stage IV sarcoidosis failed to respond to PRED therapy. CONCLUSIONS: Systematic therapy with oral corticosteroids for ocular and stage II approximately III pulmonary sarcoidosis is a curative intervention. Corticosteroids can relieve symptoms, reduce inflammation, and improve the prognosis of ocular and pulmonary sarcoidosis.

Adolescent↗
PubMed2003

High expression of steroid sulfatase mRNA predicts poor prognosis in patients with estrogen receptor-positive breast cancer.

PURPOSE: Prognostic significance of the intratumoral mRNA expression of three enzymes related to in situ estrogen biosynthesis, i.e., aromatase, sulfatase, and 17beta-hydroxysteroid dehydrogenase type 1 (17beta-HSD1), was evaluated in patients with invasive breast cancer. EXPERIMENTAL DESIGN: Aromatase, sulfatase, and 17beta-HSD1 mRNA levels in tumor tissues (n = 181) and normal breast tissues (n = 34) were examined by a quantitative, real-time PCR assay and compared with various clinicopathological factors as well as prognosis. RESULTS: The sulfatase mRNA levels, but not the aromataseor 17beta-HSD1 mRNA levels, were significantly associated with lymph node metastases (P < 0.005), histological grade III (P < 0.001), and poor prognosis (P < 0.005). The association between the sulfatase mRNA and poor prognosis was found to be significant (P < 0.001) only in patients with estrogen receptor (ER)-positive tumors but not in ER negative tumors. In ER-positive tumors, the sulfatase mRNA levels was a significant prognostic factor independent of the lymph node status and histological grade by multivariate analysis. CONCLUSIONS: The sulfatase mRNA levels can serve as a significant, independent prognostic factor only in ER-positive tumors. It is speculated that the up-regulation of sulfatase mRNA levels leads to a high intratumoral estrogen concentration and, thus, an enhanced stimulation of tumor growth through ERs.

17-Hydroxysteroid Dehydrogenases↗
PubMed2003

[Curative effect on aggressive B cell non-Hodgkin's lymphoma and relevant influencing factors of its prognosis, a study of 203 cases].

OBJECTIVE: To analyze the curative effect of aggressive B cell non-Hodgkin's lymphoma and relevant influencing factors of its prognosis. METHODS: The curative effects of aggressive non-Hodgkin's lymphoma which were diagnosed as diffuse small cleaved (E), diffuse mixed (F), diffuse large cell (G) or diffuse immunoblastic lymphoma (H) pathologically and certified as B cell lymphoma immunohistologically and treated with CHOP or other ADM-containing regimens for at least 4 cycles from 1993 to 1997 were analyzed. An analysis of the correlation of prognosis with different factors was made. RESULTS: The curative effects of 191 out of the 230 cases were evaluated. 131 (68.9%) patients achieved CR, and 47 (24.6%) achieved PR. The 6-year overall survival (OS) rates and progress free survival (PFS) rates were 51.4% and 43.3% respectively. According to IPI risk stratification, the 6-year OS rates were 66.6%, 42.2%, 23.6%, and 10.0% in the low-risk, low-intermediate-risk, high-intermediate-risk, and high risk groups respectively (P = 0.000 0). The 6-year PFS rates were 59.7%, 30.2%, 16.7%, and 10.3% in the low-risk, low intermediate risk, high-intermediate-risk, and high risk groups respectively. The prognosis analysis showed that OS and PFS were significantly correlated with different clinical characteristics such as stage, PS, number of extra-nodal lesions, LDH bulky disease, and B symptom. CONCLUSION: The treatment with CHOP as its main component has a beneficial effect on aggressive B cell lymphoma in low risk group, but is less effective for the low-intermediate, high-intermediate, and high risk.

Adolescent↗
PubMed2003

[Overexpression of c-erbB-2 and hypoexpression of nm23 relating to poor prognosis of colorectal carcinoma].

