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PubMed2002

The relation of laparotomy timing to prognosis in patients with acute necrotizing pancreatitis.

OBJECTIVE: To evaluate the relation of laparotomy timing to the prognosis in patients with acute necrotizing pancreatitis (ANP). METHODS: The laparotomy timing, morbidity, mortality and reoperation rate were reviewed in 78 patients with ANP at our hospital from 1988 to 2001. RESULTS: The morbidity rates of early operation, delayed operation and non-operation groups were 68.7%, 34.2% and 29.1%, respectively, and their mortality rates were 37.5%, 10.5% and 12.5%. The reoperation rates in early operation and delayed operation groups were 87.5% and 18.4%, respectively. CONCLUSIONS: The strategy for the management of ANP is an important factor influencing the prognosis of ANP patients. For ANP, delayed operation if necessary is more preferable than early operation in terms of better prognosis, and surgery should be simple and free from severe trauma.

Adult↗
PubMed2003

Lymph node occult micrometastasis in patients with non-small cell lung carcinoma: genetic diagnosis and its impact on prognosis.

BACKGROUND & OBJECTIVE: Occult micrometastasis to mediastinal lymph node, which could not be detected by routinely histopathologic examination, might be correlated with the prognosis of patients with non-small cell lung carcinoma (NSCLC). The aim of this stud y was to diagnose occult micrometastasis of mediastinal lymph node in NSCLC patients and evaluate its prognostic significance. METHODS: Using reverse transcription-polymerase chain reaction (RT-PCR), 242 stations of mediastinal lymph nodes, which were free of tumor determined by histopathologic examination(pN0), from 58 patients were examined for MUC1 gene mRNA and to diagnose occult micrometastasis. All the patients were followed-up for three years. The survival rate was calculated by Kaplan-Meier method and the survival was compared with log-rank test between the patients with and without occult nodal micrometastasis. RESULTS: The MUC1 gene mRNA was identified in 23 stations of lymph nodes from 16 patients, and nodal occult micrometastasis was diagnosed in the 27.6% of the patients. TNM staging for these patients was up-regulated from stageI(A)-II(B) to stage III(A). The 3-year survival rate in the patients with nodal occult micrometastasis (43.7%) was lower than that in the patients without nodal occult micrometastasis (73.8%) (P< 0.05). CONCLUSION: The expression of MUC1 gene mRNA in mediastinal lymph node is associated with poor prognosis of NSCLC patients with pN0 disease, suggesting that it may be an indicator of poor prognosis.

Adult↗
PubMed2003

[Prognosis of patients with stage Ib-IIb node-positive cervical carcinoma].

BACKGROUND & OBJECTIVE: Pelvic lymph node metastasis was the important prognostic factor for the patients with cervical carcinoma. However, the relationship among the number of positive nodes, site of metastatic nodes, adjuvant therapy, and the prognosis were unknown. The purpose of this study was to investigate the variables that could predict the prognosis of the patients with stage Ib-IIb node-positive cervical carcinoma. METHODS: Sixty-six patients with stage Ib-IIb cervical carcinoma who underwent radical hysterectomy and pelvic lymphadenectomy were analyzed retrospectively. Potential prognostic variables were studied by Cox proportional hazard model. RESULTS: The 5-year survival rate of the patients with pelvic lymph node metastasis was 40.7%. Cox proportional hazard model analysis showed cellular differentiation, number of positive nodes, and adjuvant therapy were the important prognostic factors (P< 0.05). The 5-year survival rate of patients with one positive node (56.5%) was higher than that (36.4%) of those with two or more positive nodes (P< 0.05). The former's distant metastatic rate (5.9%) was lower than the latter's (32.7%) (P=0.05). However, there was no difference of pelvic recurrence between them (P >0.05). The 5-year survival rate of the patients who had no adjuvant therapy (12.6%) was much lower than that (53.7%) of those with adjuvant therapy (P< 0.05). However, the differences of the effects among adjuvant radiotherapy, chemotherapy, and chemoradiotherapy were not obvious (P >0.05). CONCLUSION: The prognosis of patients with stage Ib-IIb node-positive cervical carcinoma who underwent radical surgery was poor. Adjuvant therapy can improve the survival rate, decrease the pelvic recurrence and distant metastasis.

