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Prognostic Indicator (prognostic + indicator)
Kinds of Prognostic Indicator Selected AbstractsPlasma Antithrombin Activity as a Diagnostic and Prognostic Indicator in Dogs: A Retrospective Study of 149 DogsJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 3 2010S. Kuzi Background: Antithrombin (AT) is the major inhibitor of coagulation. In people, hypoantithrombinemia is associated with hypercoagulability, thrombosis, and poor prognosis. Veterinary studies, however, have not demonstrated similar prognostic significance. Thus, AT activity (ATA) in dogs currently is interpreted based on human medicine guidelines. Hypothesis: ATA can serve as a prognostic marker in dogs, as has been shown in people. Objectives: (1) To describe the clinical and clinicopathologic findings, diagnoses, and outcome of dogs with decreased versus normal ATA, (2) to identify diseases and mechanisms associated with hypoantithrombinemia, and (3) to assess ATA as a prognostic indicator. Animals and Methods: Retrospective study of 149 dogs with ATA measurement during their disease course. Results: Hypoantithrombinemic dogs had a higher proportion of leukocytosis, hemostatic abnormalities, hypoalbuminemia, and hyperbilirubinemia versus dogs with normal ATA. Hypoantithrombinemia commonly was present in immune-mediated hemolytic anemia (IMHA), pancreatitis, hepatopathy, and neoplasia. It was associated with higher risk of mortality in the entire study population and for specific diseases (eg, IMHA, neoplasia). The odds ratio for mortality significantly and progressively increased when ATA was <60 and <30% (9.9, 14.7, respectively). A receiver operating characteristics analysis of ATA as a predictor of mortality showed an area under the curve of 0.7, and an optimal cutoff point of 60% yielded sensitivity and specificity of 58 and 85%, respectively. Conclusions and Clinical Importance: In dogs, ATA <60% indicates increased mortality risk, similarly to human patients, but ATA has limited value as a single discriminating factor in the outcome. [source] Potential Prognostic Indicators in Diffuse Peritonitis Treated with Open Peritoneal Drainage in the Canine PatientJOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 4 2000DACVS, Kevin P. Winkler DVM Summary The purpose of this study was to identify prognostic indicators that may help to predict outcome in clinical cases of diffuse peritonitis treated with open peritoneal drainage. Medical records from 19 canine patients with generalized peritonitis treated with open peritoneal drainage between 1990 and 1996 were reviewed. The signalment, preoperative complete blood count (CBC), preoperative biochemical profiles, and number of days of open peritoneal drainage of surviving patients (n = 15) were compared to nonsurviving patients (n = 4). Significant differences were noted between the surviving and nonsurviving groups in the ALT (p = 0.02) and GGT (p = 0.01) values. Seventy-nine percent of the patients in this study survived. [source] Sequential Plasma Lactate Concentrations as Prognostic Indicators in Adult Equine EmergenciesJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 1 2010B.S. Tennent-Brown Background: Sequential lactate concentration ([LAC]) measurements have prognostic value in that hospitalized humans and neonatal foals that have a delayed return to normolactatemia have greater morbidity and case fatality rate. Hypothesis: Prognosis for survival is decreased in horses with a delayed return to normal [LAC]. Animals: Two hundred and fifty adult horses presented for emergency evaluation excepting horses evaluated because of only ophthalmologic conditions, superficial wounds, and septic synovitis without systemic involvement. Methods: Prospective observational study. [LAC] was measured at admission and then at 6, 12, 24, 48, and 72 hours after admission. The change in [LAC] over time ([LAC],T) was calculated from changes in [LAC] between sampling points. Results: Median [LAC] was significantly (P < .001) higher at admission in nonsurvivors (4.10 mmol/L [range, 0.60,18.20 mmol/L]) when compared with survivors (1.30 mmol/L [range, 0.30,13.90 mmol/L]) and this difference remained at all subsequent time points. The odds ratio for nonsurvival increased from 1.29 (95% confidence interval 1.17,1.43) at admission to 49.90 (6.47,384) at 72 hours after admission for every 1 mmol/L increase in [LAC]. [LAC],T was initially positive in all horses but became negative and significantly lower in nonsurvivors for the time periods between 24,72 hours (, 0.47, P= .001) and 48,72 hours (, 0.07, P= .032) when compared with survivors (0.00 at both time periods) consistent with lactate accumulation in nonsurvivors. Conclusions and Clinical Importance: These results indicate that lactate metabolism is impaired in critically ill horses and [LAC],T can be a useful prognostic indicator in horses. [source] Prognostic Indicators of Occult Metastases in Oral CancerTHE LARYNGOSCOPE, Issue 7 2002Mario Russolo MD Abstract Objective We evaluated the importance of several tumor factors related to predicting the presence of occult metastases in the oral cavity. Study Design Retrospective case study. Methods The study comprises 29 patients treated at the Department of Otorhinolaryngology (University of Trieste, Cattinara Hospital, Trieste, Italy) between January 1990 and December 2000, who had T1-T2 carcinoma of the oral cavity that had or had not extended to the oropharynx and were clinically evaluated as N0 neck. The patients all underwent surgery with removal of tumor and neck dissection. Four tumor-related parameters were examined with the aim of evaluating their predictivity of metastasis: tumor class, degree of keratinization, degree of differentiation according to Brooler's histopathological grading, and invasive cell grading (ICG). With the exception of tumor class, these parameters were evaluated both in the biopsy and in the surgical specimen and the findings were then compared. We evaluated