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  1. Understanding survival analysis: Kaplan-Meier estimate

    Science.gov (United States)

    Goel, Manish Kumar; Khanna, Pardeep; Kishore, Jugal

    2010-01-01

    Kaplan-Meier estimate is one of the best options to be used to measure the fraction of subjects living for a certain amount of time after treatment. In clinical trials or community trials, the effect of an intervention is assessed by measuring the number of subjects survived or saved after that intervention over a period of time. The time starting from a defined point to the occurrence of a given event, for example death is called as survival time and the analysis of group data as survival analysis. This can be affected by subjects under study that are uncooperative and refused to be remained in the study or when some of the subjects may not experience the event or death before the end of the study, although they would have experienced or died if observation continued, or we lose touch with them midway in the study. We label these situations as censored observations. The Kaplan-Meier estimate is the simplest way of computing the survival over time in spite of all these difficulties associated with subjects or situations. The survival curve can be created assuming various situations. It involves computing of probabilities of occurrence of event at a certain point of time and multiplying these successive probabilities by any earlier computed probabilities to get the final estimate. This can be calculated for two groups of subjects and also their statistical difference in the survivals. This can be used in Ayurveda research when they are comparing two drugs and looking for survival of subjects. PMID:21455458

  2. KMWin--a convenient tool for graphical presentation of results from Kaplan-Meier survival time analysis.

    Directory of Open Access Journals (Sweden)

    Arnd Gross

    Full Text Available BACKGROUND: Analysis of clinical studies often necessitates multiple graphical representations of the results. Many professional software packages are available for this purpose. Most packages are either only commercially available or hard to use especially if one aims to generate or customize a huge number of similar graphical outputs. We developed a new, freely available software tool called KMWin (Kaplan-Meier for Windows facilitating Kaplan-Meier survival time analysis. KMWin is based on the statistical software environment R and provides an easy to use graphical interface. Survival time data can be supplied as SPSS (sav, SAS export (xpt or text file (dat, which is also a common export format of other applications such as Excel. Figures can directly be exported in any graphical file format supported by R. RESULTS: On the basis of a working example, we demonstrate how to use KMWin and present its main functions. We show how to control the interface, customize the graphical output, and analyse survival time data. A number of comparisons are performed between KMWin and SPSS regarding graphical output, statistical output, data management and development. Although the general functionality of SPSS is larger, KMWin comprises a number of features useful for survival time analysis in clinical trials and other applications. These are for example number of cases and number of cases under risk within the figure or provision of a queue system for repetitive analyses of updated data sets. Moreover, major adjustments of graphical settings can be performed easily on a single window. CONCLUSIONS: We conclude that our tool is well suited and convenient for repetitive analyses of survival time data. It can be used by non-statisticians and provides often used functions as well as functions which are not supplied by standard software packages. The software is routinely applied in several clinical study groups.

  3. Kaplan-Meier analysis on seizure outcome after epilepsy surgery: do gender and race influence it?

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    Burneo, Jorge G; Villanueva, Vicente; Knowlton, Robert C; Faught, R Edward; Kuzniecky, Ruben I

    2008-06-01

    To evaluate seizure outcome following epilepsy surgery for patients with temporal lobe epilepsy and evaluate is gender and race/ethnicity influence it. Data were obtained from the discharge database of the University of Alabama at Birmingham, Epilepsy Center, between 1985 and 2001. The sample consisted of all patients with a primary diagnosis of medically intractable temporal lobe epilepsy (TLE) who underwent anterior temporal lobectomy. Seizure recurrence was tabulated at 7 days, 2 months, 6 months, 1, 2, 3, 4, 5, and 6 years following surgery. Logistic regression analysis was used to model the presence of seizure recurrence after anterior temporal lobectomy for all patients. Kaplan-Meier analysis was done to obtain estimates and 95% CIs of seizure freedom from baseline. Baseline variables--age at surgery, age at seizure onset, sex, side of resection, immediate postoperative seizures, and pathology results--were assessed as potential predictors of each outcome by comparing the survival curves within each variable with a log rank test. Three hundred sixty-eight patients underwent surgical treatment for TLE, mean age of 30.2 years. Thirty-five patients were African American, 43% were men. Immediate postoperative seizures were seen in 23 patients, while seizure recurrence occurred in 27.3% patients within a year after surgery, and in 33.6% within 6 years. Logistic regression results showed no differences between African Americans and whites, between males and females. The occurrence of immediate postoperative seizures was a strong predictor of late seizure recurrence only at 1 year after surgery. The occurrence of seizures in the immediate postoperative period is a strong predictor of later seizure recurrence. Sex and race/ethnicity do not appear to be predictors of long-term outcome following surgery for temporal lobe epilepsy.

  4. Application of Kaplan-Meier analysis in reliability evaluation of products cast from aluminium alloys

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    J. Szymszal

    2010-04-01

    Full Text Available The article evaluates the reliability of AlSi17CuNiMg alloys using Kaplan-Meier-based technique, very popular as a survival estimation tool in medical science. The main object of survival analysis is a group (or groups of units for which the time of occurrence of an event (failure taking place after some time of waiting is estimated. For example, in medicine, the failure can be patient’s death. In this study, the failure was the specimen fracture during a periodical fatigue test, while the survival time was either the test duration to specimen failure (complete observations, or the test end time (censored observations. The parameters of theoretical survival function were estimated with procedures based on the method of least squares, while typical survival time distribution followed either an exponential or two-parameter Weibull distribution. The goodness of fit of a model survival function was estimated with an incremental chi-square test, based on the values of the log likelihood ratio. The effect of alloy processing history on the run of a survival function was examined. The factors shaping the alloy processing history included: mould type (sand or metal mould, alloy modification process, and heat treatment type (solution heat treatment and ageing.

  5. Total Ankle Replacement Survival Rates Based on Kaplan-Meier Survival Analysis of National Joint Registry Data.

    Science.gov (United States)

    Bartel, Annette F P; Roukis, Thomas S

    2015-10-01

    National joint registry data provides unique information about primary total ankle replacement (TAR) survival. We sought to recreate survival curves among published national joint registry data sets using the Kaplan-Meier estimator. Overall, 5152 primary and 591 TAR revisions were included over a 2- to 13-year period with prosthesis survival for all national joint registries of 0.94 at 2-years, 0.87 at 5-years and 0.81 at 10-years. National joint registry datasets should strive for completion of data presentation including revision definitions, modes and time of failure, and patients lost to follow-up or death for complete accuracy of the Kaplan-Meier estimator.

  6. Quantitative estimation of the stability of methicillin-resistant Staphylococcus aureus strain-typing systems by use of Kaplan-Meier survival analysis.

    Science.gov (United States)

    O'Sullivan, Matthew V N; Sintchenko, Vitali; Gilbert, Gwendolyn L

    2013-01-01

    Knowledge concerning stability is important in the development and assessment of microbial molecular typing systems and is critical for the interpretation of their results. Typing system stability is usually measured as the fraction of isolates that change type after several in vivo passages, but this does not necessarily reflect in vivo stability. The aim of this study was to utilize survival analysis to provide an informative quantitative measure of in vivo stability and to compare the stabilities of various techniques employed in typing methicillin-resistant Staphylococcus aureus (MRSA). We identified 100 MRSA pairs (isolated from the same patient ≥ 1 month apart) and typed them using multilocus sequence typing (MLST), phage-derived open reading frame (PDORF) typing, toxin gene profiling (TGP), staphylococcal cassette chromosome mec (SCCmec) subtyping, pulsed-field gel electrophoresis (PFGE), and spa sequence typing. Discordant isolate pairs, belonging to different MLST clonal complexes, were excluded, leaving 81 pairs for analysis. The stabilities of these methods were examined using Kaplan-Meier survival analysis, and discriminatory power was measured by Simpson's index of diversity. The probability percentages that the type remained unchanged at 6 months for spa sequence typing, TGP, multilocus variable number of tandem repeats analysis (MLVA), SCCmec subtyping, PDORF typing, and PFGE were 95, 95, 88, 82, 71, and 58, respectively, while the Simpson's indices of diversity were 0.48, 0.47, 0.70, 0.72, 0.89, and 0.88, respectively. Survival analysis using sequential clinical isolates adds an important quantitative dimension to the measurement of stability of a microbial typing system. Of the methods compared here, PDORF typing provides high discriminatory power, comparable with that of PFGE, and a level of stability suitable for MRSA surveillance and outbreak investigations.

  7. On an exponential bound for the Kaplan-Meier estimator.

    Science.gov (United States)

    Wellner, Jon A

    2007-12-01

    We review limit theory and inequalities for the Kaplan-Meier Kaplan and Meier (J Am Stat Assoc 53:457-481, 1958) product limit estimator of a survival function on the whole line [Formula: see text] . Along the way we provide bounds for the constant in an interesting inequality due to Biotouzé et al. (Ann Inst H Poincaré Probab Stat 35:735-763, 1999), and provide some numerical evidence in support of one of their conjectures.

  8. A comparison between Kaplan-Meier and weighted Kaplan-Meier methods of five-year survival estimation of patients with gastric cancer.

    Science.gov (United States)

    Zare, Ali; Mahmoodi, Mahmood; Mohammad, Kazem; Zeraati, Hojjat; Hosseini, Mostafa; Holakouie Naieni, Kourosh

    2014-01-01

    The 5-year survival rate is a good prognostic indicator for patients with Gastric cancer that is usually estimated based on Kaplan-Meier. In situations where censored observations are too many, this method produces biased estimations. This study aimed to compare estimations of Kaplan-Meier and Weighted Kaplan-Meier as an alternative method to deal with the problem of heavy-censoring. Data from 330 patients with Gastric cancer who had undergone surgery at Iran Cancer Institute from 1995- 1999 were analyzed. The Survival Time of these patients was determined after surgery, and the 5-year survival rate for these patients was evaluated based on Kaplan-Meier and Weighted Kaplan-Meier methods. A total of 239 (72.4%) patients passed away by the end of the study and 91(27.6%) patients were censored. The mean and median of survival time for these patients were 24.86±23.73 and 16.33 months, respectively. The one-year, two-year, three-year, four-year, and five-year survival rates of these patients with standard error estimation based on Kaplan-Meier were 0.66 (0.0264), 0.42 (0.0284), 0.31 (0.0274), 0.26 (0.0264) and 0.21 (0.0256) months, respectively. The estimations of Weighted Kaplan-Meier for these patients were 0.62 (0.0251), 0.35 (0.0237), 0.24 (0.0211), 0.17 (0.0172), and 0.10 (0.0125) months, consecutively. In cases where censoring assumption is not made, and the study has many censored observations, estimations obtained from the Kaplan-Meier are biased and are estimated higher than its real amount. But Weighted Kaplan-Meier decreases bias of survival probabilities by providing appropriate weights and presents more accurate understanding.

  9. A comparison between Kaplan-Meier and weighted Kaplan-Meier methods of five-year survival estimation of patients with gastric cancer.

    Directory of Open Access Journals (Sweden)

    Ali Zare

    2014-10-01

    Full Text Available The 5-year survival rate is a good prognostic indicator for patients with Gastric cancer that is usually estimated based on Kaplan-Meier. In situations where censored observations are too many, this method produces biased estimations. This study aimed to compare estimations of Kaplan-Meier and Weighted Kaplan-Meier as an alternative method to deal with the problem of heavy-censoring. Data from 330 patients with Gastric cancer who had undergone surgery at Iran Cancer Institute from 1995- 1999 were analyzed. The Survival Time of these patients was determined after surgery, and the 5-year survival rate for these patients was evaluated based on Kaplan-Meier and Weighted Kaplan-Meier methods. A total of 239 (72.4% patients passed away by the end of the study and 91(27.6% patients were censored. The mean and median of survival time for these patients were 24.86±23.73 and 16.33 months, respectively. The one-year, two-year, three-year, four-year, and five-year survival rates of these patients with standard error estimation based on Kaplan-Meier were 0.66 (0.0264, 0.42 (0.0284, 0.31 (0.0274, 0.26 (0.0264 and 0.21 (0.0256 months, respectively. The estimations of Weighted Kaplan-Meier for these patients were 0.62 (0.0251, 0.35 (0.0237, 0.24 (0.0211, 0.17 (0.0172, and 0.10 (0.0125 months, consecutively. In cases where censoring assumption is not made, and the study has many censored observations, estimations obtained from the Kaplan-Meier are biased and are estimated higher than its real amount. But Weighted Kaplan-Meier decreases bias of survival probabilities by providing appropriate weights and presents more accurate understanding.

  10. A Berry-Essen Inequality for the Kaplan-Meier L-Estimator

    Institute of Scientific and Technical Information of China (English)

    Qi Hua WANG; Li Xing ZHU

    2001-01-01

    LetFn be the Kaplan-Meier estimator of distribution function F. Let J(.) be a measureablereal-valued function. In this paper, a U-statistic representation for the Kaplan-Meier L-estimator,T(Fn) = xJ(Fn(x))dFn(x), is derived. Furthermore, the representation is also used to establish aBerry-Essen inequality for T(Fn).

  11. THE LAW OF THE ITERATED LOGARITHM OF THE KAPLAN-MEIER INTEGRAL AND ITS APPLICATION

    Institute of Scientific and Technical Information of China (English)

    HE SHUYUAN; WANG YANHUA

    2004-01-01

    For right censored data, the law of the iterated logarithm of the Kaplan-Meier integral is established. As an application, the authors prove the law of the iterated logarithm for weighted least square estimates of randomly censored linear regression model.