Adult↗
PubMed2002

Chalkley estimates of angiogenesis in early breast cancer--relevance to prognosis.

The aim of this study was to investigate whether Chalkley estimates of angiogenesis add new knowledge regarding prediction of prognosis in 455 consecutive early breast carcinomas, both node-positive (52%) and node-negative (48%). Median follow-up was 101 months. Intense vascularization indicated poor disease-specific (p = 0.003) and overall (p = 0.004) survival. In node-negative patients, Chalkley counts were not associated with prognosis, whereas in node-positive patients, high Chalkley scores indicated poor disease-specific (p = 0.0006) and overall (p = 0.0008) survival. A multivariate analysis showed that positive lymph nodes, high histopathological grades, and negative oestrogen receptors were independent markers of cancer-related death. A high histopathological grade was associated with cancer-related death in node-negative patients, whereas in node-positive patients, many lymph nodes, high malignancy grade, negative oestrogen receptor, and increasing Chalkley counts (both tertiles and continuous) were independent markers of disease-specific death. Thus, in a univariate analysis it was found that high Chalkley estimates of angiogenesis indicated a poor prognosis, but high Chalkley estimates were independent prognostic markers only in node-positive patients.

Adult↗
PubMed2003

Cyclin-dependent kinase 1 gene expression is associated with poor prognosis in gastric carcinoma.

PURPOSE: A low expression level of cyclin-dependent kinase (Cdk) inhibitor p27 is associated with high aggressiveness and poor prognosis of various carcinomas. Human Cdk subunit 1 (Cks1), as well as S-phase kinase-associated protein 2 (Skp2), is an essential and specific factor in the p27 proteolysis by SCF(Skp2) ubiquitin ligase. The purpose of this study is to clarify the clinical significance of Cks1 expression and the relationship between Cks1 and p27 expression in gastric carcinomas. EXPERIMENTAL DESIGN: We measured Cks1 expression using quantitative reverse transcription-PCR in 76 human gastric carcinomas and p27 expression using immunohistochemistry in 28 cases. Moreover, we established Cks1- and/or Skp2-transfected gastric carcinoma cell lines and assessed the relationship between Cks1, Skp2, and p27 expression using quantitative reverse transcription-PCR and Western blot analysis. RESULTS: Cks1 high expression was correlated with poor prognosis (P < 0.05) and Cks1 expression was inversely correlated with the expression level of p27 protein in gastric carcinomas (P < 0.05). Using combined Skp2 data [T-a. Masuda, Cancer Res., 62: 3819-3825, 2002], 88.9% of the Cks1/Skp2 double-high cases expressed a low level of p27 protein and showed the poorest prognosis (P < 0.05). Western blot analysis showed that Cks1/Skp2-cotransfected cells expressed a much lower level of p27 protein than the controls. CONCLUSIONS: These findings indicate that Cks1, as well as Skp2, regulates the expression level of p27 protein in gastric carcinomas. Cks1 could play an important role in gastric carcinoma progression and would be a novel target for the treatment of gastric carcinomas as well as a strong prognostic marker.

Aged↗
PubMed2003

[Stage and prognosis of COPD].

Clinical stages of chronic obstructive pulmonary disease(COPD) have been described in the guideline by American Thoracic Society(ATS), European Respiratory Society(ERS), and Japanese Respiratory Society. Recently, the clinical stage in GOLD(Global Initiative Obstructive Lung Disease) was also published in the guideline as an international standard. Although severity or clinical stages of COPD in ATS, ERS, and JRS guidelines is determined by only % predicted FEV1.0/FVC(%FEV1.0), GOLD guideline added clinical symptoms to %FEV1.0 for determining clinical stages of COPD. Prognosis is also correlated with %FEV1.0 in COPD patients. Prognosis of COPD patients shows a clear decline in proportion to that of %FEV1.0. However, pulmonary circulation disorder also affects the prognosis of COPD. Pulmonary hypertension is often found in severe COPD.

Evidence-Based Medicine↗
PubMed2003

[Expression of P-glycoprotein and lung resistance protein in breast carcinoma and its relationship with prognosis].