existing correlations between each individual parameter and the histopathological presence of micrometastases (pN+) and extracapsular spread revealed when specimens from the neck were examined. Results There was a highly significant correlation between ICG equal to or greater than 13 (range, 5,20) and the presence of occult metastases (P = .0017). On the basis of our findings, the ICG parameter correctly identified 9 of 10 (pN+) patients and could have reduced overtreatment from 65.5% to 17.2% in histopathologically negative necks (pN0). Conclusion It would appear that with a delay in programming a neck dissection so as to consider ICG in combination with thickness, as in seven recent patients, identification of locoregional occult metastases (pN+) might be more precise. [source] Prognostic indicators of gastric carcinoma confined to the muscularis propriaHISTOPATHOLOGY, Issue 1 2007H Son Aims:, Gastric carcinoma confined to the muscularis propria (MPGC) is considered an intermediate-stage carcinoma. A method of discriminating between more favourable and less favourable prognostic groups of this entity is critically needed in dealing with this heterogeneous disease. The aim of this study was to examine the correlation between survival of patients with MPGC and its various clinicopathological parameters. Methods and results:, Various clinicopathological parameters were studied in 171 tissue samples including: macroscopic appearance, size, age, sex, stage, invasion depth, Lauren and Ming classifications, extent, lymphatic emboli and nodal metastasis. Tumours macroscopically resembling early gastric cancers, younger patient age, absence of lymphatic tumour emboli and lower stage were significantly associated with better prognosis of MPGC by univariate analysis. Tumours macroscopically resembling early gastric cancers, younger patient age and Lauren's diffuse type were significantly associated with a better prognosis of MPGC by multivariate analysis. Conclusions:, These indicators are practical parameters for predicting patient prognosis in clinical practice. The description of these parameters should be carefully noted in the final report and pathologists should evaluate the macroscopic appearance of MPGC. [source] Prognostic indicators in node-negative advanced gastric cancer patientsJOURNAL OF SURGICAL ONCOLOGY, Issue 7 2010Hiroaki Saito MD Abstract Background and Objectives Despite carrying better overall prognoses, some node-negative gastric cancer patients die from recurrent malignancies. Identifying factors associated with disease-specific survival in adequately staged node-negative gastric cancer is important, as these patients are presumably free of microscopic regional metastases and may derive significant benefit from existing or future adjuvant strategies. Methods To investigate significant prognostic indicators in node-negative advanced gastric cancer patients, we reviewed 777 advanced gastric cancer patients who had undergone curative gastrectomies. Results The 5-year survival rate of node-negative advanced gastric cancer patients is 84.9%, which is significantly better than that of patients with lymph node metastasis. Multivariate analysis indicated that tumor size, histology, and depth of invasion are independent prognostic factors. The 5-year survival rate of patients with larger tumors (,7,cm), poorly differentiated adenocarcinoma, and serosal invasion was 49.1%, which was significantly worse that of patients with fewer or none of these factors. Conclusions Tumor size, histology, and the presence of serosal invasion are strong indicators of poor prognosis in node-negative advanced gastric cancer patients. J. Surg. Oncol. 2010; 101:622,625. © 2010 Wiley-Liss, Inc. [source] Postoperative serum carcinoembryonic antigen levels in patients with pathologic stage IA nonsmall cell lung carcinomaCANCER, Issue 4 2004Subnormal levels as an indicator of favorable prognosis Abstract BACKGROUND Elevated serum carcinoembryonic antigen (CEA) levels are sometimes attributable to the production of CEA by malignant cells, and in turn, the antigen itself can enhance the metastatic potential of malignant cells. The authors speculated that low serum CEA levels might be indicative of relatively low levels of malignant cells and a low probability of disease recurrence. This hypothesis led them to investigate whether low CEA levels in serum represented a useful prognostic factor for patients with pathologic Stage IA nonsmall cell lung carcinoma. METHODS Between 1993 and 2001, 724 patients underwent surgery for NSCLC at Toneyama National Hospital (Toyonaka, Japan). Of these patients, the 242 who were diagnosed with pathologic Stage IA disease were included in the current study. Smoking behavior, gender, age, tumor diameter, disease histology, and preoperative and postoperative serum CEA levels were chosen as study variables, with the cutoff level between subnormal and normal serum CEA levels set at 2.5 ng/mL and the cutoff level between normal and high serum CEA levels set at 5.0 ng/mL. Prognostic indicators were evaluated using a Cox hazard model. In addition, survival probabilities were calculated using the Kaplan,Meier method, and differences in survival were assessed by log-lank analysis. RESULTS Subnormal postoperative serum CEA levels were found to be an independent prognostic indicator (hazard ratio, 2.3; 95% confidence interval, 1.1,4.7; P = 0.03 for comparison with patients who had normal CEA levels) on multivariate analysis. Furthermore, the 5-year survival rate was 87% for patients with subnormal postoperative CEA levels (n = 146), compared with 75% for patients with normal postoperative CEA levels (n = 80) and 53% for patients with high postoperative CEA levels (n = 16) (P < 0.0001). CONCLUSIONS Among patients with pathologic Stage IA NSCLC, those who had an extremely favorable prognosis were distinguished by their subnormal postoperative serum CEA levels. Cancer 2004. © 2004 American Cancer Society. [source] Theory of mind functioning in mentally