  12. Gastric emptying of solids in humans: improved evaluation by Kaplan-Meier plots, with special reference to obesity and gender

    Energy Technology Data Exchange (ETDEWEB)

    Grybaeck, P. [Department of Diagnostic Radiology, Karolinska Hospital, Stockholm (Sweden); Naeslund, E. [Department of Surgery, Karolinska Institute at Danderyd Hospital, Stockholm (Sweden); Hellstroem, P.M. [Department of Internal Medicine, Karolinska Hospital, Stockholm (Sweden); Jacobsson, H. [Department of Diagnostic Radiology, Karolinska Hospital, Stockholm (Sweden)]|[Department of Nuclear Medicine, Karolinska Hospital, Stockholm (Sweden); Backman, L. [Department of Surgery, Karolinska Institute at Danderyd Hospital, Stockholm (Sweden)

    1996-12-01

    It has been suggested that obesity is associated with an altered rate of gastric emptying, and that there are also sex differences in gastric emptying. The results of earlier studies examining gastric emptying rates in obesity and in males and females have proved inconsistent. The aim of this study was to investigate the influence of obesity and gender on gastric emptying, by extending conventional evaluation methods with Kaplan-Meier plots, in order to assess whether these factors have to be accounted for when interpreting results of scintigraphic gastric emptying tests. Twenty-one normal-weight volunteers and nine obese subjects were fed a standardised technetium-99m labelled albumin omelette. Imaging data were acquired at 5- and 10-min intervals in both posterior and anterior projections with the subjects in the sitting position. The half-emptying time, analysed by Kaplan-Meier plot (log-rank test), were shorter in obese subjects compared to normal-weight subjects and later in females compared to males. Also, the lag-phase and half-emptying time were shorter in obese females than in normal females. This study shows an association between different gastric emptying rates and obesity and gender. Therefore, body mass index and gender have to be accounted for when interpreting results of scintigraphic gastric emptying studies. (orig.). With 6 figs., 4 tabs.

  13. A practical divergence measure for survival distributions that can be estimated from Kaplan-Meier curves.

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    Cox, Trevor F; Czanner, Gabriela

    2016-06-30

    This paper introduces a new simple divergence measure between two survival distributions. For two groups of patients, the divergence measure between their associated survival distributions is based on the integral of the absolute difference in probabilities that a patient from one group dies at time t and a patient from the other group survives beyond time t and vice versa. In the case of non-crossing hazard functions, the divergence measure is closely linked to the Harrell concordance index, C, the Mann-Whitney test statistic and the area under a receiver operating characteristic curve. The measure can be used in a dynamic way where the divergence between two survival distributions from time zero up to time t is calculated enabling real-time monitoring of treatment differences. The divergence can be found for theoretical survival distributions or can be estimated non-parametrically from survival data using Kaplan-Meier estimates of the survivor functions. The estimator of the divergence is shown to be generally unbiased and approximately normally distributed. For the case of proportional hazards, the constituent parts of the divergence measure can be used to assess the proportional hazards assumption. The use of the divergence measure is illustrated on the survival of pancreatic cancer patients. Copyright © 2016 John Wiley & Sons, Ltd.

  14. Factors Determining Disease Duration in Alzheimer’s Disease: A Postmortem Study of 103 Cases Using the Kaplan-Meier Estimator and Cox Regression

    Directory of Open Access Journals (Sweden)

    R. A. Armstrong

    2014-01-01

    Full Text Available Factors associated with duration of dementia in a consecutive series of 103 Alzheimer’s disease (AD cases were studied using the Kaplan-Meier estimator and Cox regression analysis (proportional hazard model. Mean disease duration was 7.1 years (range: 6 weeks–30 years, standard deviation = 5.18; 25% of cases died within four years, 50% within 6.9 years, and 75% within 10 years. Familial AD cases (FAD had a longer duration than sporadic cases (SAD, especially cases linked to presenilin (PSEN genes. No significant differences in duration were associated with age, sex, or apolipoprotein E (Apo E genotype. Duration was reduced in cases with arterial hypertension. Cox regression analysis suggested longer duration was associated with an earlier disease onset and increased senile plaque (SP and neurofibrillary tangle (NFT pathology in the orbital gyrus (OrG, CA1 sector of the hippocampus, and nucleus basalis of Meynert (NBM. The data suggest shorter disease duration in SAD and in cases with hypertensive comorbidity. In addition, degree of neuropathology did not influence survival, but spread of SP/NFT pathology into the frontal lobe, hippocampus, and basal forebrain was associated with longer disease duration.

  15. Days of Shanghai Stock Index Successive Rises and Fall Based on Kaplan-Meier Algorithms%基于Kaplan-Meier算法的上证指数涨跌天数研究

    Institute of Scientific and Technical Information of China (English)

    毕建欣

    2011-01-01

    运用Kaplan-Meier算法对上证指数连续上涨和下跌天数进行研究,研究了在不同的市场交易制度(即T+0,T+1和涨停板制度)对上证指数涨跌天数的影响,其结果表明Kaplan-Meier算法对于分析股市的变动是有效的.%In this paper, Days of Shanghai Stock Index Successive rises and fall are analyzed by Kaplan-Meier Algorithms. It demonstrates the policy effect on days of Shanghai Stock Index successive rises and fall , such as" T + 0","T + 1"and"soaring deadline system". It also reveals that Kaplan-Meier Algorithms is valid for analyzing the changes of the stock market.

  16. Actuarial and actual analysis of surgical results: empirical validation.

    Science.gov (United States)

    Grunkemeier, G L; Anderson, R P; Starr, A

    2001-06-01

    This report validates the use of the Kaplan-Meier (actuarial) method of computing survival curves by comparing 12-year estimates published in 1978 with current assessments. It also contrasts cumulative incidence curves, referred to as "actual" analysis in the cardiac-related literature with Kaplan-Meier curves for thromboembolism and demonstrates that with the former estimate the percentage of events that will actually occur.

  17. Bias and precision of methods for estimating the difference in restricted mean survival time from an individual patient data meta-analysis

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    Béranger Lueza

    2016-03-01

    Full Text Available Abstract Background The difference in restricted mean survival time ( rmstD t ∗ $$ rmstD\\left({t}^{\\ast}\\right $$ , the area between two survival curves up to time horizon t ∗ $$ {t}^{\\ast } $$ , is often used in cost-effectiveness analyses to estimate the treatment effect in randomized controlled trials. A challenge in individual patient data (IPD meta-analyses is to account for the trial effect. We aimed at comparing different methods to estimate the rmstD t ∗ $$ rmstD\\left({t}^{\\ast}\\right $$ from an IPD meta-analysis. Methods We compared four methods: the area between Kaplan-Meier curves (experimental vs. control arm ignoring the trial effect (Naïve Kaplan-Meier; the area between Peto curves computed at quintiles of event times (Peto-quintile; the weighted average of the areas between either trial-specific Kaplan-Meier curves (Pooled Kaplan-Meier or trial-specific exponential curves (Pooled Exponential. In a simulation study, we varied the between-trial heterogeneity for the baseline hazard and for the treatment effect (possibly correlated, the overall treatment effect, the time horizon t ∗ $$ {t}^{\\ast } $$ , the number of trials and of patients, the use of fixed or DerSimonian-Laird random effects model, and the proportionality of hazards. We compared the methods in terms of bias, empirical and average standard errors. We used IPD from the Meta-Analysis of Chemotherapy in Nasopharynx Carcinoma (MAC-NPC and its updated version MAC-NPC2 for illustration that included respectively 1,975 and 5,028 patients in 11 and 23 comparisons. Results The Naïve Kaplan-Meier method was unbiased, whereas the Pooled Exponential and, to a much lesser extent, the Pooled Kaplan-Meier methods showed a bias with non-proportional hazards. The Peto-quintile method underestimated the rmstD t ∗ $$ rmstD\\left({t}^{\\ast}\\right $$ , except with non-proportional hazards at t ∗ $$ {t}^{\\ast } $$ = 5 years. In the presence of treatment effect

  18. Vorapaxar for secondary prevention of thrombotic events for patients with previous myocardial infarction: a prespecified subgroup analysis of the TRA 2°P-TIMI 50 trial.

    Science.gov (United States)

    Scirica, Benjamin M; Bonaca, Marc P; Braunwald, Eugene; De Ferrari, Gaetano M; Isaza, Daniel; Lewis, Basil S; Mehrhof, Felix; Merlini, Piera A; Murphy, Sabina A; Sabatine, Marc S; Tendera, Michal; Van de Werf, Frans; Wilcox, Robert; Morrow, David A

    2012-10-13

    Vorapaxar inhibits platelet activation by antagonising thrombin-mediated activation of the protease-activated receptor 1 on human platelets. The effect of adding other antiplatelet drugs to aspirin for long-term secondary prevention of thrombotic events in stable patients with previous myocardial infarction is uncertain. We tested this effect in a subgroup of patients from the Thrombin Receptor Antagonist in Secondary Prevention of Atherothrombotic Ischemic Events (TRA 2°P)-TIMI 50 trial. In TRA 2°P-TIMI 50--a randomised, placebo-controlled, parallel trial--we randomly assigned patients with a history of atherothrombosis to receive vorapaxar (2·5 mg daily) or matching placebo in a 1:1 ratio. Patients, and those giving treatment, assessing outcomes, and analysing results were masked to treatment allocation. Patients with a qualifying myocardial infarction within the previous 2 weeks to 12 months were analysed as a pre-defined subgroup. The primary efficacy endpoint was cardiovascular death, myocardial infarction, or stroke, analysed by intention to treat. We analysed events by Kaplan-Meier analysis and compared groups with a Cox proportional hazard model. TRA 2°P-TIMI 50 is registered at ClinicalTrials.gov (NCT00526474). 17,779 of 26,449 patients had a qualifying myocardial infarction and were assigned treatment (8898 to vorapaxar and 8881 to placebo). Median follow-up was 2·5 years (IQR 2·0-2·9). Cardiovascular death, myocardial infarction, or stroke occurred in 610 of 8898 patients in the vorapaxar group and 750 of 8881 in the placebo group (3-year Kaplan-Meier estimates 8·1%vs 9·7%, HR 0·80, 95% CI 0·72-0·89; p<0·0001). Moderate or severe bleeding was more common in the vorapaxar group versus the placebo group (241/8880 [3·4%, 3-year Kaplan-Meier estimate] vs 151/8849 [2·1%, 3-year Kaplan-Meier estimate], HR 1·61, 95% CI 1·31-1·97; p<0·0001). Intracranial haemorrhage occurred in 43 of 8880 patients (0·6%, 3-year Kaplan-Meier estimate) with

  19. Long-term survival and radiological results of the Duracon™ total knee arthroplasty

    OpenAIRE

    Bachmann, Matthias; Bolliger, Lilianna; Ilchmann, Thomas; Clauss, Martin

    2013-01-01

    Purpose The aim of this study was to analyse the long-term (>ten years) survival rate and radiological results of the Duracon TKA. Methods Between 1992 and 1999 159 Duracon TKA were implanted at our institution. A Kaplan-Meier survival analysis for the endpoints exchange, addition or removal of any component for any reason, revision due to aseptic loosening and mechanical failure was performed. Radiological long-term (>ten years) follow-up (FU) analysis was performed according to the Knee Soc...

  20. Hazard Rate Estimation for Censored Data via Strong Representation of the Kaplan-Meier Estimator.

    Science.gov (United States)

    1985-08-01

    of bounded variation (condition (k4).) The process( /n 1 has mean zero and covariance SA t (26) r(s,t) E E[C(s) C(t)] - F(s) F(t) f [(u)]- 2 d Lj(u...continuous with density f(x) > 0 at x. Suppose k is of bounded variation and is continuous. Then fn(x) admits the strong approximation on the interval [0,T

  1. Talent in Female Gymnastics: a Survival Analysis Based upon Performance Characteristics.

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    Pion, J; Lenoir, M; Vandorpe, B; Segers, V

    2015-11-01

    This study investigated the link between the anthropometric, physical and motor characteristics assessed during talent identification and dropout in young female gymnasts. 3 cohorts of female gymnasts (n=243; 6-9 years) completed a test battery for talent identification. Performance-levels were monitored over 5 years of competition. Kaplan-Meier and Cox Proportional Hazards analyses were conducted to determine the survival rate and the characteristics that influence dropout respectively. Kaplan-Meier analysis indicated that only 18% of the female gymnasts that passed the baseline talent identification test survived at the highest competition level 5 years later. The Cox Proportional Hazards Model indicated that gymnasts with a score in the best quartile for a specific characteristic significantly increased chances of survival by 45-129%. These characteristics being: basic motor skills (129%), shoulder strength (96%), leg strength (53%) and 3 gross motor coordination items (45-73%). These results suggest that tests batteries commonly used for talent identification in young female gymnasts may also provide valuable insights into future dropout. Therefore, multidimensional test batteries deserve a prominent place in the selection process. The individual test results should encourage trainers to invest in an early development of basic physical and motor characteristics to prevent attrition. © Georg Thieme Verlag KG Stuttgart · New York.

  2. Survival analysis in total joint replacement: an alternative method of accounting for the presence of competing risk.

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    Fennema, P; Lubsen, J

    2010-05-01

    Survival analysis is an important tool for assessing the outcome of total joint replacement. The Kaplan-Meier method is used to estimate the incidence of revision of a prosthesis over time, but does not account appropriately for competing events which preclude revision. In the presence of competing death, this method will lead to statistical bias and the curve will lose its interpretability. A valid comparison of survival results between studies using the method is impossible without accounting for different rates of competing events. An alternative and easily applicable approach, the cumulative incidence of competing risk, is proposed. Using three simulated data sets and realistic data from a cohort of 406 consecutive cementless total hip prostheses, followed up for a minimum of ten years, both approaches were compared and the magnitude of potential bias was highlighted. The Kaplan-Meier method overestimated the incidence of revision by almost 4% (60% relative difference) in the simulations and more than 1% (31.3% relative difference) in the realistic data set. The cumulative incidence of competing risk approach allows for appropriate accounting of competing risk and, as such, offers an improved ability to compare survival results across studies.