BACKGROUND & OBJECTIVE: The multidrug resistance of tumor cells is the reason to failure of chemotherapy. The overexpression of P-glycoprotein (P-gp) and lung resistance protein (LRP) play important roles in the multidrug resistance of breast carcinoma. The objective of this study was to investigate the expression of P-gp and LRP in breast carcinoma and its relationship with prognosis. METHODS: Immunohistochemical assay with the LSAB immunostaining technique was used to determine protein expression of P-gp and LRP in the specimens of paraffin-embedded tissues from 151 cases of breast carcinoma and 40 normal breast tissues (control). The results were evaluated on the basis of clinical pathological factors and the survival time of these cases. RESULTS: The expression of P-gp were found in 62 (40.8%) of the breast carcinoma samples and in 1 (2.5%) of control samples. The difference between the two groups was statistically significant (Chi(2)=21.27,P< 0.01). The expression of LRP were found in 121 (80.1%) of the breast carcinoma samples and in 22 (55.0%) of control samples. The difference between the two groups was statistically significant (Chi(2)=10.62,P< 0.01). The expression of P-gp were irrelative to age,tumor size,histotype,lymph nodes metastasis,tissue grading,clinical staging, ER condition,and prognosis. The expression of LRP were found in 62 (88.6%) of 70 cases with positive lymph nodes and 59 (72.8%) of 81 cases with negative lymph nodes. The difference between the two groups was statistically significant (Chi(2)=4.891, P< 0.05). The expression of P-gp were found in 55 (45.5%) of breast carcinomas with positive immunohistochemical reaction of LRP protein; while the expression of P-gp were found in 7(23.3%) of breast carcinomas with negative immunohistochemical reaction of LRP protein. The difference between the two groups was statistically significant (Chi(2)=3.990,P< 0.05). The expression of LRP were positively correlated with the lymph nodes metastases (r=0.197, P< 0.05) and the expression of P-gp (r=0.179,P< 0.05) and irrelative to age tumor size, histotype, lymph nodes metastases, tissue grading,clinical staging, and ER condition. Univariate analysis demonstrated worse disease-free survival in the patients with positive LRP than in those with negative LRP (Chi(2)=6.892,P< 0.01). Multivariate analysis of clinical and pathological data by Cox regression method did not demonstrated that both expression of P-gp and LRP were independent factors affecting the survival of breast carcinoma patients. CONCLUSION: The expression of P-gp and LRP have their characteristics and dissimilarity clinical significance in breast carcinoma tissues. The expression of LRP may correlate not only with MDR but also the lymph nodes metastases,prognosis and expression of P-gp in breast carcinoma tissues.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMedDate not supplied

Factors affecting the prognosis of patients with hepatocellular carcinoma invading the portal vein--a retrospective analysis using 952 consecutive HCC patients.

BACKGROUND/AIMS: Hepatocellular carcinoma with portal venous invasion has a very poor prognosis. The aim of this study is to clarify the factors contributing to the survival of hepatocellular carcinoma patients with portal venous invasion. METHODOLOGY: Out of 952 patients with hepatocellular carcinoma admitted to Tokyo University hospital and its affiliated hospitals from 1987 to 1999, 53 patients developed portal venous invasion until December 2000. The main portal vein was invaded in 33 patients, and the first branch was invaded in the 20 patients. The factors contributing to the prognosis of hepatocellular carcinoma patients with portal venous invasion were determined by univariate and multivariate analyses using 19 clinicopathological parameters. RESULTS: Overall survival rates of the 53 patients at 6 months, and 1 and 2 years were 40%, 18%, and 12%, respectively. Univariate analysis indicated that the serum albumin level, Child classification, number of tumor foci, portal venous invasion-targeted irradiation, and percutaneous tumor ablation of the parenchymal main tumor were significant. Multivariate analysis showed that percutaneous tumor ablation (P = 0.033; risk ratio = 0.28) was the most important factor contributing to a favorable prognosis followed by number of tumor foci (P = 0.048; risk ratio = 0.41). CONCLUSIONS: This study showed the significance of treatment for the parenchymal main tumor in addition to portal venous invasion in patients with hepatocellular carcinoma involving portal venous invasion. Therefore, the efficacy of combined therapy using portal venous invasion-targeted irradiation and percutaneous tumor ablation for the parenchymal main tumor on survival of hepatocellular carcinoma patients with portal venous invasion is suggested.