disordered offenders detained in high security psychiatric care: its relationship to clinical outcome, need and riskCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 5 2007David Murphy Background,Theory of mind (ToM) refers to the cognitive mechanisms that allow us to infer our own mental states and those of others. Whilst ToM deficits are frequently observed among individuals with schizophrenia, little is known about their relationship to functional outcome. Aims,Among patients with schizophrenia in a high security hospital, to test whether ToM performance, in relation to other cognitive and clinical variables, is related to measures of subsequent clinical outcome. Methods,ToM was assessed using the modified advanced test (MAT) and the revised eyes task (RET). Outcome, including ongoing need and risk, was assessed using the HoNOS secure, CANFOR and HCR-20 respectively three years post ToM assessment. Results,Performance on the RET was the only variable to be significantly correlated with the symptom ratings of the HoNOS secure and the HCR-20 total scores. Performance on the RET also accounted for approximately half of the variance in the CANFOR ratings and a third in the risk management item ratings of the HCR-20. Age, number of years diagnosed with schizophrenia and other aspects of cognition were also significantly correlated with the HoNOS security scale. Conclusions,The results suggest that social perceptual ToM may be a useful prognostic indicator, but also that ToM impairments may represent an unmet need. Replication of the work with larger and more diverse samples of people with schizophrenia is necessary, as well as trials of therapeutic effort directed at improvement of ToM impairments. Copyright © 2007 John Wiley & Sons, Ltd. [source] The long-term impact of ferritin level on treatment and complications of type 2 diabetesDIABETES OBESITY & METABOLISM, Issue 6 2008L. Jiang Aim:, To investigate if high-serum ferritin has long-term impact on response to treatment and the development of diabetic complications in patients with type 2 diabetes. Research design and methods:, We analysed the record of 90 consecutive type 2 diabetic subjects who had serum ferritin level determined soon after diagnosis of diabetes and who also had long-term follow-up data. Results:, Patients with higher serum ferritin level had slightly worse triglyceride, blood pressure and liver enzyme levels at the end of follow up. However, ferritin level had no impact on the initial or final requirements for diabetic medication and the development of diabetic complications. Conclusions:, Although elevated serum ferritin is a marker of insulin resistance and chronic inflammation, it is not necessarily a bad prognostic indicator that should affect the clinician's approach to management. [source] Insight in early psychosis: a 1 year follow-upACTA PSYCHIATRICA SCANDINAVICA, Issue 2002A. Mintz Insight is an important prognostic indicator in early psychosis, as its presence can enhance treatment compliance, thus reducing the risk of clinical deterioration. The Calgary Early Psychosis Programme (EPP) is a comprehensive treatment programme for individuals experiencing their first episode of psychosis. Purpose, (i) to examine insight on admission and determine if change occurred in the first year of treatment and (ii) to determine if insight was associated with other symptoms. Methods, Participants were 180 consecutive admissions to EPP who completed a 1-year follow-up. Insight, positive and negative symptoms were measured with the PANSS. Depression was measured with the Calgary Depression Scale. Results, There was a significant improvement in insight from initial to 1-year follow-up (P < 0.001). Insight was positively correlated with positive and negative symptoms (P < 0.001) over time. Insight was negatively correlated with depression (P < 0.001) at the initial assessment. Conclusions, In these first episode patients, there is a significant improvement in insight over time. Insight is significantly related to positive and negative symptoms and to depression in the initial stages of the illness when the presence of depression is notable. [source] An Abnormal Right Ventricular Apical Angle is Indicative of Global Right Ventricular ImpairmentECHOCARDIOGRAPHY, Issue 5 2006Angel López-Candales M.D. The presence of right ventricular (RV) dysfunction is an adverse prognostic indicator but current echocardiographic methods have some limitations. RV apical angles in systole and diastole were correlated with known parameters of RV function in patients without pulmonary hypertension (Group 1) and in patients with pulmonary hypertension (Group 2). RV apical angles were significantly smaller in both systole (22 ± 7°) and diastole (33 ± 6°) in Group 1 patients when compared to Group 2 (54 ± 18°, p < 0.0001 and 59 ± 17°, p < 0.0001, respectively). RV apical angles, both in systole and diastole, were strongly correlated with RV end-systolic area (R = 0.89, p < 0.0001) and end-diastolic area (R = 0.81, p < 0.0001), respectively. Similarly, the apical systolic and diastolic angle correlated well with decreased tricuspid annular plane systolic excursion (TAPSE, R =,0.76 and R =,0.73, p < 0.001) as well as with decreased RV fractional area change (R =,0.81 and R =,0.77, p < 0.001). Therefore, we conclude that this new measurement of RV apical angle is simple and useful to quantify RV apical structural and functional abnormalities that are well correlated with global RV impairment in patients with chronic pulmonary hypertension. [source] Prognostic Implication of Contralateral Secondary Electrographic Seizures in Temporal Lobe EpilepsyEPILEPSIA, Issue 11 2000Ki Hyeong Lee Summary: Purpose: Interhemispheric propagation of seizures in temporal lobe epilepsy is frequently noted during intracranial EEG monitoring. We hypothesized that a distinct secondary electrographic seizure (DSES) in the temporal lobe contralateral to primary seizure onset may be an unfavorable prognostic indicator. Methods: We reviewed