  3. Long-term results of pneumatic dilation for achalasia: A 15 years' experience

    Institute of Scientific and Technical Information of China (English)

    Panagiotis Katsinelos; Jannis Kountouras; George Paroutoglou; Athanasios Beltsis; Christos Zavos; Basilios Papaziogas; Kostas Mlimidis

    2005-01-01

    AIM: Although most patients with achalasia respond to pneumatic dilation, one-third experienced recurrence, and prolonged follow-up studies on parameters associated with various outcomes are scanty. In this retrospective study, we reported a 15-years' experience with pneumatic dilation treatment in patients with primary achalasia, and determined whether previously described predictors of outcome remain significant after endoscopic dilation.METHODS: Between September 1989 and September 2004, 39 consecutive patients with primary symptomatic achalasia (diagnosed by clinical presentation, esophagoscopy,barium esophagogram, and manometry) who received balloon dilation were followed up at regular intervals in person or by phone interview. Remission was assessed by a structured interview and a previous symptoms score.The median dysphagia-free duration was calculated by Kaplan-Meier analysis.RESULTS: Symptoms were dysphagia (n = 39, 100%),regurgitation (n =23, 58.7%), chest pain (n = 4, 10.2%),and weight loss (n = 26, 66.6%). A total of 74 dilations were performed in 39 patients; 13 patients (28%) underwent a single dilation, 17 patients (48.7%) required a second procedure within a median of 26.7 mo (range 5-97 mo), and 9 patients (23.3%) underwent a third procedure within a median of 47.8 mo (range 37-120 mo). Post-dilation lower esophageal sphincter (LES) pressure, assessed in 35 patients, has decreased from a baseline of 35.8±10.4-10.0±7.1 mmHg after the procedure. The median follow-up period was 9.3 years (range 0.5-15 years). The dysphagiafree duration by Kaplan-Meier analysis was 78%, 61%and 58.3% after 5, 10 and 15 years respectively.CONCLUSION: Balloon dilation is a safe and effective treatment for primary achalasia. Post-dilation LES pressure estimation may be useful in assessing response.

  4. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy with oxaliplatin for peritoneal mesothelioma: preliminary results and survival analysis.

    Science.gov (United States)

    Hubert, Julien; Thiboutot, Eva; Dubé, Pierre; Cloutier, Alexis-Simon; Drolet, Pierre; Sideris, Lucas

    2015-03-01

    Peritoneal mesothelioma is a rare disease with poor prognosis. The present study reports single center experience with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy with oxaliplatin (HIPEC-OX) over an eight-year period. Prospectively collected data of all consecutive patients with epithelial or multicystic peritoneal mesothelioma from August 2004 to October 2012 was analyzed. Patients with sarcomatoid or biphasic peritoneal mesothelioma were not included due to general poor prognosis. Treatment consisted in CRS and HIPEC-OX (460 mg/m(2)) at 43 °C during 30 min. For statistical analysis, Kaplan-Meier survival curves were plotted and compared using log-rank tests. Cox proportional-hazards regression model was used to analyze the influence of different variables on survival. Nineteen patients with peritoneal mesothelioma underwent laparotomy with CRS and HIPEC-OX with curative intent (15 epithelial, and 4 multicystic). Mean follow-up was 36.7 months. The estimated one-year and three-year overall survival rates were respectively 100% and 91%. The estimated one-year and three-year disease-free survival rates were respectively 77% and 50%. Complications were graded according to the Clavien-Dindo classification [1] and major complications occurred in 57% of cases. There was no postoperative mortality. Histological grade was not a prognostic factor of disease-free survival (p = 0.37). When comparing survival results as well as morbidity-mortality rates, the present study shows that CRS and HIPEC-OX is a valid treatment for peritoneal mesothelioma. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Countrywise results of total hip replacement. An analysis of 438,733 hips based on the Nordic Arthroplasty Register Association database

    DEFF Research Database (Denmark)

    Mäkelä, Keijo T; Matilainen, Markus; Pulkkinen, Pekka

    2014-01-01

    Background and purpose An earlier Nordic Arthroplasty Register Association (NARA) report on 280,201 total hip replacements (THRs) based on data from 1995-2006, from Sweden, Norway, and Denmark, was published in 2009. The present study assessed THR survival according to country, based on the NARA...... database with the Finnish data included. Material and methods 438,733 THRs performed during the period 1995-2011 in Sweden, Denmark, Norway, and Finland were included. Kaplan-Meier survival analysis was used to calculate survival probabilities with 95% confidence interval (CI). Cox multiple regression...

  6. Carbonic anhydrase IX and response to postmastectomy radiotherapy in high-risk breast cancer: a subgroup analysis of the DBCG82 b and c trials

    DEFF Research Database (Denmark)

    Kyndi, M.; Sorensen, F.B.; Alsner, J.;

    2008-01-01

    -points were loco-regional recurrence, distant metastases, disease-specific survival and overall survival. Statistical analyses included kappa statistics, chi(2) or exact tests, Kaplan-Meier probability plots, Log-rank test and Cox regression analyses. Results CA IX was assessable in 945 cores. The percentage...

  7. Carbonic anhydrase IX and response to postmastectomy radiotherapy in high-risk breast cancer: a subgroup analysis of the DBCG82 b and c trials

    DEFF Research Database (Denmark)

    Kyndi, Marianne; Sørensen, Flemming Brandt; Knudsen, Helle;

    2008-01-01

    -points were loco-regional recurrence, distant metastases, disease-specific survival and overall survival. Statistical analyses included kappa statistics, chi2 or exact tests, Kaplan-Meier probability plots, Log-rank test and Cox regression analyses. RESULTS: CA IX was assessable in 945 cores. The percentage...

  8. Double-blind comparison of survival analysis models using a bespoke web system.

    Science.gov (United States)

    Taktak, A F G; Setzkorn, C; Damato, B E

    2006-01-01

    The aim of this study was to carry out a comparison of different linear and non-linear models from different centres on a common dataset in a double-blind manner to eliminate bias. The dataset was shared over the Internet using a secure bespoke environment called geoconda. Models evaluated included: (1) Cox model, (2) Log Normal model, (3) Partial Logistic Spline, (4) Partial Logistic Artificial Neural Network and (5) Radial Basis Function Networks. Graphical analysis of the various models with the Kaplan-Meier values were carried out in 3 survival groups in the test set classified according to the TNM staging system. The discrimination value for each model was determined using the area under the ROC curve. Results showed that the Cox model tended towards optimism whereas the partial logistic Neural Networks showed slight pessimism.

  9. Marital status and survival in pancreatic cancer patients: a SEER based analysis.

    Directory of Open Access Journals (Sweden)

    Michael Baine

    Full Text Available BACKGROUND: Recent findings suggest that marital status affects survival in patients with different types of cancer. However, its role in the survival of patients with pancreatic ductal adenocarcinoma is unknown. In this study, we investigated whether there was an association between marital status and overall survival (OS in patients with pancreatic ductal adenocarcinoma (PDAC. METHODS: Adult patients diagnosed with PDAC between 1998 and 2003 with known marital statuses were identified from the Surveillance, Epidemiology, and End Results registry of the National Cancer Institute. OS for these patients was plotted using the Kaplan-Meier method. Comparative risks of mortality were evaluated by using univariate and multivariate-adjusted Cox regression models. RESULTS: Using Kaplan-Meier analysis, we found that the median overall survival of patients was 4 months and 3 months (p<0.001 for married and unmarried patients, respectively. Subgroup analysis on patients with cancer-directed surgery showed that the median survival was 16 months and 13 months (P<0.0005 for married and unmarried groups, respectively. Multivariate analysis adjusting for age, race, sex, stage, year of diagnosis, radiation therapy and cancer-directed surgery showed that patients who were married at the time of diagnosis had a significantly decreased risk of death at both 2 months (15% risk reduction and 3 years (13% risk reduction post diagnosis. CONCLUSIONS: Marital status is an independent prognostic factor of both perioperative and long-term survival in patients with PDAC. This observation may suggest a suboptimally met psychosocial need among PDAC patients that is partially fulfilled by the support system provided by marriage.

  10. Multiple factor analysis of metachronous upper urinary tract transitional cell carcinoma after radical cystectomy

    Directory of Open Access Journals (Sweden)

    P. Wang

    2007-07-01

    Full Text Available Transitional cell carcinoma (TCC of the urothelium is often multifocal and subsequent tumors may occur anywhere in the urinary tract after the treatment of a primary carcinoma. Patients initially presenting a bladder cancer are at significant risk of developing metachronous tumors in the upper urinary tract (UUT. We evaluated the prognostic factors of primary invasive bladder cancer that may predict a metachronous UUT TCC after radical cystectomy. The records of 476 patients who underwent radical cystectomy for primary invasive bladder TCC from 1989 to 2001 were reviewed retrospectively. The prognostic factors of UUT TCC were determined by multivariate analysis using the COX proportional hazards regression model. Kaplan-Meier analysis was also used to assess the variable incidence of UUT TCC according to different risk factors. Twenty-two patients (4.6%. developed metachronous UUT TCC. Multiplicity, prostatic urethral involvement by the bladder cancer and the associated carcinoma in situ (CIS were significant and independent factors affecting the occurrence of metachronous UUT TCC (P = 0.0425, 0.0082, and 0.0006, respectively. These results were supported, to some extent, by analysis of the UUT TCC disease-free rate by the Kaplan-Meier method, whereby patients with prostatic urethral involvement or with associated CIS demonstrated a significantly lower metachronous UUT TCC disease-free rate than patients without prostatic urethral involvement or without associated CIS (log-rank test, P = 0.0116 and 0.0075, respectively. Multiple tumors, prostatic urethral involvement and associated CIS were risk factors for metachronous UUT TCC, a conclusion that may be useful for designing follow-up strategies for primary invasive bladder cancer after radical cystectomy.

  11. Interim analysis for binary outcome trials with a long fixed follow-up time and repeated outcome assessments at pre-specified times.

    Science.gov (United States)

    Parpia, Sameer; Julian, Jim A; Gu, Chushu; Thabane, Lehana; Levine, Mark N

    2014-01-01

    In trials with binary outcomes, assessed repeatedly at pre-specified times and where the subject is considered to have experienced a failure at the first occurrence of the outcome, interim analyses are performed, generally, after half or more of the subjects have completed follow-up. Depending on the duration of accrual relative to the length of follow-up, this may be inefficient, since there is a possibility that the trial will have completed accrual prior to the interim analysis. An alternative is to plan the interim analysis after subjects have completed follow-up to a time that is less than the fixed full follow-up duration. Using simulations, we evaluated three methods to estimate the event proportion for the interim analysis in terms of type I and II errors and the probability of early stopping. We considered: 1) estimation of the event proportion based on subjects who have been followed for a pre-specified time (less than the full follow-up duration) or who experienced the outcome; 2) estimation of the event proportion based on data from all subjects that have been randomized by the time of the interim analysis; and 3) the Kaplan-Meier approach to estimate the event proportion at the time of the interim analysis. Our results show that all methods preserve and have comparable type I and II errors in certain scenarios. In these cases, we recommend using the Kaplan-Meier method because it incorporates all the available data and has greater probability of early stopping when the treatment effect exists.

  12. High lncRNA H19 expression as prognostic indicator: data mining in female cancers and polling analysis in non-female cancers

    Science.gov (United States)

    Peng, Li; Liu, Zhao-Yang; Li, Wen-Ling; Zhang, Chao-Yang; Zhang, Ya-Qin; Pan, Xi; Chen, Jun; Li, Yue-Hui

    2017-01-01

    Upregulation of lncRNA H19 expression is associated with an unfavorable prognosis in some cancers. However, the prognostic value of H19 in female-specific cancers has remained uncharacterized. In this study, the prognostic power of high H19 expression in female cancer patients from the TCGA datasets was analyzed using Kaplan-Meier survival curves and Cox's proportional hazard modeling. In addition, in a meta-analysis of non-female cancer patients from TCGA datasets and 12 independent studies, hazard ratios (HRs) with 95% confidence interval (CI) for overall survival (OS) and disease-free survival (DFS)/relapse-free survival (RFS)/metastasis-free survival (MFS)/progression-free survival (PFS) were pooled to assess the prognostic value of high H19 expression. Kaplan-Meier analysis revealed that patients with uterine corpus cancer and higher H19 expression had a shorter OS (HR=2.710, p<0.05), while females with cervical cancer and increased H19 expression had a shorter RFS (HR=2.261, p<0.05). Multivariate Cox regression analysis showed that high H19 expression could independently predict a poorer prognosis in cervical cancer patients (HR=4.099, p<0.05). In the meta-analysis, patients with high H19 expression showed a poorer outcome in non-female cancer (p<0.05). These results suggest that high lncRNA H19 expression is predictive of an unfavorable prognosis in two female cancers (uterine corpus endometrioid cancer and cervical cancer) as well as in non-female cancer patients. PMID:27926484

  13. Two-year survival analysis of twisted wire fixed retainer versus spiral wire and fiber-reinforced composite retainers: a preliminary explorative single-blind randomized clinical trial

    Science.gov (United States)

    Sobouti, Farhad; Rakhshan, Vahid; Saravi, Mahdi Gholamrezaei; Zamanian, Ali

    2016-01-01

    Objective Traditional retainers (both metal and fiber-reinforced composite [FRC]) have limitations, and a retainer made from more flexible ligature wires might be advantageous. We aimed to compare an experimental design with two traditional retainers. Methods In this prospective preliminary clinical trial, 150 post-treatment patients were enrolled and randomly divided into three groups of 50 patients each to receive mandibular canine-to-canine retainers made of FRC, flexible spiral wire (FSW), and twisted wire (TW). The patients were monitored monthly. The time at which the first signs of breakage/debonding were detected was recorded. The success rates of the retainers were compared using chi-squared, Kaplan-Meier, and Cox proportional-hazard regression analyses (α = 0.05). Results In total, 42 patients in the FRC group, 41 in the FSW group, and 45 in the TW group completed the study. The 2-year failure rates were 35.7% in the FRC group, 26.8% in the FSW group, and 17.8% in the TW group. These rates differed insignificantly (chi-squared p = 0.167). According to the Kaplan-Meier analysis, failure occurred at 19.95 months in the FRC group, 21.37 months in the FSW group, and 22.36 months in the TW group. The differences between the survival rates in the three groups were not significant (Cox regression p = 0.146). Conclusions Although the failure rate of the experimental retainer was two times lower than that of the FRC retainer, the difference was not statistically significant. The experimental TW retainer was successful, and larger studies are warranted to verify these results. PMID:27019825

  14. Midterm results of a femoral stem with a modular neck design: clinical outcomes and metal ion analysis.

    Science.gov (United States)

    Silverton, Craig D; Jacobs, Joshua J; Devitt, Jeffrey W; Cooper, H John

    2014-09-01

    Modular neck femoral stems have a higher-than-anticipated rate of failure in registry results, but large single-center cohort studies are lacking. This is a retrospective cohort of 152 hips implanted with a single titanium stem with a modular titanium neck, presenting clinical, radiographic, and metal ion results at a mean 4.5-year follow-up. Five hips were revised during the study period, for an overall Kaplan-Meier survival of 0.894 at 8 years. There was one modular neck fracture (0.66%), but others demonstrated corrosion or adverse tissue reaction. Serum metal levels demonstrated wide variability. Despite good clinical results in the majority of patients, we confirmed an increased rate of femoral revision at mid-term follow-up, and therefore urge caution in the use of this particular stem design.