Aged↗
PubMed2004

Recovery of ambulation during inpatient rehabilitation: physical therapist prognosis for children and adolescents with traumatic brain injury.

BACKGROUND AND PURPOSE: Evidence to guide physical therapist prognosis for recovery of the ability to ambulate in children and adolescents with traumatic brain injury (TBI) is limited. The aim of this study was to delineate a predictive model and determine the value of key demographic and clinical variables in establishing a prognosis for ambulation without the assistance of a device or person over 15.24 m on a flat, level surface following inpatient rehabilitation. SUBJECTS AND METHODS: For this retrospective study, a consecutive series of 95 children and adolescents with TBI (aged 2-18 years) admitted to an inpatient rehabilitation program was assessed using information from medical records. A multiple logistic regression analysis was conducted to identify predictors for ambulation at the time of discharge from the rehabilitation setting. RESULTS: Fifty-six percent of the children achieved ambulation at discharge. Lower-extremity hypertonicity (measured on physical therapist examination as resistance to passive stretch), brain injury severity, and lower-extremity injury together were predictors of the ability to ambulate. DISCUSSION AND CONCLUSION: Impairment and injury-related variables were important in predicting a minimal level of unassisted ambulation after discharge from inpatient rehabilitation. Awareness of predictors of recovery of the ability to ambulate that are gathered as part of a physical therapist's examination may assist in developing a prognosis for ambulation and in establishment of an appropriate plan of care.

Adolescent↗
PubMed2004

[Effect of a 2-year pulmonary rehabilitation on the 7-year prognosis in patients with advanced chronic obstructive pulmonary disease].

Pulmonary rehabilitation (PR) improve the quality of life in COPD patients, however, little has been known whether it may improve the survival. We assessed 7-year prognosis in 46 patients with advanced COPD, 27 of which completed successfully 2-year course of PR whereas 19 COPD patients made a control (C) group. At the end of 7-year observation 41.3% of total number of patients survived, among them 12 (42.8%) PR patients and 7 (38%) C patients. COPD progression was the main (80%) reason of mortality in both groups. The survivors had better results of baseline FVC, FEV1 and treadmill exercise test. They did not differ from non-survivors with age, baseline results of the weight, PaO2, PaCO2 and the number of PR patients. The Cox proportional hazard analysis showed that neither of baseline parameters influenced significantly the 7-year prognosis in this group of COPD patients. In conclusion, PR failed to improve 7-year prognosis in the studied group of patients with advanced COPD.

Adult↗
PubMedDate not supplied

[Mesial temporal lobe epilepsy: its physiopathology, clinical characteristics, treatment and prognosis].

INTRODUCTION: The prevalence of epilepsy in the population is between 15 and 18 per 1000. About 60 to 80% of the people affected are considered to have an appropriate long term prognosis (from 5 to 10 years), while between 20 and 40% respond partially to pharmacological therapy. Temporal lobe epilepsy (TLE) is the main cause of refractory epilepsies and is associated to atrophy and sclerosis of the hippocampus. Aims. To determine the physiopathology, clinical characteristics, modes of therapy and prognosis of TLE through a survey of the literature. DEVELOPMENT: The physiopathology of this disease is unknown but early brain injury, with ensuing neuronal death and loss, triggered by mechanisms of excitotoxicity has been put forward as an explanation. TLE presents a clinical picture, which is heterogeneous in childhood and homogeneous in adulthood, that is characterised by the presence of simple partial seizures and complex partial seizures. These seizures can become generalised. Diagnosis is based on the results from the electroencephalogram and from the cranial magnetic resonance, which is currently considered to be the standard diagnostic method. The pharmacological treatment of TLE only achieves complete control over the seizures in less than 20% of patients. Surgical methods, such as anterior temporal lobectomy and amygdalohippocampectomy, reach control rates in 67 85% of patients, with low morbidity and mortality rates. Although prognosis depends on a number of factors, surgical treatment improves the quality of life of these patients.