intracranial depth electrode EEG recordings, 1-year outcome, and medical records of 51 patients (M 29, F 22: age 15,64 years) who underwent anterior temporal lobectomy during 1988,96. We defined DSES as a seizure that spread to the contralateral temporal lobe and produced distinct contralateral EEG features. The distinct feature was focal involvement of one or two electrode contacts at onset, which starts and evolves independently from the ipsilateral temporal lobe. We considered DSES as the predominant seizure pattern when it occurred in more than one half of the patients' recorded seizures. Results: Only nine of 19 (47%) patients with predominant DSES had a 1-year seizure-free outcome, whereas 27 of 32 (84%) patients without predominant DSES had a 1-year seizure-free outcome (p <0.01). Bitemporal independent seizures were more common in patients with predominant DSES (9/19 versus 0/32; p <0.001). Conclusion: Our results suggest that distinct contralateral secondary electrographic seizure is a predictor of unfavorable outcome and is also more likely to be associated with bitemporal seizures. [source] Cytotoxic factor-autoantibodies: possible role in the pathogenesis of dengue haemorrhagic feverFEMS IMMUNOLOGY & MEDICAL MICROBIOLOGY, Issue 3 2001U.C. Chaturvedi Abstract During dengue virus infection a unique cytokine, cytotoxic factor (hCF), is produced that is pathogenesis-related and plays a key role in the development of dengue haemorrhagic fever (DHF). However, what regulates the adverse effects of hCF is not known. We have previously shown that anti-hCF antibodies raised in mice, neutralise the pathogenic effects of hCF. In this study we have investigated the presence and levels of hCF-autoantibodies in sera of patients with various severity of dengue illness (n=136) and normal healthy controls (n=50). The highest levels of hCF-autoantibodies (mean±S.D.=36±20 U ml,1) were seen in patients with mild illness, the dengue fever (DF), and 48 out of 50 (96%) of the sera were positive. On the other hand the hCF-autoantibody levels declined sharply with the development of DHF and the levels were lowest in patients with DHF grade IV (mean±S.D.=5±2 U ml,1; P=<0.001 as compared to DF). Only one of the 13 DHF grade IV patients had an antibody level above the ,cut-off' value (mean plus 3 S.D. of the control sera). The analysis of data with respect to different days of illness further showed that the highest levels of hCF-autoantibodies were present in DF patients at >9 days of illness. Moreover, the DF patients at all time points, i.e. 1,4, 5,8 and >9 days of illness had significantly higher levels of hCF-autoantibodies (P<0.001) than patients with DHF grade I, II, III and IV. In addition DHF grade I and grade II patients had significantly more positive specimens than DHF grade III and grade IV patients at all time points. These results suggest that elevated levels of hCF-autoantibodies protect the patients against the development of severe forms of DHF and, therefore, it may be useful as a prognostic indicator. [source] Mitochondrial DNA mutations and mitochondrial DNA depletion in breast cancerGENES, CHROMOSOMES AND CANCER, Issue 7 2006Ling-Ming Tseng Somatic mutations in mitochondrial DNA (mtDNA) have been demonstrated in various tumors, including breast cancer. However, it still remains unclear whether the alterations in mtDNA are related to the clinicopathological features and/or the prognosis in the breast cancer. We analyzed somatic mutations in the D-loop region, the common 4,977-bp deletion, and the copy number of mtDNA in breast cancer and paired nontumorous breast tissues from 60 Taiwanese patients. We found that 18 of the 60 (30%) breast cancers displayed somatic mutations in mtDNA D-loop region. The incidence of the 4,977-bp deletion in nontumorous breast tissues (47%) was much higher than that in breast cancers (5%). The copy number of mtDNA was significantly decreased in 38 of the 60 (63%) breast cancers as compared to their corresponding nontumorous breast tissues (P = 0.0008). The occurrence of D-loop mutations was associated with an older onset age (,50 years old, P = 0.042), and tumors that lacked expressions of estrogen receptor and progesterone receptor (P = 0.024). Patients with mtDNA D-loop mutation and breast cancer had significantly poorer disease-free survival than those without mutation, when assessed by Kaplan,Meier curves and log-rank test (P = 0.005). Multivariate Cox regression analysis indicated that a D-loop mutation is a significant marker that is independent of other clinical variables and that it can be used to assess the prognosis of patients. Our findings suggest that somatic mutations in mtDNA D-loop can be used as a new molecular prognostic indicator in breast cancer. © 2006 Wiley-Liss, Inc. [source] Hypoxia in head and neck cancer: How much, how important?HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 7 2005H. L. Janssen MD Abstract Background. Hypoxia develops in tumors because of a less ordered, often chaotic, and leaky vascular supply compared with that in normal tissues. In preclinical models, hypoxia has been shown to be associated with treatment resistance and increased malignant potential. In the clinic, several reports show the presence and extent of tumor hypoxia as a negative prognostic indicator. This article reviews the biology and importance of hypoxia in head and neck cancer. Methods. A review of literature was carried out and combined with our own experience on hypoxia measurements using exogenous and endogenous markers. Results. Hypoxia can increase resistance to radiation and cytotoxic drugs and lead to malignant progression, affecting all treatment modalities, including surgery. Hypoxia measurements using electrodes, exogenous bioreductive markers, or endogenous markers show the presence of hypoxia in most head and neck cancers, and correlations with outcome, although limited, consistently indicate hypoxia as an important negative factor. Each hypoxia measurement method has disadvantages, and