  15. Survival Analysis of Patients with End Stage Renal Disease

    Science.gov (United States)

    Urrutia, J. D.; Gayo, W. S.; Bautista, L. A.; Baccay, E. B.

    2015-06-01

    This paper provides a survival analysis of End Stage Renal Disease (ESRD) under Kaplan-Meier Estimates and Weibull Distribution. The data were obtained from the records of V. L. MakabaliMemorial Hospital with respect to time t (patient's age), covariates such as developed secondary disease (Pulmonary Congestion and Cardiovascular Disease), gender, and the event of interest: the death of ESRD patients. Survival and hazard rates were estimated using NCSS for Weibull Distribution and SPSS for Kaplan-Meier Estimates. These lead to the same conclusion that hazard rate increases and survival rate decreases of ESRD patient diagnosed with Pulmonary Congestion, Cardiovascular Disease and both diseases with respect to time. It also shows that female patients have a greater risk of death compared to males. The probability risk was given the equation R = 1 — e-H(t) where e-H(t) is the survival function, H(t) the cumulative hazard function which was created using Cox-Regression.

  16. A capture-recapture survival analysis model for radio-tagged animals

    Science.gov (United States)

    Pollock, K.H.; Bunck, C.M.; Winterstein, S.R.; Chen, C.-L.; North, P.M.; Nichols, J.D.

    1995-01-01

    In recent years, survival analysis of radio-tagged animals has developed using methods based on the Kaplan-Meier method used in medical and engineering applications (Pollock et al., 1989a,b). An important assumption of this approach is that all tagged animals with a functioning radio can be relocated at each sampling time with probability 1. This assumption may not always be reasonable in practice. In this paper, we show how a general capture-recapture model can be derived which allows for some probability (less than one) for animals to be relocated. This model is not simply a Jolly-Seber model because it is possible to relocate both dead and live animals, unlike when traditional tagging is used. The model can also be viewed as a generalization of the Kaplan-Meier procedure, thus linking the Jolly-Seber and Kaplan-Meier approaches to survival estimation. We present maximum likelihood estimators and discuss testing between submodels. We also discuss model assumptions and their validity in practice. An example is presented based on canvasback data collected by G. M. Haramis of Patuxent Wildlife Research Center, Laurel, Maryland, USA.

  17. “Magic” of our gastric cancer results on perioperative chemotherapy

    Institute of Scientific and Technical Information of China (English)

    Carlos León-Espinoza; Fernando López-Mozos; Roberto Marti-Obiol; Marina Garces-Albir; Joaquin Ortega-Serrano

    2016-01-01

    AIM: To determine reproducibility of perioperative chemotherapy for gastric cancer(GC) on our settings by identifying patient’s overall survival and comparing them to larger studies.METHODS: Retrospective analysis of our series,where we present our eleven-year’s experience on GC managed according to perioperative approach of three preoperative chemotherapy cycles followed by surgery and finally three postoperative chemotherapy cycles.Chemotherapic scheme used was Xelox(Oxaliplatin and Capecitabine).Epidemiologic parameters as well as surgical variables were analysed,presented,and compared to other series with similar approaches.Survival was estimated by Kaplan Meier/log rank method and also compared to these studies.RESULTS: Mean age was 65 years old.Overall survival in our series was 37.7%,similar to other groups using perioperative schemes.Mortality was 4% and morbidity 30%,which are also similar to those groups.Survival curves were compared to larger studies,finding similarities on them.Subgroup survival analysis between chemotherapy responders and non-responders didn’t reach statically significant differences.CONCLUSION: Perioperative chemotherapic scheme can be reproduced on our setting with good results and without increasing morbidity or mortality.

  18. An increased total resected lymph node count benefits survival following pancreas invasive intraductal papillary mucinous neoplasms resection: an analysis using the surveillance, epidemiology, and end result registry database.

    Directory of Open Access Journals (Sweden)

    Wenming Wu

    Full Text Available BACKGROUND: The therapeutic effect of lymph node dissection for pancreas invasive intraductal papillary mucinous neoplasms (IPMN remains unclear. The study investigated whether cancer-specific survival (CSS and overall survival (OS rates among invasive IPMN patients improve when more lymph nodes are harvested during surgery. STUDY DESIGN: The study cohort was retrieved from the Surveillance, Epidemiology, and End Results (SEER database. The lymph node count was categorized into quartiles. The relationship between lymph node count and survival was analyzed using Kaplan-Meier curves and a Cox proportional-hazards model. The stage migration was assessed by Chi-square tests. Propensity score matching (PSM was used to minimize confounding variables between groups. RESULTS: In total, 1,080 patients with resected invasive IPMNs from 1992 to 2011 were included. Univariate and multivariate Cox models indicated that an increased lymph node count independently improves survival. The Kaplan-Meier and log-rank tests identified 16 nodes as an optimal cut-off value that yielded a significant survival benefit for all invasive IPMN patients. The stage migration effect existed in this cohort. After PSM, the 5-year CSS increased from 36% to 47%, and the median survival rate increased from 30 months to 40 months by increasing the lymph node count to over 16, alone. The 5-year OS rate also provided additional support for this result. CONCLUSION: Increased lymph node counts were associated with improved survival in invasive IPMN patients. One cut-off value of lymph node count was 16 for this improvement.

  19. Epidemiology of Uromodulin-Associated Kidney Disease – Results from a Nation-Wide Survey

    Directory of Open Access Journals (Sweden)

    Karl Lhotta

    2012-06-01

    Full Text Available Background/Aims: Uromodulin-associated kidney disease (UAKD is caused by uromodulin mutations and leads to end-stage renal disease. Our objective was to examine the epidemiology of UAKD. Methods: Data from all UAKD families in Austria were collected. Patients included in the Austrian Dialysis and Transplantation Registry (OEDTR with unclear diagnoses or genetic diseases were asked whether they had (1 a family history of kidney disease or (2 had suffered from gout. Patients with gout and autosomal dominant renal disease underwent mutational analysis. Kaplan-Meier and Cox analysis was employed to estimate time to renal failure. Results: Of the 6,210 patients in the OEDTR, 541 were approached with a questionnaire; 353 patients answered the questionnaire. Nineteen of them gave two affirmative answers. In 7 patients, an autosomal dominant renal disease was found; in 1 patient a UMOD mutation was identified. One family was diagnosed through increased awareness as a consequence of the study. At present, 14 UAKD patients from 5 families are living in Austria (1.67 cases per million, and 6 of them require renal replacement therapy (0.73 per 1,000 patients. Progression to renal failure was significantly associated with UMOD genotype. Conclusion: UAKD patients can be identified by a simple questionnaire. UMOD genotype may affect disease progression.

  20. Evaluation of percutaneous radiologic placement of peritoneal dialysis catheters: technical aspects, results, and complications

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Hyun Pyo; Oh, Joo Hyeong; Yoon, Yub; Lee, Tae Won; Ihm, Chun Gyoo [Kyunghee University Hospital, seoul (Korea, Republic of)

    2001-01-01

    To evaluate the technical aspects, results and complications of the percutaneous radiologic placement of peritoneal dialysis catheters. Between December 1999 and April 2001, 26 peritoneal dialysis catheters were placed percutaneously in 26 consecutive patients by interventional radiologists. The patient group consisted of 16 men and ten women with a mean age of 55 (range, 30-77) years. The results and complications arising were reviewed, and the expected patency of the catheters was determined by means of Kaplan-Meier survival analysis. The technical success rate for catheter placement was 100% (26/26 patients). Severe local bleeding occurred in one patient due to by inferior epigastric artery puncture, and was treated by compression and electronic cautery. The duration of catheter implantation ranged from 1 to 510 days and the patency rate was 416{+-}45 days. Catheter malfunction occurred in four patients. In two, this was restored by manipulation in the intervention room, and in one, through the use of urokinase. In three patients, peritonitis occurred. Catheters were removed from four patients due to malfunction (n=2), peritonitis (n=1), and death (n=1). Percutaneous radiologic placement of a peritoneal dialysis catheter is a relatively simple procedure that reduces the complication rate and improves catheter patency.

  1. Below the knee PTA in critical limb ischemia results after 12 months: Single center experience

    Energy Technology Data Exchange (ETDEWEB)

    Balzer, Joern O., E-mail: balzerjo@t-online.d [Dept. for Radiology and Nuclear medicine, Catholic Clinic Mainz, An der Goldgrube 11, Mainz 55131 (Germany); Khan, Verena [Dept. of Diagnostic and Interventional Radiology, Clinic Nurnberg North (Germany); Thalhammer, Axel; Vogl, Thomas J.; Lehnert, Thomas [Dept. of Diagnostic and Interventional Radiology, Univ. Clinic, Johann Wolfgang Goethe-University Frankfurt/Main (Germany)

    2010-07-15

    Purpose: Evaluation of angioplasty with bare metal stents in infrapopliteal occlusions or severe stenoses in patients with critical limb ischemia. Material and methods: Percutaneous stent angioplasty was performed in 58 limbs in 47 patients with critical limb ischemia (CLI) in Rutherford stage 4-6. Lesions with up to 5 cm in length with at least one patent vessel below the obstruction were treated. 121 bare metal stents (diameter of 2.5-4 mm; length of 18-38 mm) were implanted. Follow-up examinations were performed up to 12 months postinterventionally using clinical examination, ABI calculation, and color-coded duplex sonography. Patency rates were calculated on the basis of the Kaplan-Meier analysis. Results: Technical success was achieved in 100%. Minor complications (hematoma, distal emboli, vessel dissection) were documented in 5.17% (n = 3) limbs, respectively. The 3-month, 6-month, and 1-year primary patency rate was 93.0%, 78.9% and 66.7%, respectively. 86.9% of the lesions healed postinterventionally. The cumulative limb salvage rate was 96.6%. Conclusion: Stent angioplasty in infrapopliteal arteries is a safe and effective technique for the treatment of patients with CLI. By consequent clinical monitoring high secondary patency rates can be achieved. The use of a bare metal stent seems to result in high limb salvage, primary and secondary patency rates in the mid-term follow-up.

  2. Geographical variation in cardiovascular incidence: results from the British Women's Heart and Health Study

    Directory of Open Access Journals (Sweden)

    Ebrahim Shah

    2010-11-01

    Full Text Available Abstract Background Prevalence of cardiovascular disease (CVD in women shows regional variations not explained by common risk factors. Analysis of CVD incidence will provide insight into whether there is further divergence between regions with increasing age. Methods Seven-year follow-up data on 2685 women aged 59-80 (mean 69 at baseline from 23 towns in the UK were available from the British Women's Heart and Health Study. Time to fatal or non-fatal CVD was analyzed using Cox regression with adjustment for risk factors, using multiple imputation for missing values. Results Compared to South England, CVD incidence is similar in North England (HR 1.05 (95% CI 0.84, 1.31 and Scotland (0.93 (0.68, 1.27, but lower in Midlands/Wales (0.85 (0.64, 1.12. Event severity influenced regional variation, with South England showing lower fatal incident CVD than other regions, but higher non-fatal incident CVD. Kaplan-Meier plots suggested that regional divergence in CVD occurred before baseline (before mean baseline age of 69. Conclusions In women, regional differences in CVD early in adult life do not further diverge in later life. This may be due to regional differences in early detection, survivorship of women entering the study, or event severity. Targeting health care resources for CVD by geographic variation may not be appropriate for older age-groups.

  3. Single-plate Molteno implants in complicated glaucomas : Results, survival rates, and complications

    Directory of Open Access Journals (Sweden)

    Neelakantan Arvind

    1994-01-01

    Full Text Available Sixty-two single-plate single-stage Molteno implantations for complicated glaucomas were performed between March 1991 and November 1992. The charts of all these patients were reviewed to determine the intraocular pressure (IOP control success rate (< 21 mm Hg with or without medications, visual success rate (retention or improvement of visual acuity from preoperative level and the rate of complications encountered. A Kaplan-Meier life-table (survival analysis was also performed. IOP control was obtained in 74.2% of cases. Mean postoperative IOP was 16.97 +/- 8.07 mm Hg (Mean +/- SD. Visual success was obtained in 51.6% of the eyes. Eyes with aphakia/pseudophakic glaucomas showed the best response with 80% of them achieving IOP control and 60% achieving visual success. The survival plot for IOP control revealed 75.81% and 74.19% success rates at 48 and 72 weeks, respectively. Complications encountered were either due to the early postoperative hypotony or were tube-related. These results were gratifying considering the severity of the glaucoma in these cases and they reaffirm the usefulness of the Molteno implant in the management of difficult glaucomas.