Adult↗
PubMed2004

[Prognosis for the fetus with congenital heart defects in the era of modern diagnostics and therapeutics].

BACKGROUND: Prenatal detection of structural heart diseases and rhythm disturbance has become possible using echocardiography. Authors have already documented the high diagnostic accuracy of intrauterin diagnosis of heart diseases in our country as well. AIM OF THIS STUDY: To examine the prognosis of fetal cardiac diseases diagnosed by echocardiography in the institute between 1985-2001. METHODS: The prognosis of 223 (6.3%) cardiac anomalies found in 3468 fetal echocardiograms was assessed by postnatal echo/surgery/or autopsy. RESULTS: The authors detected cardiac anomalies in 153, rhythm disturbance in 70 fetuses. They could follow (mean 4.2 yrs) the 83% of patients by postnatal echo/surgery or autopsy. They lost 46 pts (36%) by elective termination, intrauterine death, or during the postnatal period. 83% of these pts had hypoplastic left heart syndrome, fibroeleastosis, or aortic stenosis. Right heart anomalies (tetralogy of Fallot, critical pulmonary stenosis etc.) showed good prognosis with early surgical or catheter intervention. Isolated fetal supraventricular tachycardias can be successfully treated prenatally, and fetal complete heart block by emergency postnatal permanent pacemaker implantation. CONCLUSIONS: Fetal echocardiography must be considered in our country also such a method which can influence the natural history of fetal heart diseases. The result of infant cardiac surgery also dramatically improved, so we think this knowledge is very important during the counselling.

Algorithms↗
PubMed2004

[Evaluation for degree of malignancy and prognosis of patients with brain glioma using 99Tcm-MIBI brain SPECT].

BACKGROUND & OBJECTIVE: It is important and useful to evaluate the degree of malignancy for therapeutic scheme and prognosis evaluation. Traditional imaging methods such as CT and MRI play the important role in distinguishing glioma, but sometimes it was still difficult to diagnose accurately only having the aid of these anatomic information. Stereotaxic needle biopsy is an invasive method and indicates only local pathologic change, sometimes the error of sample collection will result in inaccurate grading. 18F-FDG PET can reflect the glucose metabolic rate of tumor directly and is thought as the most useful method, but the cost is too high so that it cannot be used widely at present. This study measured (99)Tc(m)-MIBI uptake in the patients with different pathological types using (99)Tc(m)-MIBI brain scan and evaluated the malignant degree of astrocytoma and its prognosis. METHODS: Fifty-two patients with glioma and 15 collators were retrospectively analyzed. (99)Tc(m)-MIBI was injected into each patient via elbow vein. SPECT was performed 20 min(early phase) and 2 h (delayed phase) after injection. (1)Diagnostic indices such as sensitivity, specificity, and accuracy were calculated. (2) The tumor to non-tumor ratios (T/N) were calculated according to ROI and compared between groups of different malignancy grading by t-test. (3) The survival time (by means of mean survival time, MST) after (99)Tc(m)-MIBI brain SPECT was follow-up surveyed. According to T/N ratios, the patients were divided into four groups. The MST was compared between four groups by t-test. RESULTS: (1) Among 52 cases of glioma, 44 showed positive and 2 collators showed false-positive on (99)Tc(m)-MIBI SPECT and the sensitivity, specificity, and accuracy were 84.6%, 86.7%, and 85.1%,respectively. (2) On early phase and delayed phase,when T/N ratio was compared, there was no significant difference between grade-I astrocytoma and grade-II astrocytoma (P >0.05), nor was between patients with ependymocytomas and patients with oligodendrogliomas (P >0.05). There was significantly different between every other two groups (P< 0.001),showing the higher the malignancy of astrocytoma,the more the T/N ratio. (3)Comparison of MST indicated that the more the T/N ratio, the shorter the MST. MST in group with T/NT ratio of 1.2-2.0 was significantly longer than that in group with T/NT ratio of 4.1-(t=5.412,P< 0.001) and that in group with T/N ratio of 3.1-4.0(t=4.418,P< 0.001). MST in group of 2.1-3.0 was significantly longer than that in group of 4.1-(t=3.382, 0.002< P< 0.005) and that in group of 3.1-4.0 (t=2.389,0.02< P< 0.05). MST showed no significant difference between the group of 1.2-2.0 and the group of 2.1-3.0 (t=1.691,P >0.05), nor did between the group of 3.1-4.0 and group of 4.1-(t=1.629,P >0.05). CONCLUSION: As a noninvasive technique, (99)Tc(m)-MIBI brain SPECT is effective to diagnose brain glioma and distinguish its malignancy degree. This method, by monitoring the T/N ratio closely, is useful to discriminate tumor viability and determine the prognosis of patients.