no "gold standard" yet exists. Distinctions among chronic, acute, and intermediate hypoxia need to be made, because their biology and relevance to treatment resistance differ. Reliable methods for measuring these different forms in the clinic are still lacking. Several methods to overcome hypoxia have been tested clinically, with radiosensitizers (nimorazole), hypoxic cytotoxins (tirapazamine), and carbogen showing some success. New treatments such as hypoxia-mediated gene therapy await proper clinical testing. Conclusions. The hypoxia problem in head and neck cancer needs to be addressed if improvements in current treatments are to be made. Increased knowledge of the molecular biology of intermediate, severe, and intermittent hypoxia is needed to assess their relevance and indicate strategies for overcoming their negative influence. © 2005 Wiley Periodicals, Inc. Head Neck27: XXX,XXX, 2005 [source] Invasive pattern grading score designed as an independent prognostic indicator in oral squamous cell carcinomaHISTOPATHOLOGY, Issue 2 2010Yun-Ching Chang Chang Y-C, Nieh S, Chen S-F, Jao S-W, Lin Y-L & Fu E (2010) Histopathology,57, 295,303 Invasive pattern grading score designed as an independent prognostic indicator in oral squamous cell carcinoma Aims:, To test the validity of an invasive pattern grading score (IPGS) developed for oral squamous cell carcinoma (OSCC) as a prognostic indicator and to elucidate the relationship between the IPGS and clinical parameters. Methods and results:, The IPGS was applied to a total of 153 cases of OSCC. There were significant correlations between IPGS and distant metastasis (P = 0.01) or recurrence (P = 0.001). However, there were no significant correlations between IPGS and gender, age, size or extent, location, status of lymph node metastasis, clinical staging, or histological grading. Cases of OSCC with higher IPGS were associated with poor patient survival (P < 0.001) and higher probability of tumour recurrence (P = 0.001). Intraobserver (, = 0.74) and interobserver agreement (, = 0.67) were very satisfactory. Conclusions:, Our study confirms the validity of the IPGS, an indicator that is simple and easy to use. IPGS not only provides histological assessment of biological behaviour, but also offers an independent prognostic factor that may influence the treatment of OSCC. [source] Apoptotic activity in gestational trophoblastic disease correlates with clinical outcome: assessment by the caspase-related M30 CytoDeath antibodyHISTOPATHOLOGY, Issue 3 2001P M Chiu The objective of this study was to assess apoptotic activity in gestational trophoblastic disease (GTD) and its prognostic value in hydatidiform mole (HM). Expression of the specific caspase cleavage site within cytokeratin 18 was assessed immunohistochemically using the monoclonal antibody M30 CytoDeath in 12 spontaneous abortions, 22 partial and 57 complete HM, eight choriocarcinoma (CCA) and 28 normal placentas. The M30 immunoreactivity occurred predominantly in the syncytiotrophoblasts. A significantly higher M30 index in HM and CCA was found when compared with normal placentas and spontaneous abortions (P < 0.001). The M30 index of those HM which spontaneously regressed was significantly higher than those HM which developed persistent disease requiring chemotherapy (P < 0.001). The M30 index correlated with another apoptotic index previously detected by TdT-mediated dUTP nick-end labelling (TUNEL) (P = 0.007) and the proliferation index assessed by the Ki67 antigen (P = 0.034). We conclude that apoptosis is important in the pathogenesis of GTD. Assessment of apoptotic activity in HM by the M30 index may be considered as an alternative prognostic indicator for predicting the clinical behaviour. [source] The six-minute walk test: a useful metric for the cardiopulmonary patientINTERNAL MEDICINE JOURNAL, Issue 8 2009T. Rasekaba Abstract Measurement of exercise capacity is an integral element in assessment of patients with cardiopulmonary disease. The 6-min walk test (6MWT) provides information regarding functional capacity, response to therapy and prognosis across a range of chronic cardiopulmonary conditions. A distance less than 350 m is associated with increased mortality in chronic obstructive pulmonary disease, chronic heart failure and pulmonary arterial hypertension. Desaturation during a 6MWT is an important prognostic indicator for patients with interstitial lung disease. The 6MWT is sensitive to commonly used therapies in chronic obstructive pulmonary disease such as pulmonary rehabilitation, oxygen, long-term use of inhaled corticosteroids and lung volume reduction surgery. However, it appears less reliable to detect changes in clinical status associated with medical therapies for heart failure. A change in walking distance of more than 50 m is clinically significant in most disease states. When interpreting the results of a 6MWT, consideration should be given to choice of predictive values and the methods by which the test was carried out. [source] Prognostic significance of integrin-linked kinase1 overexpression in astrocytomaINTERNATIONAL JOURNAL OF CANCER, Issue 6 2010Jun Li Abstract Integrin-linked kinase 1 (ILK1), a member of the serine/threonine kinases, has been demonstrated to be associated with numerous biological and pathological processes. However, the clinical and functional significance of ILK1 expression has not been characterized previously in human astrocytoma. In this study, we found that ILK1 was overexpressed, at both mRNA and protein levels, in astrocytoma cell lines as compared with normal human astrocytes. The ILK1 mRNA and protein were significantly increased up to 5.6-fold and 10.1-fold, respectively, in primary astrocytoma in comparison with the paired adjacent noncancerous brain tissues obtained from the same patient. Furthermore, immunohistochemical analysis revealed that ILK1 protein was positive in 208 of 228 (91.2%) paraffin-embedded archival astrocytoma specimens. Statistical analysis suggested that the