  4. Latent cluster analysis of ALS phenotypes identifies prognostically differing groups.

    Directory of Open Access Journals (Sweden)

    Jeban Ganesalingam

    Full Text Available BACKGROUND: Amyotrophic lateral sclerosis (ALS is a degenerative disease predominantly affecting motor neurons and manifesting as several different phenotypes. Whether these phenotypes correspond to different underlying disease processes is unknown. We used latent cluster analysis to identify groupings of clinical variables in an objective and unbiased way to improve phenotyping for clinical and research purposes. METHODS: Latent class cluster analysis was applied to a large database consisting of 1467 records of people with ALS, using discrete variables which can be readily determined at the first clinic appointment. The model was tested for clinical relevance by survival analysis of the phenotypic groupings using the Kaplan-Meier method. RESULTS: The best model generated five distinct phenotypic classes that strongly predicted survival (p<0.0001. Eight variables were used for the latent class analysis, but a good estimate of the classification could be obtained using just two variables: site of first symptoms (bulbar or limb and time from symptom onset to diagnosis (p<0.00001. CONCLUSION: The five phenotypic classes identified using latent cluster analysis can predict prognosis. They could be used to stratify patients recruited into clinical trials and generating more homogeneous disease groups for genetic, proteomic and risk factor research.

  5. Treatment of malignant biliary occlusion by means of transhepatic percutaneous biliary drainage with insertion of metal stents - results of an 8-year follow-up and analysis of the prognostic parameters; Behandlung der malignen Gallenwegsstenose mittels perkutaner transhepatischer Metallendoprothesenimplantation: 8 Jahres-Ergebnisse und Analyse prognostischer Faktoren

    Energy Technology Data Exchange (ETDEWEB)

    Alfke, H.; Alfke, B.; Froelich, J.J.; Klose, K.J.; Wagner, H.J. [Klinik fuer Strahlendiagnostik Philipps Univ. Marburg (Germany)

    2003-08-01

    Purpose: To analyze outcome and predictive factors for patient survival and patency rates of unresectable malignant biliary obstruction treated with percutaneous transhepatic insertion of metal stents. Materials and Methods: This is a retroselective analysis of 130 patients treated in one interventional radiological center with data collected from patient records and by telephone interviews. The procedure-related data had been prospectively documented in a computer data base. The Kaplan-Meier analysis was performed for univariate and multivariate comparison of survival and patency rates with the log-rank test used for different tumor types. Predictive factors for survival and 30-day mortality were analyzed by a stepwise logistic regression. Results: Underlying causes of malignant biliary obstructions were cholangiocarcinoma in 50, pancreatic carcinoma in 29, liver metastases in 27, gallbladder carcinoma in 20, and other tumors in 4 patients. The technical success rate was 99%, the complication rate 27% and the 30-day mortality 11%. Primary patency rates (406 days with a median of 207 days) did not differ significantly for different tumor types. The survival rates were significantly (p = 0.03 by log-rank test) better for patients with cholangiocarcinoma than for patients with pancreatic carcinoma and liver metastases. Multiple regression analysis revealed no predictive factor for patient survival and 30-day mortality. Conclusion: Percutaneous transhepatic insertion of metal biliary endoprostheses offers a good initial and long-term relief of jaundice caused by malignant biliary obstruction. Although survival rates for patients with cholangiocarcinoma are better than for other causes of malignant biliary obstruction, a clear predictive factor is lacking for patients undergoing palliative biliary stent insertion. (orig.) [German] Ziel: Ergebnisse der perkutanen transhepatischen Metallendoprothesenimplantation bei malignen Gallenwegsverschluessen zu evaluieren und

  6. A review and comparison of methods for recreating individual patient data from published Kaplan-Meier survival curves for economic evaluations: a simulation study.

    Directory of Open Access Journals (Sweden)

    Xiaomin Wan

    Full Text Available In general, the individual patient-level data (IPD collected in clinical trials are not available to independent researchers to conduct economic evaluations; researchers only have access to published survival curves and summary statistics. Thus, methods that use published survival curves and summary statistics to reproduce statistics for economic evaluations are essential. Four methods have been identified: two traditional methods 1 least squares method, 2 graphical method; and two recently proposed methods by 3 Hoyle and Henley, 4 Guyot et al. The four methods were first individually reviewed and subsequently assessed regarding their abilities to estimate mean survival through a simulation study.A number of different scenarios were developed that comprised combinations of various sample sizes, censoring rates and parametric survival distributions. One thousand simulated survival datasets were generated for each scenario, and all methods were applied to actual IPD. The uncertainty in the estimate of mean survival time was also captured.All methods provided accurate estimates of the mean survival time when the sample size was 500 and a Weibull distribution was used. When the sample size was 100 and the Weibull distribution was used, the Guyot et al. method was almost as accurate as the Hoyle and Henley method; however, more biases were identified in the traditional methods. When a lognormal distribution was used, the Guyot et al. method generated noticeably less bias and a more accurate uncertainty compared with the Hoyle and Henley method.The traditional methods should not be preferred because of their remarkable overestimation. When the Weibull distribution was used for a fitted model, the Guyot et al. method was almost as accurate as the Hoyle and Henley method. However, if the lognormal distribution was used, the Guyot et al. method was less biased compared with the Hoyle and Henley method.

  7. Early Results with the Use of Heparin-bonded Stent Graft to Rescue Failed Angioplasty of Chronic Femoropopliteal Occlusive Lesions: TASC D Lesions Have a Poor Outcome

    Energy Technology Data Exchange (ETDEWEB)

    Kuhan, Ganesh, E-mail: gkuhan@nhs.net; Abisi, Said; Braithwaite, Bruce D.; MacSweeney, Shane T. R. [Nottingham University Hospitals, Vascular and Endovascular Unit, Queens Medical Centre (United Kingdom); Whitaker, Simon C.; Habib, Said B. [Nottingham University Hospitals, Department of Radiology, Queen' s Medical Centre (United Kingdom)

    2012-10-15

    Purpose: To evaluate early patency rate of the heparin-bonded stent grafts in atherosclerotic long femoropopliteal occlusive disease, and to identify factors that affect outcome. Methods: Heparin-bonded Viabahn stent grafts were placed in 33 limbs in 33 patients during 2009-2010. The stents were deployed to rescue failed conventional balloon angioplasty. Mean age was 69 (range 44-88) years, and 67 % (22 of 33) were men. Most procedures (21 of 33, 64 %) were performed for critical limb ischemia (33 % for rest pain, 30 % tissue loss). Kaplan-Meier plots and Cox regression analysis were used to identify significant risk factors. Results: The average length of lesions treated was 25 {+-} 10 cm, and they were predominantly TASC (Transatlantic Intersociety Consensus) D (n = 13) and C (n = 17) lesions. The median primary patency was 5.0 months (95 % confidence interval 1.22-8.77). The mean secondary patency was 8.6 months (95 % confidence interval 6.82-10.42). Subsequently, 4 patients underwent bypass surgery and 5 patients underwent major amputation. One patient died. There were 5 in-stent or edge-stent stenoses. Cox multivariate regression analysis identified TASC D lesions to be a significant risk factor for early occlusion (p = 0.035). Conclusion: TASC D lesions of femoropopliteal occlusions have poor patency rates with the use of heparin-bonded stent grafts after failed conventional angioplasty. Alternative options should be considered for these patients.

  8. [Survival analysis of 104 cases of osteosarcoma with lung metastases].

    Science.gov (United States)

    Ren, J; Xu, Y F; Kuang, T H; Chen, J; Liu, Y X

    2017-04-23

    Objective: To investigate the prognosis of osteosarcoma patients with lung metastases and its correlated factors. Methods: The clinical data of 104 osteosarcoma patients with lung metastasis from April 2007 to September 2015 were retrospectively analyzed. Univariate analysis was performed using Kaplan-Meier and Log rank test. Multivariate Cox regression was applied to analyze independent prognostic factor for patient survival. Results: The one-year, two-year and five-year survival rates of the 104 osteosarcoma patients with lung pulmonary metastasis were 93.3%, 61.5% and 11.5%, respectively, and the median survival time was 33 months. The univariate analysis revealed that number of lung metastases, objective response of first-line chemotherapy and therapeutic methods for lung metastases were significant prognostic factors for patient survival, whereas gender, age, time to lung metastasis and time to other metastasis were not (P>0.05). The multivariate analysis indicated that number of lung metastases, objective response of first-line chemotherapy and therapeutic methods for lung metastases were independent significant prognostic factors for patient survival. Conclusions: The prognosis of osteosarcoma patients with advanced lung metastases and active treatment is better. Surgery and adjuvant chemotherapy could effectively prolong survival time for osteosarcoma patients with pulmonary metastasis.

  9. Clinicopathologic and survival analysis of resected ampullary adenocarcinoma.

    Science.gov (United States)

    Doepker, Matthew P; Thompson, Zachary J; Centeno, Barbara A; Kim, Richard D; Wong, Joyce; Hodul, Pamela J

    2016-08-01

    Ampullary adenocarcinoma (AAC) is a rare neoplasm. We sought to determine the clinicopathologic factors contributing to the overall survival (OS) and recurrence-free (RFS) survival. Patients (pts) with resected AAC were identified from 1996 to 2015 and reviewed for clinicopathologic factors and correlated with outcome. We identified and evaluated 106 pts diagnosed with AAC. The median age was 70.2 years (range 41-86) and 60 (56.6%) were male. Overall, 105 pts (99.1%) had a pancreaticoduodenectomy. An R0 resection was achieved in 101 (95%) pts. Median follow-up was 19 months with a median OS of 49.3 months. Lymph node metastasis and poorly differentiated tumors adversely affected OS on multivariate analysis (MVA). Twenty patients (18.9%) developed recurrence. The median RFS was 27 months. RFS was adversely affected by lymph node count and metastasis, tumor differentiation, and histological subtype on MVA. Survival was not affected by the addition of adjuvant therapy. Retrieval of ≤12 lymph nodes and lymph node ratio ≥0.10 resulted in worse OS on Kaplan-Meier analysis. Our data show retrieval of ≤12 nodes, involvement of nodes with AAC, moderately or poorly differentiated tumors, and pancreaticobiliary subtype adversely affected survival, while the use of adjuvant therapy demonstrated no significant benefit. J. Surg. Oncol. 2016;114:170-175. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  10. TMA Navigator: Network inference, patient stratification and survival analysis with tissue microarray data.

    Science.gov (United States)

    Lubbock, Alexander L R; Katz, Elad; Harrison, David J; Overton, Ian M

    2013-07-01

    Tissue microarrays (TMAs) allow multiplexed analysis of tissue samples and are frequently used to estimate biomarker protein expression in tumour biopsies. TMA Navigator (www.tmanavigator.org) is an open access web application for analysis of TMA data and related information, accommodating categorical, semi-continuous and continuous expression scores. Non-biological variation, or batch effects, can hinder data analysis and may be mitigated using the ComBat algorithm, which is incorporated with enhancements for automated application to TMA data. Unsupervised grouping of samples (patients) is provided according to Gaussian mixture modelling of marker scores, with cardinality selected by Bayesian information criterion regularization. Kaplan-Meier survival analysis is available, including comparison of groups identified by mixture modelling using the Mantel-Cox log-rank test. TMA Navigator also supports network inference approaches useful for TMA datasets, which often constitute comparatively few markers. Tissue and cell-type specific networks derived from TMA expression data offer insights into the molecular logic underlying pathophenotypes, towards more effective and personalized medicine. Output is interactive, and results may be exported for use with external programs. Private anonymous access is available, and user accounts may be generated for easier data management.

  11. Satistical Graphical User Interface Plug-In for Survival Analysis in R Statistical and Graphics Language and Environment

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    Daniel C. LEUCUŢA

    2008-12-01

    Full Text Available Introduction: R is a statistical and graphics language and environment. Although it is extensively used in command line, graphical user interfaces exist to ease the accommodation with it for new users. Rcmdr is an R package providing a basic-statistics graphical user interface to R. Survival analysis interface is not provided by Rcmdr. The AIM of this paper was to create a plug-in for Rcmdr to provide survival analysis user interface for some basic R survival analysis functions.Materials and Methods: The Rcmdr plug-in code was written in Tinn-R. The plug-in package was tested and built with Rtools. The plug-in was installed and tested in R with Rcmdr package on a Windows XP workstation with the "aml" and "kidney" data sets from survival R package.Results: The Rcmdr survival analysis plug-in was successfully built and it provides the functionality it was designed to offer: interface for Kaplan Meier and log log survival graph, interface for the log-rank test, interface to create a Cox proportional hazard regression model, interface commands to test and assess graphically the proportional hazard assumption, and influence observations. Conclusion: Rcmdr and R though their flexible and well planed structure, offer an easy way to expand their functionality that was used here to make the statistical environment more user friendly in respect with survival analysis.

  12. Role of supportive maintenance therapy on implant survival: a university-based 17 years retrospective analysis.

    Science.gov (United States)

    Gay, I C; Tran, D T; Weltman, R; Parthasarathy, K; Diaz-Rodriguez, J; Walji, M; Fu, Y; Friedman, L

    2016-11-01

    The objective of this study was to determine whether professional maintenance appointments were related to a decrease on dental implant loss. We performed a retrospective review (1995-2012) of 1020 patient dental charts to collect data including a cadre of different variables such as age, gender, race, diabetes, osteoporosis, jaw location, implant dimensions and professional maintenance therapy. As a patient may have multiple implants which are correlated, we selected one random implant per patient to assure independence of observations assumption of the Cox proportional hazards regression model. Data analysis was performed using Kaplan-Meier survival curves and multivariate analysis using Cox proportional hazards regression analysis. Our results demonstrate that subjects with no maintenance had the lowest cumulative survival rate as compared to subjects with regular maintenance. In a multivariate Cox regression model, regular maintenance patients had the dental implant failure rate reduced by 90% as compared to no maintenance (P = 0.001). If patients had less than one maintenance visit per year, the failure rate was reduced by 60% as compared to no maintenance, but the difference was not statistically significant (P = 0.08). From this research, we conclude that a professional administered periodontal maintenance at least on an annual basis is a critical factor for implant survival. © 2015 The Authors. International Journal of Dental Hygiene Published by John Wiley & Sons Ltd.