OBJECTIVE: To investigate the relationship between expression of c-erbB-2, CD44v6 and nm23 gene proteins and the clinicopathological features of colorectal carcinomas. METHODS: Immunohistochemical technique was adopted to detect the protein expression of c-erbB-2, CD44v6 and nm23 genes in 92 cases of colorectal carcinomas. Of the 92 cases, 28 cases were followed up for more than 10 years, in which the prognosis was analyzed. RESULTS: Expression of c-erbB-2 and CD44v6 was correlating with UICC staging (P < 0.05), and c-erbB-2 was associated with prominent peritumoral lymphocytic infiltration (P < 0.05). In the 28 cases with followed-up data, univariant analysis revealed that the survival rate was correlated with histological grading, UICC staging, tumor growth pattern, peritumoral lymphocytic infiltration, and expression of c-erbB-2, CD44v6 and nm23. However, Cox stepwise proportional hazards analysis showed that only UICC staging, c-erbB-2 and nm23 status retained significant independently in prospecting prognosis. CONCLUSIONS: Besides UICC III and IV stage, overexpression of c-erbB-2 and decreased expression of nm23 are considered acceptable as the parameters in predicting of poor prognosis in colorectal carcinoma.

Adenocarcinoma↗
PubMed2003

[Prognosis and possibilities of treatment of inaugural metastases].

Prognosis depending on clinical presentation The prognosis of carcinomas of unknown primary site (CUP) is poor, with median survival of 8 months. Prognosis is better for specific clinical forms. Recent predictive models rely on the general status of the patient and simple biological parameters (lacticodehydrogenase or alkaline phosphatase levels) refine the prognostic assessment of CUP except in certain specific clinical forms. Treatment of specific clinical forms Cervical node metastases revealing an unfound epidermoid carcinoma require surgical node excision and radiotherapy. Axillary node metastases in woman require lymph node excision and systemic adjuvant therapy, similar to that used in breast cancer. The management of peritoneal serous papillary carcinomatosis in women consists in chemotherapy as in ovarian cancer, combined with debulking surgery. Median line syndrome requires radiotherapy or chemotherapy (with a cisplatin-etoposide combination or the regimen used for treatment of germ-cell tumours). Other therapeutic possibilities Excluding these forms, no chemotherapy regimen is a gold standard. Best supportive care is an acceptable option. There is little data on locoregional treatments.

Aged↗
PubMedDate not supplied

Thymidylate synthase expression as a predictor of the prognosis of curatively resected colon carcinoma in patients registered in an adjuvant immunochemotherapy clinical trial.

The expression levels of thymidylate synthase (TS) affect the sensitivity of tumor cells to fluorinated pyrimidine cytotoxic agents and determine the response of patients with colorectal cancer to fluorinated-pyrimidine-based chemotherapy. The correlation between the expression of TS and the prognosis of patients with colorectal cancer was examined in a prospective study. Evaluation of biomarkers including TS expression was performed using tumor specimens from 229 colorectal cancer patients. Immunohistochemical analysis of TS expression was performed using an antibody raised against a C-terminal epitope (D186-V313) of the human TS. The intensity of TS staining and the expression of other biomarkers were blindly scored. The five-year survival rates were 63.4% and 85.6% among patients with high and low intratumoral TS expressions, respectively (p=0.0007). Similarly, the disease-free survival (DFS) rate was 51.2% and 80.3% in the high and low TS expression groups, respectively (p=0.0004). In a subset analysis of Dukes' stage C patients, the survival and DFS rates were 44.0% and 40.0% in the high TS expression group, and 73.5% and 67.4% in the low TS expression group, respectively. Significant differences were observed in both survival (p=0.0048) and DFS (p=0.0054) rates. No significant correlation was observed between the expression of other biomarkers and prognosis. Significantly poorer prognosis of curatively resected colon cancer in patients with high TS expression levels in tumor tissue was confirmed by a double-blind prospective study conducted on samples obtained from patients enrolled in an adjuvant immunochemotherapy randomized clinical trial.

Adult↗