upregulation of ILK1 was significantly correlated with the histological grading of astrocytoma (p = 0.000), and that patients with high ILK1 level exhibited shorter survival time (p < 0.001). Multivariate analysis revealed that ILK1 upregulation might be an independent prognostic indicator for the survival of patients with astrocytoma. Taken together, our results suggest that ILK1 might represent a novel and useful prognostic marker for astrocytoma and play a role during the development and progression of the disease. [source] Over-expression of phosphatase of regenerating liver-3 correlates with tumor progression and poor prognosis in nasopharyngeal carcinomaINTERNATIONAL JOURNAL OF CANCER, Issue 8 2009Jun Zhou Abstract This study aimed at clarifying the expression of phosphatase of regenerating liver-3 (PRL-3), one member of protein tyrosine phosphatase (PTP) superfamily, in nasopharyngeal carcinoma (NPC) and its correlation with clinicopathologic features, including the survival of patients with NPC. Real-time PCR and Western blot showed that the expression level of PRL-3 was markedly higher in NPC cell lines than that in the normal nasopharyngeal epithelial cell at both mRNA and protein levels. Immunohistochemical analysis revealed overexpression of PRL-3 in 97 of 174 (55.7%) paraffin-embedded archival NPC biopsies. Statistical analysis showed that PRL-3 expression was positively correlated with N classification (p = 0.033), distant metastasis (M classification, p = 0.048) and clinical stage (p = 0.005) of patients. Patients with higher PRL-3 expression had shorter overall survival time, whereas patients with lower level of PRL-3 had better survival. Multivariate analysis suggested that PRL-3 expression might be an independent prognostic indicator for the survival of patients with NPC. Disruption of endogenous PRL-3 protein through a siRNA knockdown technique was shown to suppress the invasion ability and migration potency of 5-8F and HONE1 cells, substantially. Interestingly, we also found that no significant effect on the proliferation of 5-8F and HONE1 cells was observed after PRL-3 was down-regulated. Our results suggest that PRL-3 protein is a valuable marker for progression of NPC patients. High PRL-3 expression is associated with poor overall survival in patients with NPC. © 2008 Wiley-Liss, Inc. [source] Nm23-H1 expression of metastatic tumors in the lymph nodes is a prognostic indicator of oral squamous cell carcinomaINTERNATIONAL JOURNAL OF CANCER, Issue 2 2008Yi-Fen Wang Abstract We recently reported that low Nm23-H1 expression of primary oral squamous cell carcinoma (OSCC) was correlated with the occurrence of lymphatic metastasis. However, little is known about whether Nm23-H1 level of metastatic tumors in the cervical lymph nodes is reduced in comparison with primary oral cancers and its significance for patients' prognosis. By immunohistochemistry, we analyzed the Nm23-H1 expression in 52 pairs of OSCC specimens from primary oral cancers and their metastatic lymph nodes. Western blot analysis further confirmed the immunohistochemical interpretation. To verify the effects of Nm23-H1 on cell migration and invasion, we established several stable clones derived from a human OSCC cell line (SAS) by knockdown and overexpression. Wound-healing closure, transwell migration and invasion assays were performed to determine cell motility, migratory and invasive activities. Western blot analysis was carried out to evaluate cyclin A expression of OSCC cells with the altered Nm23-H1 levels following knockdown and overexpression. By immunohistochemistry, Nm23-H1 expression of metastatic lymph nodes was significantly lower than that of their primary oral cancers, supporting a role of Nm23-H1 in metastasis suppression. Negative Nm23-H1 interpretation of OSCC specimens, in either primary oral cancers or metastatic lymph nodes, indicated a poor survival outcome of patients. On the basis of in vitro studies of Nm23-H1 knockdown and overexpression, we demonstrated an inverse correlation between Nm23-H1 expression and the invasiveness of OSCC cells. Moreover, we observed the concomitant reduction in Nm23-H1 and cyclin A levels of metastatic tumors in both results of in vitro OSCC cells and ex vivo tumor specimens. © 2007 Wiley-Liss, Inc. [source] Stromelysin-3 expression is an early event in human oral tumorigenesisINTERNATIONAL JOURNAL OF CANCER, Issue 2 2003Shilpi Soni Abstract Stromelysin-3 (ST3/MMP11) is associated with human tumour progression. To determine the clinical significance of ST3 in oral tumorigenesis, its expression was analysed in different stages of tobacco-associated oral cancer. Immunohistochemical analysis of ST3 expression in 79 oral precancerous lesions, 177 SCCs and 35 histologically normal oral tissues was carried out and corroborated by immunoblotting and RT-PCR. ST3/MMP11 protein expression was observed in 45/79 (57%) precancerous lesions [28/48 (58%) with hyperplasia and 17/31 (55%) with dysplasia] and in 123/177 (70%) oral SCCs. In precancerous lesions, ST3 expression was higher compared to normal oral tissues (p = 0.000) and associated with MVD (p = 0.05), a marker for angiogenesis. ST3 was also expressed in cells cultured from precancerous and cancerous lesions that had undergone epithelial-to-mesenchymal transition. In oral cancer patients, ST3 positivity was associated with lymph node involvement (p = 0.025) and increased intratumoral MVD (p = 0.009). Ninety-eight oral SCC patients were followed up for a period of 94 months (median 22.5 months). Kaplan-Meier survival analysis showed that ST3 expression was not a significant prognostic indicator. ST3 expression in oral hyperplastic and dysplastic lesions suggests its association with progression of phenotypic alterations acquired early during the malignant transformation pathway of oral epithelium and implicates it not only in angiogenesis and invasion but also in tumorigenesis. Thus, ST3 may serve as a potential target for developing molecular therapeutics for early