  13. Multimodality treatment of brain metastases: an institutional survival analysis of 275 patients

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    Demakas John J

    2011-07-01

    Full Text Available Abstract Background Whole brain radiation therapy (WBRT, surgical resection, stereotactic radiosurgery (SRS, and combinations of the three modalities are used in the management of patients with metastatic brain tumors. We present the previously unreported survival outcomes of 275 patients treated for newly diagnosed brain metastases at Cancer Care Northwest and Gamma Knife of Spokane between 1998 and 2008. Methods The effects treatment regimen, age, Eastern Cooperative Oncology Group-Performance Status (ECOG-PS, primary tumor histology, number of brain metastases, and total volume of brain metastases have on patient overall survival were analyzed. Statistical analysis was performed using Kaplan-Meier survival curves, Andersen 95% confidence intervals, approximate confidence intervals for log hazard-ratios, and multivariate Cox proportional hazard models. Results The median clinical follow up time was 7.2 months. On multivariate analysis, survival statistically favored patients treated with SRS alone when compared to patients treated with WBRT alone (p Conclusions In our analysis, patients benefited from a combined modality treatment approach and physicians must consider patient age, performance status, and primary tumor histology when recommending specific treatments regimens.

  14. Multivariate analysis of factors influencing the effect of radiosynovectomy; Multivariate Analyse der Einflussfaktoren auf die Wirkung der Radiosynoviorthese bei entzuendlichen Gelenkerkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Farahati, J.; Schulz, G.; Koerber, C.; Geling, M.; Schmeider, P.; Reiners, Chr. [Wuerzburg Univ. (Germany). Klinik fuer Nuklearmedizin; Wendler, J. [Erlangen-Nuernberg Univ. (Germany). Klinik fuer Innere Medizin III; Kenn, W. [Wuerzburg Univ. (Germany). Inst. fuer Roentgendiagnostik; Reidemeister, C. [Wuerzburg Univ. (Germany). Klinik fuer Innere Medizin

    2002-04-01

    Objective: In this prospective study, the time to remission after radiosynovectomy (RSV) was analyzed and the influence of age, sex, underlying disease, type of joint, and duration of illness on the success rate of RSV was determined. Methods: A total number of 57 patients with rheumatoid arthritis (n = 33) and arthrosis (n = 21) with a total number of 130 treated joints (36 knee, 66 small and 28 medium-size joints) were monitored using visual analogue scales (VAS) from one week before RSV up to four to six months after RSV. The patients had to answer 3 times daily for pain intensity of the treated joint. The time until remission was determined according to the Kaplan-Meier survivorship function. The influence of the prognosis parameters on outcome of RSV was determined by multivariate discriminant analysis. Results: After six months, the probability of pain relief of more than 20% amounted to 78% and was significantly dependent on the age of the patient (p = 0.02) and the duration of illness (p = 0.05), however not on sex (p = 0.17), underlying disease (p = 0.23), and type of joint (p = 0.69). Conclusion: Irrespective of sex, type of joint and underlying disease, a measurable pain relief can be achieved with RSV in 78% of the patients with synovitis, whereby effectiveness is decreasing with increasing age and progress of illness. (orig.) [German] Ziel: In dieser prospektiven Studie wurde die Zeit bis zur Remission nach einer Radiosynoviorthese (RSO) untersucht. Ebenso wurde der Einfluss von Alter, Geschlecht, Grunderkrankung, Gelenktyp und Erkrankungsdauer auf die Erfolgsrate der RSO ermittelt. Methodik: Bei insgesamt 57 Patienten mit rheumatoider Arthritis (n = 33) und Arthritis bei aktivierter Arthrose (n = 24) wurden 130 Gelenke (36 Kniegelenke, 66 kleine und 28 mittelgrosse Gelenke) behandelt. Die Patienten wurden unter Verwendung so genannter visueller Analogskalen eine Woche vor RSO und vier bis sechs Monate danach 3-mal taeglich zur Schmerzintensitaet des

  15. Indicadores clínicos e pré-hospitalares de sobrevivência no trauma fechado: uma análise multivariada Indicadores clínicos y prehospitalarios de supervivencia al trauma cerrado: un análisis multivariado Clinical and prehospital survival indicators in blunt trauma: a multivariate analysis

    Directory of Open Access Journals (Sweden)

    Marisa Aparecida Amaro Malvestio

    2010-06-01

    protector en todos los períodos. Los resultados sugieren que la magnitud de la hipoxemia y la inestabilidad hemodinámica debida a la hemorragia influyeron de manera significativa en la muerte temprana y tardía en este grupo de víctimas.The aim of the study was to identify the clinical and prehospital indicators associated to the survival of blunt trauma victims. The Kaplan Meier survival analysis and the Cox proportional hazards model were used to analyze the association of 33 variables to early and late death, proposing multivariate models. The final models until 48 hours post-trauma showed high rates of risk promoted by abdominal injuries, Injury Severity Score > 25, advanced respiratory procedures and prehospital chest compressions. In the model up to 7 days, a systolic blood pressure in accident site lower than 75mmHg was associated with increased risk of death, and if absent it was associated with higher risk of death after 7 days. The prehospital volume replacement showed a protective effect in all periods. Results suggest that the magnitude of hypoxemia and hemodynamic instability due to bleeding had a significant influence on early and late death in this group of victims.

  16. New fluoride MI Varnish as root canal sealer: An in vitro analysis of bacterial leakage

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    Dhanu G Rao

    2016-01-01

    Full Text Available Aims: The aim of the present study was to evaluate and compare the sealing ability of root canal obturation after the application of fluoride varnish (MI Varnish containing 5% sodium fluoride and casein phosphopeptide-amorphous calcium phosphate, fluoride varnish, and AH Plus and AH-Plus as root canal sealer by bacterial penetration test. Materials and Methods: Root canals of 65 single-rooted and single-canalled teeth were prepared. They were divided into three experimental groups (n = 15 and two control groups (n = 10. The root canal walls in Group I were coated with AH Plus, Group II were coated with AH Plus and fluoride varnish, and Group III were coated with fluoride varnish. All the teeth were obturated with gutta-percha using the lateral condensation technique. Enterococcus faecalis were used as test bacteria to determine the leakage during 100 days. Statistical Analysis: The data were analyzed using log-rank test and Kaplan-Meier survival analysis. Results: Group III showed significantly less bacterial penetration as compared to Group I (P = 0.01 and Group II (P = 0.03. However, there was no statistical significance between Groups I and II (P = 0.672. Conclusions: It can be concluded from the present study that fluoride varnish can be used as a root canal sealer. However, further in vitro and in vivo studies are required.

  17. [Factors influencing long-term survival in patients with nonoperable lung cancer: an analysis by Cox model].

    Science.gov (United States)

    Dong, W; Zhao, W; Sun, L

    1996-09-01

    This paper reports a prospective survey of 173 patients with nonoperable lung cancer between January. 1, 1983 to March. 1, 1985. The follow-up rate was 97.7% over five years. Fourteen factors including sex, age, course of disease before treatment, clinical stage, performance status, size of mass, metastatic status, hemoglobin before treatment, short-term response to treatment and so on which might influence long term survival were studied by univariate analysis (Kruskal-Wallis test for Kaplan-Meier survival curve) and by multivariate analysis (Cox's proportional hazad model and audio-visual chart test for goodness of fit). Multivariate analysis using Cox's model revealed 6 significant prognostic factors: performance status, short-term response to treatment, clinical stage, hemoglobin before treatment, smoking index and method of treatment. The survival prediction equation was chi 2 = 72.14, nu = 6, P < 0.0001. The results indicate that the performance status and the CR rate of the initial treatment, among other things, is the major factors affecting prognosis.

  18. Multivariate Analysis of Prognostic Factors Among 2,313 Patients With Stage III Melanoma: Comparison of Nodal Micrometastases Versus Macrometastases

    Science.gov (United States)

    Balch, Charles M.; Gershenwald, Jeffrey E.; Soong, Seng-jaw; Thompson, John F.; Ding, Shouluan; Byrd, David R.; Cascinelli, Natale; Cochran, Alistair J.; Coit, Daniel G.; Eggermont, Alexander M.; Johnson, Timothy; Kirkwood, John M.; Leong, Stanley P.; McMasters, Kelly M.; Mihm, Martin C.; Morton, Donald L.; Ross, Merrick I.; Sondak, Vernon K.

    2010-01-01

    Purpose To determine the survival rates and independent predictors of survival using a contemporary international cohort of patients with stage III melanoma. Patients and Methods Complete clinicopathologic and follow-up data were available for 2,313 patients with stage III disease in an updated and expanded American Joint Committee on Cancer (AJCC) melanoma staging database. Kaplan-Meier and Cox multivariate survival analyses were performed. Results Among all 2,313 patients with stage III disease, 81% had micrometastases, and 19% had clinically detectable macrometastases. The 5-year overall survival was 63%; it was 67% for patients with nodal micrometastases, and it was 43% for those with nodal macrometastases (P Multivariate analysis demonstrated that in patients with nodal micrometastases, number of tumor-containing lymph nodes, primary tumor thickness, patient age, ulceration, and anatomic site of the primary independently predicted survival (all P < .01). When added to the model, primary tumor mitotic rate was the second-most powerful predictor of survival after the number of tumor-containing nodes. In contrast, for patients with nodal macrometastases, the number of tumor-containing nodes, primary ulceration, and patient age independently predicted survival (P < .01). Conclusion In this multi-institutional analysis, we demonstrated remarkable heterogeneity of prognosis among patients with stage III melanoma, especially among those with nodal micrometastases. These results should be incorporated into the design and interpretation of future clinical trials involving patients with stage III melanoma. PMID:20368546

  19. Five year retrospective survival analysis of triple negative breast cancer in North-West India

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    B Sharma

    2013-01-01

    Full Text Available Background: In our institute, about 10% of total cancer is female breast cancer. This analysis was performed to check triple negativity among these patients with their survival strength up to 5 years in relation to different age groups, stage and chemotherapy protocols. Materials and Methods: 208 immunohistochemistry proved triple negative breast cancer patients registered and treated until 2008 were retrospectively selected for the study. Overall survival up to 5 years was observed on the basis of stage, different age groups and chemotherapy regimens. All patients had undergone surgery, conventional external beam radiation therapy and adjuvant chemotherapy. The survival analyses were performed using the Kaplan-Meier method. Results: The majority of patients (41% were in the age group 21-30 years. Stage IV was seen in 18% of the patients at diagnosis and mainly in 21-40 years age group. Only 3% of females were >70 years age and were of Stage I and II. Overall 5 year survival in Stage I in Cyclophosphamide, Adriamycin/Epirubicin, 5-Flurouracil group was 37.5% as compared with Docetaxel/Paclitaxel, Epirubicin group 93% (P < 0.0001. Conclusion: Triple negativity in North-West India is about 11.8%. We observed it in younger patients mainly with highly aggressive behaviors. Taxane based chemotherapy gives better result as compared with anthracycline based regimens in all stages.

  20. Markov chains and semi-Markov models in time-to-event analysis.

    Science.gov (United States)

    Abner, Erin L; Charnigo, Richard J; Kryscio, Richard J

    2013-10-25

    A variety of statistical methods are available to investigators for analysis of time-to-event data, often referred to as survival analysis. Kaplan-Meier estimation and Cox proportional hazards regression are commonly employed tools but are not appropriate for all studies, particularly in the presence of competing risks and when multiple or recurrent outcomes are of interest. Markov chain models can accommodate censored data, competing risks (informative censoring), multiple outcomes, recurrent outcomes, frailty, and non-constant survival probabilities. Markov chain models, though often overlooked by investigators in time-to-event analysis, have long been used in clinical studies and have widespread application in other fields.

  1. Adenoid cystic carcinoma of head and neck: A single institutional analysis of 66 patients treated with multi-modality approach

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    Ajeet Kumar Gandhi

    2015-01-01

    Full Text Available Background: Adenoid cystic carcinoma (ACC accounts for 1% of all head and neck (HN cancers. Materials and Methods: Demographic, clinical, treatment, and survival details of 66 patients were collected (1995-2011 and analyzed. Disease-free survival (DFS was estimated by Kaplan-Meier method. Results: Primary disease sites were sinonasal (n = 27, salivary gland (n = 30, and others (n = 9. Median follow-up was 23 months (range: 12-211 months. Estimated DFS at 2- and 5-year were 75% and 67.2%, respectively. On univariate analysis, intra-cranial extension (ICE (hazard ratio [HR]: 3.59, P = 0.0071, lymph node involvement (HR: 4.05, P = 0.0065, treatment modality (others vs. surgery plus adjuvant radiotherapy, HR: 2.39, P = 0.0286 and T stage (T3/4 vs. T1/2, HR: 3.27, P = 0.007 had significant impact on DFS. Lymph node involvement (P = 0.038 and ICE (P = 0.038 continued to have significant impact on DFS on multivariate analysis. Conclusion: Surgery followed by adjuvant radiotherapy remains the treatment of choice for HN ACC. Lymph node involvement and ICE confer poor prognosis.