Adult↗
PubMed1992

[Prognosis and complications of open fractures].

This paper reviews records of Liestal Country hospital, AO Catalogue files and National Swiss Insurance Industry actuarials regarding open fractures. Specific regards are tended toward prognosis forecasting, complications and outcome assessments with respect to industrial "down time" resulting from bone infections and/or pseudarthroses. Evaluation of injuries is contingent upon the Gustilo Classification (1987) which bases prognosis on soft tissue preservation in open fracture injuries. We adhere to well accepted protocols which provide for adequate local primary débridement and stabilization of structural osseous components by means of appropriate fracture fixation. In addition, we have implemented protocols for the preservation of bony vascular elements along with sequential provisions for cancellous bone and soft tissue grafting. Outcome assessments on the range of cases reviewed confirm a traditional perspective that open fractures demonstrate considerably greater morbidity than closed fractures. However, by comparison with previous studies, the results of this series show positive progress toward optimal wound healing. While this more aggressive approach tends initially to be quite expensive, we believe initial costs to the carrier are justified by improved outcome, prognosis and industrial down time.

Adolescent↗
PubMed2004

[Prognosis of presyncope in patients with structural heart disease].

INTRODUCTION AND OBJECTIVES: Few data are available on the prognosis of presyncope in patients with structural heart disease. The aim of this study was to compare the clinical characteristics and long-term prognosis of patients with structural heart disease admitted for presyncope or syncope in the cardiology department of a tertiary hospital. METHODS: We reviewed the medical records of 449 patients (65% men, mean age 66.8 [13.1] years) with structural heart disease admitted because of syncope (n = 272) or presyncope (n = 177) during the period from 1992 to 1998. Clinical and demographic variables were analyzed and the final diagnosis was classified according to European Society of Cardiology criteria. The follow-up (available in 97.1% of patients) consisted of a personal interview with the patient or a review of the medical records and an interview with the relatives of the patients who had died. RESULTS: Both groups had similar demographic and clinical characteristics, except for the presence of atrial fibrillation on admission, which was more common in the presyncope group. Previous syncopal episodes were more frequent in patients admitted for syncope. The mechanism of the episode was considered arrhythmic in 25.7% of the patients with syncope and 22.0% of those in the presyncope group (P=.37). After a mean follow-up of 57.4 [30.5 months the survival curves were similar for both groups and no significant differences were found regarding the causes of death or the rate of sudden death. CONCLUSIONS: The clinical characteristics and the long-term prognosis in patients with structural heart disease admitted to a cardiology department for presyncope are similar to those of patients admitted for syncope. This suggests that the approach to diagnosis and risk stratification should be similar in both groups of patients.

Aged↗
PubMed2004

Surgical procedure and prognosis of hilar cholangiocarcinoma.