intervention in oral tumorigenesis. © 2003 Wiley-Liss, Inc. [source] Should bulimia nervosa be subtyped by historyof anorexia nervosa?INTERNATIONAL JOURNAL OF EATING DISORDERS, Issue S3 2007A longitudinal validation Abstract Objective: To determine whether a past diagnosis of anorexia nervosa (AN) predicts longitudinal course and outcome among women with bulimia nervosa (BN). Method: A subset (n = 176) of participants in the Longitudinal Study of Anorexia and Bulimia Nervosa who met DSM-IV criteria for BN either at study intake (n = 144) or during follow-up (n = 32; 4 had restricting AN at intake, 28 had binge/purge AN at intake) were included in this report. Over a median of 9 years, weekly eating disorder symptom data were collected from participants using the Longitudinal Interview Follow-up Examination, Eating Disorders Version. Results: While there were no between-group differences in likelihood of partial recovery, women with BN who had a history of AN were more likely to have a protracted illness, relapsing into AN during follow-up, compared to those with no AN history who were more likely to move from partial to full recovery. Conclusion: Lifetime AN is an important prognostic indicator among women with BN and these longitudinal data would support the subtyping of BN on the basis of AN history. © 2007 by Wiley Periodicals, Inc. Int J Eat Disord 2007 [source] Raf kinase inhibitor protein correlates with sensitivity of nasopharyngeal carcinoma to radiotherapy,JOURNAL OF CELLULAR BIOCHEMISTRY, Issue 4 2010Lin Ruan Abstract Raf kinase inhibitory protein (RKIP) is a metastasis suppressor whose expression is reduced in nasopharyngeal carcinoma (NPC) tissues and is absent in NPC metastases. To investigate the effect of RKIP on radiosensitivity of NPC, high metastatic 5-8F with low RKIP expression and non-metastatic 6-10B with high RKIP expression were stably transfected with plasmids that expressed sense and antisense RKIP cDNA. Overexpression of RKIP sensitized 5-8F cells to radiation-induced cell death, G2 -M cell cycle arrest and apoptosis. In contrast, downexpression of RKIP in 6-10B cells protected cells from radiation-induced cell death, G2 -M cell cycle arrest and apoptosis. In addition, RKIP expression altered the radiosensitivity of NPC cells through MEK and ERK phosphorylation changes of Raf-1/MEK/ERK signaling pathway. We further investigated the RKIP expression in NPC patients and its association with patients' survival after radiotherapy. Downexpression of RKIP was significantly correlated with advanced clinical stage, lymph node metastasis and radioresistance. Furthermore, survival curves showed that patients with RKIP downexpression had a poor prognosis and induced relapse. Multivariate analysis confirmed that RKIP expression was an independent prognostic indicator. The data suggested that RKIP was a potential biomarker for the radiosensitivity and prognosis of NPC, and its dysregulation might play an important role in the radioresistance of NPC. J. Cell. Biochem. 110: 975,984, 2010. © 2010 Wiley-Liss, Inc. [source] Family-focused treatment for bipolar disorder in adults and youthJOURNAL OF CLINICAL PSYCHOLOGY, Issue 5 2007Chad D. Morris Levels of familial expressed emotion during an acute episode are consistently associated with rates of recurrence among bipolar patients. This article briefly reviews the evidence for expressed emotion (EE) as a prognostic indicator and then illustrates family-focused treatment (FFT) with adults and adolescents suffering from bipolar disorder. FFT is a time-limited, modularized treatment consisting of psychoeducation, communication enhancement training, and problem-solving skills. Controlled trials indicate that FFT is an efficacious adjunct to pharmacotherapy for patients with bipolar disorder. We describe its recent application to early onset bipolar patients and include a clinical vignette. © 2007 Wiley Periodicals, Inc. J Clin Psychol: In Session 63: 433,445, 2007. [source] Peritoneal mesothelioma presenting as an acute surgical abdomen due to jejunal perforationJOURNAL OF DIGESTIVE DISEASES, Issue 4 2007Nikolaos S SALEMIS BACKGROUND: Peritoneal mesothelioma is a rare disease associated with poor prognosis. Acute abdomen as the first presentation is an extremely rare occurrence. We report an exceptional case of a patient who was found to have a jejunal perforation due to infiltration of peritoneal mesothelioma. METHODS: A 62-year-old man was admitted with clinical signs of peritonitis. Computerized tomographic scans showed a mass distal to the ligament of Treitz, thickening of the mesentery and a small amount of ascites. RESULTS: Emergency laparotomy revealed a perforated tumor 15 cm distal to the ligament of Treitz and diffuse peritoneal disease. Segmental small bowel resection and suboptimal cytoreduction were performed. Histopathology and immunohistochemistry showed infiltration of malignant mesothelioma. During the postoperative period pleural mesothelioma was also diagnosed. Despite adjuvant chemotherapy, the patient died of disseminated progressive disease 7 months after surgery. CONCLUSIONS: Peritoneal mesothelioma is a rare malignancy with grim prognosis. Small bowel involvement is a poor prognostic indicator. Our case of a small bowel perforation due to direct infiltration by peritoneal mesothelioma appears to be the first reported in the English literature. [source] Tumor R2* is a prognostic indicator of acute radiotherapeutic response in rodent tumorsJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 4 2004Loreta M. Rodrigues MSc Abstract Purpose To test the prognostic potential of tumor R2* with respect to radiotherapeutic outcome. Blood oxygenation level dependent (BOLD) MRI images are sensitive to changes in deoxyhemoglobin concentration through the transverse MRI relaxation rate R2* of tissue water, hence the quantitative measurement of tumor R2* may be related to tissue oxygenation. Methods and Materials Tumor growth inhibition in response to radiation was established for both