  2. New breast cancer prognostic factors identified by computer-aided image analysis of HE stained histopathology images.

    Science.gov (United States)

    Chen, Jia-Mei; Qu, Ai-Ping; Wang, Lin-Wei; Yuan, Jing-Ping; Yang, Fang; Xiang, Qing-Ming; Maskey, Ninu; Yang, Gui-Fang; Liu, Juan; Li, Yan

    2015-05-29

    Computer-aided image analysis (CAI) can help objectively quantify morphologic features of hematoxylin-eosin (HE) histopathology images and provide potentially useful prognostic information on breast cancer. We performed a CAI workflow on 1,150 HE images from 230 patients with invasive ductal carcinoma (IDC) of the breast. We used a pixel-wise support vector machine classifier for tumor nests (TNs)-stroma segmentation, and a marker-controlled watershed algorithm for nuclei segmentation. 730 morphologic parameters were extracted after segmentation, and 12 parameters identified by Kaplan-Meier analysis were significantly associated with 8-year disease free survival (P < 0.05 for all). Moreover, four image features including TNs feature (HR 1.327, 95%CI [1.001-1.759], P = 0.049), TNs cell nuclei feature (HR 0.729, 95%CI [0.537-0.989], P = 0.042), TNs cell density (HR 1.625, 95%CI [1.177-2.244], P = 0.003), and stromal cell structure feature (HR 1.596, 95%CI [1.142-2.229], P = 0.006) were identified by multivariate Cox proportional hazards model to be new independent prognostic factors. The results indicated that CAI can assist the pathologist in extracting prognostic information from HE histopathology images for IDC. The TNs feature, TNs cell nuclei feature, TNs cell density, and stromal cell structure feature could be new prognostic factors.

  3. MULTIVISCERAL RESECTION FOR COLORECTAL CANCERS: AN ANALYSIS OF PROGNOSTIC FACTORS AND OUTCOMES

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    Happykumar Kagathara

    2016-01-01

    Full Text Available For colorectal cancer patients, long-term survival is achievable only after complete resection of the disease. However, the decision to embark on a multi-visceral resection must be made after weighing the risks against the potential benefits. We retrospectively analyzed the demographics, tumor parameters, perioperative results, oncological outcomes and survival details of 35 patients who underwent multivisceral resection for colorectal carcinoma between 1996 and 2013. 'Multivisceral resection' was defined as the resection of at least one other organ in addition to cancer affected the colon. There were 19 males and 16 females who had a mean age of 52.7 ± 13.6 years. The most common primary site of the tumor was the rectum, followed by the sigmoid, the left, and the right colon. Most frequently resected additional organ was the pancreas followed by the uterus, small bowel, urinary bladder, ureter, vagina, spleen, duodenum, ovary, and liver. Postoperative histopathological examination confirmed tumor infiltration in the adjacent organs in 48.5%. The postoperative complication was developed in 21 (60% patients. There was no surgery-related mortality. Ten patients had evidence of recurrence at last follow-up in June 2014. The 5-year survival rate was of 73.1% according to Kaplan-Meier survival analysis. Multivisceral resection for colorectal cancer is associated with a high morbidity rate, but the long-term survival is good.

  4. Tissue microarrays compared with whole sections and biochemical analyses. A subgroup analysis of DBCG 82 b

    DEFF Research Database (Denmark)

    Kyndi, Marianne; Sørensen, Flemming Brandt; Knudsen, H;

    2008-01-01

    &c trials, were IHC stained for ER, PgR and HER2. In addition, ER and PgR were measured in the DBCG82 b&c trials by a biochemical analysis. Statistical analyses included Kappa statistics, Kaplan-Meier survival curves, Log-rank tests, and Cox regression hazards analyses. RESULTS AND CONCLUSION: IHC stainings...... stainings of TMA cores and biochemical analyses. Divergence between IHC and biochemical analyses was predominantly due to the chosen thresholds. IHC staining of one 1mm core from each tumor revealed a significant independent prognostic value of PgR and HER2 on overall survival. In conclusion, IHC stainings...... cores and biochemical analyses. PATIENTS AND METHODS: A central and a peripheral 1mm core and a whole section from each of 54 paraffin blocks from 27 breast cancers included in a one-institution cohort, and a single 1mm central TMA core, from each breast tumor from 1000 patients included in the DBCG82 b...

  5. Radiotherapy and Male Breast Cancer: A Population-based Registry Analysis.

    Science.gov (United States)

    Madden, Nicholas A; Macdonald, Orlan K; Call, Jason A; Schomas, David A; Lee, Christopher M; Patel, Shilpen

    2016-10-01

    The local-regional management of female breast cancer has been extensively investigated worldwide. The optimal approach for males diagnosed with breast cancer is less clear. We have analyzed the treatment of male breast cancer using a population-based national registry to determine the impact of surgery and radiation therapy on survival. The Surveillance Epidemiology and End Results (SEER) database was queried to identify males with invasive ductal carcinoma of the breast who underwent primary surgical resection (radical mastectomy, modified radical mastectomy, total mastectomy, or segmental) for the years 1983 to 2002. Demographic, clinical, and pathologic data were culled and analyzed to determine the impact of radiation therapy (RT) following resection. Survival rates were estimated using the Kaplan-Meier method and significance was determined using the log-rank test (Pmales with breast cancer. A statistically nonsignificant improvement with postoperative RT was observed in men with lymph node involvement, larger tumor size, or higher stage. When controlled for age, stage, and grade in multivariate analysis, postoperative RT predicted for improved OS but not CSS. These data suggest a beneficial effect of RT in the postoperative setting. A prospective study is necessary to further elucidate appropriate treatment strategies for men with breast cancer.

  6. Uterine Carcinosarcoma Confined to the Pelvis: A Retrospective Review and Outcome Analysis

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    Hualei Li

    2014-01-01

    Full Text Available Objective. We compared the treatments of uterine carcinosarcoma at our institution and evaluated their impact on survival. Methods. A retrospective analysis was performed on 60 eligible patients with carcinosarcoma limited to the pelvis. Subjects were divided into four categories: surgery, surgery plus chemotherapy, surgery plus radiation therapy, and a combination of surgery, chemotherapy, and RT. The most commonly used chemotherapy was cisplatin and/or carboplatin and taxol. Radiotherapy included external beam radiation therapy (EBRT alone or with high dose rate (HDR brachytherapy or HDR brachytherapy alone. Survival probability data were computed using the Kaplan-Meier method. The differences between groups were compared using the log-rank test. Results. The combination of surgery and radiation therapy with or without chemotherapy is seen to improve overall survival (OS compared to surgery alone (P=0.044 and P=0.028, resp.. Brachytherapy involving three HDR vaginal cylinder fractions shows an equally effective reduction in local recurrence compared to EBRT. Conclusion. Our study of a relatively large number of carcinosarcoma patients suggests that adjuvant radiation therapy improves OS compared to surgery alone. Brachytherapy with 3 HDR vaginal cylinder fractions is preferred because of its time-saving, better tolerance, low toxicity and equivalent OS, and local control compared to EBRT.

  7. Tuberculosis and risk of acute myocardial infarction: a propensity score-matched analysis.

    Science.gov (United States)

    Huaman, M A; Kryscio, R J; Fichtenbaum, C J; Henson, D; Salt, E; Sterling, T R; Garvy, B A

    2017-05-01

    Several pathogens have been associated with increased cardiovascular disease (CVD) risk. Whether this occurs with Mycobacterium tuberculosis infection is unclear. We assessed if tuberculosis disease increased the risk of acute myocardial infarction (AMI). We identified patients with tuberculosis index claims from a large de-identified database of ~15 million adults enrolled in a U.S. commercial insurance policy between 2008 and 2010. Tuberculosis patients were 1:1 matched to patients without tuberculosis claims using propensity scores. We compared the occurrence of index AMI claims between the tuberculosis and non-tuberculosis cohorts using Kaplan-Meier curves and Cox Proportional Hazard models. Data on 2026 patients with tuberculosis and 2026 propensity-matched patients without tuberculosis were included. AMI was more frequent in the tuberculosis cohort compared with the non-tuberculosis cohort, 67 (3·3%) vs. 32 (1·6%) AMI cases, respectively, P Tuberculosis was associated with an increased risk of AMI (adjusted hazard ratio (HR) 1·98, 95% confidence intervals (CI) 1·3-3·0). The results were similar when the analysis was restricted to pulmonary tuberculosis (adjusted HR 2·43, 95% CI 1·5-4·1). Tuberculosis was associated with an increased risk of AMI. CVD risk assessment should be considered in tuberculosis patients. Mechanistic studies of tuberculosis and CVD are warranted.

  8. Analysis of WHO-Based Prognostic Scoring System (WPSS) of Myelodysplastic Syndrome and Its Comparison with International Prognostic Scoring System (IPSS) in 100 Chinese Patients

    Institute of Scientific and Technical Information of China (English)

    Jia Wei; Xiao-fen Zhou; Jian-feng Zhou; Yan Chen

    2009-01-01

    Objective: The aims of this study were to assess the prognostic significance of WHO-based Prognostic Scoring System (WPSS) in myelodysplastic syndrome (MDS) from a single center institute and to compare WPSS with the international prognostic scoring system (IPSS).Methods: A total of 100 cases with de novo MDS were reviewed and their karyotypes were detected. All of them were followed up and classified according to IPSS and WPSS risk groups. SPSS 13.0 software was applied to deal with all the data. The statistical methods included Kaplan - Meier, Log-rank test and cox regression.Results: Multivariate cox regression analysis indicated that WHO Classification (P=0.0190), karyotype abnormalities categorized according to IPSS (P=0.0159) and red blood cell (RBC) transfusion (P=0.0009) were the three most important independent factors for predicting overall survival (OS) of MDS. WPSS and IPSS both had great capacity in predicting the OS of MDS at the time of diagnosis (P<0.0001). In time-dependent analysis, WPSS can predict the OS accurately in the following three years after diagnosis (P<0.0001), while IPSS failed to predict the OS 24 months after diagnosis (P=0.1094).Conclusion: Our single center results proved that WPSS is a dynamic prognostic system which can predict the OS of MDS patients at any time during the course of their disease. This time-dependent prognostic scoring system may replace the IPSS in the near future.

  9. Cost-utility analysis of adjuvant goserelin (Zoladex and adjuvant chemotherapy in premenopausal women with breast cancer

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    Cheng Tsui

    2012-01-01

    Full Text Available Abstract Background Increased health care costs have made it incumbent on health-care facilities and physicians to demonstrate both clinical and cost efficacy when recommending treatments. Though studies have examined the cost-effectiveness of adjuvant goserelin with radiotherapy for locally advanced prostate cancer, few have compared the cost-effectiveness of adjuvant goserelin to adjuvant chemotherapy alone in premenopausal breast cancer. Methods In this retrospective study at one hospital, the records of 152 patients with stage Ia to IIIa ER + breast cancer who received goserelin or chemotherapy were reviewed. Survival analysis was assessed by the Kaplan-Meier method. Patients were interviewed to evaluate their quality of life using the European Organization for Research and Treatment Quality of Life questionnaire (EORTC-QLQ-C30, version 4.0, and to obtain the utility value by the standard gamble (SG and visual scale (VS methods. Total medical cost was assessed from the (National Health Insurance NHI payer's perspective. Results Survival at 11 years was significantly better in the groserelin group (P Conclusions Goserelin therapy results in better survival and higher utility-weighted life-years, and is more cost-effective than TC or TEC chemotherapy.

  10. Elevated BUBR1 expression is associated with poor survival in early breast cancer patients: 15-year follow-up analysis.

    Science.gov (United States)

    Maciejczyk, Adam; Szelachowska, Jolanta; Czapiga, Bogdan; Matkowski, Rafał; Hałoń, Agnieszka; Györffy, Balázs; Surowiak, Paweł

    2013-05-01

    BUBR1 (budding uninhibited by benzimidazole-related 1) represents the component of a controlling complex in mitosis. Defects in mitotic control complex result in chromosomal instability and, as a result, disturb the mitotic process. This study was aimed at examining the prognostic value linked to the expression of BUBR1 in a group of patients with breast cancer. We analyzed the expression of BUBR1 in 98 stage II breast cancer patients with a median follow-up of 15 years. Immunohistochemical reactions were performed using monoclonal antibodies against BUBR1. We also studied the prognostic value of BUBR1 mRNA expression using the Kaplan-Meier (KM) plotter, which assessed the effect of 22,277 genes on survival in 2422 breast cancer patients. A background database was established using gene expression data and survival information on 2422 patients downloaded from the Gene Expression Omnibus (GEO; Affymetrix HGU133A and HGU133+2 microarrays). The median relapse-free survival was 6.43 years. Univariate and multivariate analyses showed that higher expression of BUBR1 was typical for cases of shorter overall survival, disease-free time, and disease-specific survival. KM plotter analysis showed that elevated BUBR1 mRNA expression had a negative impact on patients' relapse-free, distant metastases-free, and overall survival. Elevated BUBR1 expression was associated with poor survival in early stage breast cancer patients.

  11. Long-term results of interventional treatment of large unresectable hepatocellular carcinoma (HCC): significant survival benefit from combined transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) compared to TACE monotherapy; Langzeitergebnisse der interventionellen Therapie von grossen, inoperablen hepatozellulaeren Karzinomen (HCC): signifikanter Ueberlebensvorteil von transarterieller Chemoembolisation (TACE) und perkutaner Ethanolinjektion (PEI) gegenueber der TACE-Monotherapie

    Energy Technology Data Exchange (ETDEWEB)

    Lubienski, A.; Bitsch, R.G.; Grenacher, L.; Kauffmann, G.W. [Radiologische Universitaetsklinik Heidelberg, Abt. Radiodiagnostik, Heidelberg (Germany); Schemmer, P. [Chirurgische Universitaetsklinik Heidelberg (Germany); Duex, M. [Radiologisches Zentralinstitut Krankenhaus Nordwest Frankfurt (Germany)

    2004-12-01

    Purpose: A retrospective analysis of long-term efficacy of combined transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) and TACE monotherapy was conducted in patients with large, non-resectable hepatocellular carcinoma (HCC). Methods and Materials: Fifty patients with large, unresectable HCC lesions underwent selective TACE. Liver cirrhosis was present in 42 patients, due to alcohol abuse (n = 22) and viral infection (n = 17). In three patients, the underlying cause for liver cirrhosis remained unclear. Child A cirrhosis was found in 22 and Child B cirrhosis in 20 patients. Repeated and combined TACE and PEI were performed in 22 patients and repeated TACE monotherapy was performed in 28 patients. Survival and complication rates were determined and compared. Results: The 6-, 12-, 24- and 36-month survival rates were 61%, 21%, 4%, and 4% for TACE monotherapy and 77%, 55%, 39% and 22% for combined TACE and PEI (Kaplan-Meier method). The kind of treatment significantly affected the survival rate (p=0.002 log-rank test). Severe side effects were present in two patients of the monotherapy group and in three patients of the combination therapy group. (orig.)