BACKGROUND: Hilar cholangiocarcinoma has a low radical resection rate and a poor long-term survival rate. In recent years, its prognosis has been improved with advancement of preoperative diagnostic techniques and surgical techniques. The aim of this study was to evaluate the prognostic factors of hilar cholangiocarcinoma and the relations of surgical procedure to the prognosis of the carcinoma. METHODS: A retrospective cohort study was done in 198 patients with hilar cholangiocarcinoma (117 men and 81 women, aged from 27 to 81 years), who had been admitted to this hospital from December 1997 to December 2002. Their symptoms were jaundice (94.5%), pruritus (56.6%) and abdominal pain (33.8%). Bismuth-Corlette classification showed type I in 14 patients, type II in 19, type IIIa in 12, type IIIb in 15, type IV in 112, and unclassifiable type in 26. 144 patients underwent laparotomy and others received bile drainage endoscopically (including endoscopic retrograde biliary drainage (ERBD) or endoscopic metal biliary endoprosthesis (EMBE) in 21 patients, endoscopic nose-biliary drainage (ENBD) in 31 or percutaneous transhepatic cholangiodrainage in 2. 120 patients (83.3%) received tumor resection including radical resection in 59 patients (41.0%). Twenty-three patients underwent paunched biliary exploration and drainage. RESULTS: Cox's regression model analysis showed that occupation, preoperative total serum bilirubin level, operative procedure and postoperative adjuvant radiation were significantly related to postoperative survival rate in contrast to gender, age, choledocholithiasis, hepatitis, preoperative serum CA19-9 level, Bismuth-Corlette type, histopathologic grading and postoperative chemotherapy. The survival of patients in groups of biliary drainage, palliative resection and radical resection differed statistically and prolonged in a descending order. No statistical difference was found between ERBD or EMBE group and palliative resection group. So was between ERBD or EMBE group and biliary drainage group, or between ENBD group and biliary drainage group. The survival differed statistically between ERBD or EMBE group and ENBD group. CONCLUSIONS: Operative procedure is the most important prognostic factor affecting the operative results of hilar cholangiocarcinoma. Radical resection is still the primary measure for a cure and long-term survival of the patients. For patients with irresectable hilar cholangiocarcinoma, no evidence has shown that the prognosis after treatment of ERBD or EMBE is poorer than that after laparotomy.

Adult↗
PubMed2004

[The predictive value of risk scoring system in myocardial infarction in long-term prognosis of patients referred to direct percutaneous coronary intervention].

OBJECTIVE: To evaluate the predicting values of thrombolysis in myocardial infarction (TIMI) risk scoring system for long-term prognosis in patients with ST segment elevation myocardial infarction (STEMI) referred for primary percutaneous coronary intervention (PCI). METHODS: Eight clinical variables and their relative value of score derived from TIMI risk scoring system were used to determine individual's risk score. The patients with STEMI were evaluated during the period of in-hospital and followed-up at a mean of (23.9 +/- 3.8) months for major adverse cardiovascular events (MACE), including nonfatal heart failure, nonfatal re-infarction, target vessel revascularization and cardiac mortality and the predicting value of TIMI risk scores at hospital admission for total MACE were analyzed. RESULTS: Out of 373 patients with STEMI referred for primary PCI, 89 patients were presented with MACE during the period of follow-up (average incidence: 23.9%). The presentation of the total MACE increased progressively with the rising TIMI risk scores (P < 0.05 for trends in increase of MACE). The incidence of total MACE in patients with a score > or = 8 was 9 times those with a score 0. The incidence of cardiac mortality was higher (25% vs 0, P < 0.01) and the combined incidence of cardiac mortality and nonfatal re-infarction also increased significantly (36.7% vs 2.6%, P < 0.01) in patients with a score > or = 6 than in those with a score < 6 respectively. The risk of adverse cardiovascular events increased with rising in TIMI risk scores in patients with either high or normal TnI level. CONCLUSIONS: The higher the TIMI risk score at admission, the worse the prognosis. This TIMI risk scoring system is likely to be a simple and practical tool at the bedside in quantitative risk evaluation and long-term prognosis prediction in patients with STEMI referred for primary PCI.

Aged↗
PubMed2004

[Role of ICAM-1 in eosinophilia and prognosis of nasal polyps].

OBJECTIVE: To investigate the role of adhesion molecule ICAM-1 (Intercellular adhesion molecule-1) in eosinophilia and prognosis of nasal polyps. METHOD: Expression of ICAM-1 were detected and quantified in 35 cases of nasal polyps with fluorescence-immunohistochemistry analysis and its relationships to eosinophilia and prognosis of nasal polyps were evaluated. RESULT: The numbers of eosinophils in nasal polyps and control nasal mucosas were 28.4 +/- 10.7/mm2 and 9.9 +/- 8.6/mm2, and fluorescent densities of ICAM-1 were 115.9 +/- 82.4 and 28.2 +/- 17.1. The expression of ICAM-1 was associated with the heaviness of nasal polyps. CONCLUSION: ICAM-1 may play an important role in the formation and prognosis of nasal polyps.

Adult↗