GH3 prolactinomas and RIF-1 fibrosarcomas with animals breathing either air or carbogen during radiation. In a separate cohort, the baseline R2* and carbogen (95% O2, 5% CO2)-induced ,R2* of rat GH3 prolactinomas and murine RIF-1 fibrosarcomas were quantified using multigradient echo (MGRE) MRI prior to radiotherapy, and correlated with subsequent tumor growth inhibition in response to ionizing radiation, while the animals breathed air. Results A radiation dose of 15 Gy caused pronounced growth delay in both tumor models and transient regression of the GH3 prolactinomas. When the animals breathed carbogen during radiation, the growth delay/regression was enhanced only in the GH3 prolactinomas. The GH3 prolactinomas, which exhibit a relatively fast baseline R2* and large ,R2* in response to carbogen breathing prior to radiotherapy, showed a substantial reduction in normalized tumor volume to 66 ± 3% with air breathing and 36 ± 5% with carbogen seven days after 15 Gy irradiation. In contrast, the effect of 15 Gy on the RIF-1 fibrosarcomas, which give a relatively slow baseline R2* and negligible ,R2* response to carbogen prior to treatment, showed a much smaller growth inhibition (143 ± 3% with air, 133 ± 12% with carbogen). Conclusion Quantitation of tumor R2* and carbogen-induced ,R2* by MGRE MRI provides completely noninvasive prognostic indicators of a potential acute radiotherapeutic response. J. Magn. Reson. Imaging 2004;19:482,488. © 2004 Wiley-Liss, Inc. [source] Association of spinal cord compression seen on magnetic resonance imaging with clinical outcome in 67 dogs with thoracolumbar intervertebral disc extrusionJOURNAL OF SMALL ANIMAL PRACTICE, Issue 11 2006V. Penning Objectives: To determine whether there is an association between the degree of transverse spinal cord compression detected by magnetic resonance imaging following thoracolumbar Hansen type 1 intervertebral disc disease in dogs and their presenting and postsurgical neurological status. Methods: Medical records of 67 dogs with surgically confirmed Hansen type 1 intervertebral disc disease (2000 to 2004) were reviewed to obtain the rate of onset of disease, duration of clinical signs and presurgical and postsurgical neurological grade. Percentage of spinal cord compression was determined on transverse T2-weighted magnetic resonance images. Linear regression was used to examine the association between spinal cord compression and each of the above variables. Chi-squared tests were used to examine associations among postsurgical outcome and presurgical variables. Results: Eighty-five per cent (57 of 67) of dogs were chondrodystrophoid. Mean spinal cord compression was 53 per cent (sd=219·7, range 14·3 to 84·9 per cent). There was no association between the degree of spinal cord compression and the neurological grade at presentation, rate of onset of disease, duration of clinical signs or postsurgical outcome, with no difference between chondrodystrophoid and non-chondrodystrophoid dogs. Clinical Significance: The degree of spinal cord compression documented with magnetic resonance imaging in dogs with thoracolumbar Hansen type 1 intervertebral disc disease was not associated with the severity of neurological signs and was not a prognostic indicator in this study. [source] Assessment of corticosteroid-induced alkaline phosphatase as a prognostic indicator in canine lymphomaJOURNAL OF SMALL ANIMAL PRACTICE, Issue 4 2005A. L. Wiedemann Objectives: To examine the incidence of elevated corticosteroidinduced alkaline phosphatase (sALP) in dogs with lymphoma and to determine if sALP is a reliable prognostic indicator in canine lymphoma. Methods: The medical records of 62 canine lymphoma patients treated with a combination chemotherapy protocol from 1994 to 2003 at the University of Illinois Veterinary Teaching Hospital were examined. Variables assessed with respect to response rate and remission duration included age, bodyweight, sex, breed, World Health Organization stage (I to V), substage (a or b), pretreatment administration of corticosteroid, and serum levels of alkaline phosphatase, sALP and alanine aminotransferase. Results: sALP was not statistically significant with respect to response rate or duration of remission, nor was preinduction glucocorticoid administration. Stage was significant with respect to achieving remission. Clinical Significance: It was found that sALP is not a useful prognostic indicator for response rate and remission duration in dogs with lymphoma. [source] Prognostic significance of the ratio between metastatic and dissected lymph nodes (n ratio) in patients with advanced gastric cancerJOURNAL OF SURGICAL ONCOLOGY, Issue 2 2008Hiroaki Saito MD Abstract Background and Objectives To determine the prognostic significance of the ratio between metastatic and dissected lymph nodes (n ratio) in gastric cancer patients. Methods We retrospectively reviewed 777 advanced gastric cancer patients who had undergone curative gastrectomy at our hospital. Results The n ratio was significantly greater in cases with a large tumor, undifferentiated tumor, lymphatic vessel invasion, or blood vessel invasion. Furthermore, the n ratio was significantly correlated with the depth of invasion, level of lymph node metastasis, and number of lymph node metastases. The prognosis for gastric cancer patients correlated well with the n ratio. Multivariate analysis indicated that the n ratio, but not the number of lymph node metastases, was an independent prognostic indicator. Moreover, the n ratio was an independent prognostic factor in N1, N2, and N3 patients defined by the Japanese Classification of Gastric Cancer (JCGC). Conclusions The n ratio is useful for evaluating the status of lymph node metastasis in gastric cancer. Therefore, the addition of the n ratio to the N (nodal) category defined by the JCGC may be a useful strategy in the N-staging classification of gastric cancer. J. Surg. Oncol. 2008;97:132,135. © 2007 Wiley-Liss, Inc. [source] | ||||||||||||||||||||||||||||||||||||||||