  12. Postmastectomy Radiation Therapy Is Associated With Improved Survival in Node-Positive Male Breast Cancer: A Population Analysis.

    Science.gov (United States)

    Abrams, Matthew J; Koffer, Paul P; Wazer, David E; Hepel, Jaroslaw T

    2017-06-01

    Because of its rarity, there are no randomized trials investigating postmastectomy radiation therapy (PMRT) in male breast cancer. This study retrospectively examines the impact of PMRT in male breast cancer patients in the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database. The SEER database 8.3.2 was queried for men ages 20+ with a diagnosis of localized or regional nonmetastatic invasive ductal/lobular carcinoma from 1998 to 2013. Included patients were treated by modified radical mastectomy (MRM), with or without adjuvant external beam radiation. Univariate and multivariate analyses evaluated predictors for PMRT use after MRM. Kaplan-Meier overall survival (OS) curves of the entire cohort and a case-matched cohort were calculated and compared by the log-rank test. Cox regression was used for multivariate survival analyses. A total of 1933 patients were included in the unmatched cohort. There was no difference in 5-year OS between those who received PMRT and those who did not (78% vs 77%, respectively, P=.371); however, in the case-matched analysis, PMRT was associated with improved OS at 5 years (83% vs 54%, Pmale breast cancer with node-positive disease. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. No bias of ignored bilaterality when analysing the revision risk of knee prostheses: Analysis of a population based sample of 44,590 patients with 55,298 knee prostheses from the national Swedish Knee Arthroplasty Register

    Directory of Open Access Journals (Sweden)

    Ranstam Jonas

    2003-02-01

    Full Text Available Abstract Background The current practice of the Swedish Knee Register is not to take into consideration if one or both knees in a patient are subject to surgery when evaluating risk of revision after arthroplasty. Risk calculations are typically done by statistical methods, such as Kaplan-Meier analyses and Cox's proportional hazards models, that are based on the assumption that observed events are independent, and this is rarely appreciated. The purpose of this study was to investigate if ignoring bilateral operations when using these methods biases the results. Methods The bias of not taking bilateral operations into account was investigated by statistically analysing 55 298 prostheses in 44 590 patients, undergoing knee arthroplasty surgery in Sweden during 1985–1999, using traditional proportional hazards analysis, which assumes that all observations are independent, and a shared gamma frailty model, which allows patients to contribute repeated observations. Results The effect of neglecting bilateral prostheses is minute, possibly because bilateral prosthesis failure is a rare event. Conclusion We conclude that the revision risk of knee prostheses in general can be analysed without consideration for subject dependency, at least in study populations with a relatively low proportion of subjects having experienced bilateral revisions.

  14. Young patients with colorectal cancer have poor survival in the first twenty months after operation and predictable survival in the medium and long-term: Analysis of survival and prognostic markers

    Directory of Open Access Journals (Sweden)

    Wickramarachchi RE

    2010-09-01

    Full Text Available Abstract Objectives This study compares clinico-pathological features in young (50 years with colorectal cancer, survival in the young and the influence of pre-operative clinical and histological factors on survival. Materials and methods A twelve year prospective database of colorectal cancer was analysed. Fifty-three young patients were compared with forty seven consecutive older patients over fifty years old. An analysis of survival was undertaken in young patients using Kaplan Meier graphs, non parametric methods, Cox's Proportional Hazard Ratios and Weibull Hazard models. Results Young patients comprised 13.4 percent of 397 with colorectal cancer. Duration of symptoms and presentation in the young was similar to older patients (median, range; young patients; 6 months, 2 weeks to 2 years, older patients; 4 months, 4 weeks to 3 years, p > 0.05. In both groups, the majority presented without bowel obstruction (young - 81%, older - 94%. Cancer proximal to the splenic flexure was present more in young than in older patients. Synchronous cancers were found exclusively in the young. Mucinous tumours were seen in 16% of young and 4% of older patients (p Conclusion If patients, who are less than 40 years old with colorectal cancer, survive twenty months after operation, the prognosis improves and their survival becomes predictable.

  15. Evaluation of anterior chest wall implanted port: technical aspects, results, and complications

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Young Hwan; Oh, Joo Hyeong; Yoon, Yup; Kim, Si Young [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    2000-07-01

    To evaluate the technical aspects, results and complications of patients with implanted anterior chest wall port. Between April 1997 and June 1999, a total of 63 implanted ports were placed at the anterior chest wall of 63 consecutive patients by interventional radiologists. The indications were chemotherapy in 61 patients and total parenteral nutrition in two. The peripheral portion of the subclavian vein was punctured under fluoroscopic guidance via ipsilateral peripheral vein during venography. A central venous catheter was placed in the superior vena cava, and using the subcutaneous tunneling method, a connected infusion port was implanted at the anterior chest wall. Results and complications were reviewed, and by means of Kaplan-Meier survival analysis, the expected patency of the port was determined. The technical success rate for implanted port at the anterior chest wall was 100% (63/63 patients). In two patients, hematoma and oozing were treated by compression. The duration of port implantation ranged from 12 to 855 (mean, 187) days, and the port patency rate was 305.7{+-}47.6 days. In seven patients (completed chemotherapy (n=3D3), central venous thrombosis (n=3D3) catheter-related infection (n=3D1)), the port was removed. Catheter obstruction occurred in two patients, and in one, the use of urokinase led to successful recanalization. Sixteen patients died of an underlying malignancy, but no catheter-related death was noted. Implantation of an anterior chest wall port is a safe and useful procedure, with long patency, for patients requiring chemotherapy and long-term venous access. (author)

  16. Angioplasty of the pelvic and femoral arteries in PAOD: Results and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Balzer, Joern O., E-mail: balzerjo@t-online.d [Dept. for Radiology and Nuclear medicine, Catholic Clinic Mainz, An der Goldgrube 11, 55131 Mainz (Germany); Thalhammer, Axel [Dept. of Diagnostic and Interventional Radiology, Univ. Clinic, Johann Wolfgang Goethe-University Frankfurt/Main (Germany); Khan, Verena [Dept. of Diagnostic and Interventional Radiology, Clinic Nuernberg North (Germany); Zangos, Stefan; Vogl, Thomas J.; Lehnert, Thomas [Dept. of Diagnostic and Interventional Radiology, Univ. Clinic, Johann Wolfgang Goethe-University Frankfurt/Main (Germany)

    2010-07-15

    Purpose: Evaluation of percutaneous recanalization of obstructed iliac as well as superficial femoral arteries (SFAs) in patients with peripheral arterial obstructive disease (PAOD). Material and methods: The data of 195 consecutive patients with 285 obstructions of the common and or external iliac artery as well as the data of 452 consecutive patients with 602 long occlusions (length > 5 cm) of the SFA were retrospectively analyzed. The lesions were either treated with percutaneous transluminal angioplasty (PTA) or Excimer laser assisted percutaneous transluminal angioplasty (LPTA). Overall 316 stents were implanted (Nitinol stents: 136; stainless steel stents: 180) in the iliac artery and 669 stents were implanted (Nitinol stents: 311; Easy Wallstents: 358) in the SFA. The follow-up period was 36-65 months (mean 46.98 {+-} 7.11 months) postinterventionally using clinical examination, ABI calculation, and color-coded duplex sonography. Patency rates were calculated on the basis of the Kaplan-Meier analysis. Results: The overall primary technical success rate was 97.89% for the iliac arteries and 92.35% for the SFA. Minor complications (hematoma, distal emboli and vessel dissection) were documented in 11.79% for the iliac arteries and 7.97% for the SFA. The primary patency rate was 90.3% for the iliac and 52.8% for the SFA after 4 years. The secondary patency rate was 96.84% for the iliac and 77.8% for the SFA after 4 years. Conclusion: Percutaneous recanalization of iliac and superficial femoral artery obstructions is a safe and effective technique for the treatment of patients with PAOD. By consequent clinical monitoring high secondary patency rates can be achieved. The use of a stents seems to result in higher patency rate especially in the SFA when compared to the literature in long-term follow-up.

  17. Complications after Surgical Procedures in Patients with Cardiac Implantable Electronic Devices: Results of a Prospective Registry

    Science.gov (United States)

    da Silva, Katia Regina; Albertini, Caio Marcos de Moraes; Crevelari, Elizabeth Sartori; de Carvalho, Eduardo Infante Januzzi; Fiorelli, Alfredo Inácio; Martinelli Filho, Martino; Costa, Roberto

    2016-01-01

    Background: Complications after surgical procedures in patients with cardiac implantable electronic devices (CIED) are an emerging problem due to an increasing number of such procedures and aging of the population, which consequently increases the frequency of comorbidities. Objective: To identify the rates of postoperative complications, mortality, and hospital readmissions, and evaluate the risk factors for the occurrence of these events. Methods: Prospective and unicentric study that included all individuals undergoing CIED surgical procedures from February to August 2011. The patients were distributed by type of procedure into the following groups: initial implantations (cohort 1), generator exchange (cohort 2), and lead-related procedures (cohort 3). The outcomes were evaluated by an independent committee. Univariate and multivariate analyses assessed the risk factors, and the Kaplan-Meier method was used for survival analysis. Results: A total of 713 patients were included in the study and distributed as follows: 333 in cohort 1, 304 in cohort 2, and 76 in cohort 3. Postoperative complications were detected in 7.5%, 1.6%, and 11.8% of the patients in cohorts 1, 2, and 3, respectively (p = 0.014). During a 6-month follow-up, there were 58 (8.1%) deaths and 75 (10.5%) hospital readmissions. Predictors of hospital readmission included the use of implantable cardioverter-defibrillators (odds ratio [OR] = 4.2), functional class III­-IV (OR = 1.8), and warfarin administration (OR = 1.9). Predictors of mortality included age over 80 years (OR = 2.4), ventricular dysfunction (OR = 2.2), functional class III-IV (OR = 3.3), and warfarin administration (OR = 2.3). Conclusions: Postoperative complications, hospital readmissions, and deaths occurred frequently and were strongly related to the type of procedure performed, type of CIED, and severity of the patient's underlying heart disease. PMID:27579544

  18. The Results of Self-Expandable Kissing Stents in Aortic Bifurcation.

    Science.gov (United States)

    Moon, Jae Young; Hwang, Hong Pil; Kwak, Hyo Sung; Han, Young Min; Yu, Hee Chul

    2015-03-01

    Kissing stent reconstruction is a widely used technique for the management of aortoiliac occlusive disease involving the aortic bifurcation or proximal common iliac arteries. The purpose of this study was to evaluate the results of self-expandable kissing stents in the aortic bifurcation. We reviewed medical records of the patients treated with a kissing stent retrospectively from January 2007 to December 2012. The primary and secondary patencies were determined with Kaplan-Meier analysis, and Cox regression was used to determine the factors associated with patency. A total of 21 patients were included, and all were male (median age 53±15 years, range 48-78 years). Major symptoms were claudication (n=16, 61.9%), rest pain (n=5, 23.8%) and gangrene (n=5, 23.8%). Tans-Atlantic Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC) II classification was A 2 (9.5%), B 5 (23.8%), C 7 (33.3%) and D 8 (38%). The mean follow-up was 40.7 months. Major complication occurred in only one case which consisted of distal limb ischemia by emboli. Six patients developed symptomatic restenosis or occlusion. There was no major amputation, but minor amputation occurred in 3 patients. There were 2 mortalities not associated with the procedure (lung cancer and intracranial hemorrhage). Primary patency was 89.6% at 1 year, 74.7% at 3 years and 64.0% at 5 years. Secondary patency was 94.1% at 1 year, 88.2% at 3 years and 68.6% at 5 years. No risk factors for restenosis or occlusion were identified. Self-expandable kissing stents can be used successfully with comparable patency for endovascular treatment of symptomatic atherosclerotic occlusive lesions in the aortic bifurcation area.

  19. Clinical–Pathologic Stage Discrepancy in Bladder Cancer Patients Treated With Radical Cystectomy: Results From the National Cancer Data Base

    Energy Technology Data Exchange (ETDEWEB)

    Gray, Phillip J. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Lin, Chun Chieh; Jemal, Ahmedin [Surveillance and Health Services Research Program, American Cancer Society, Atlanta, Georgia (United States); Shipley, William U. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Fedewa, Stacey A. [Surveillance and Health Services Research Program, American Cancer Society, Atlanta, Georgia (United States); Kibel, Adam S. [Division of Urology, Brigham and Women' s Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Rosenberg, Jonathan E. [Genitourinary Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Kamat, Ashish M. [Division of Surgery, Department of Urology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Virgo, Katherine S. [Department of Health Policy and Management, Emory University, Atlanta, Georgia (United States); Blute, Michael L. [Department of Urology, Massachusetts General Hospital, Boston, Massachusetts (United States); Zietman, Anthony L. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Efstathiou, Jason A., E-mail: jefstathiou@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2014-04-01

    Purpose: To examine the accuracy of clinical staging and its effects on outcome in bladder cancer (BC) patients treated with radical cystectomy (RC), using a large national database. Methods and Materials: A total of 16,953 patients with BC without distant metastases treated with RC from 1998 to 2009 were analyzed. Factors associated with clinical–pathologic stage discrepancy were assessed by multivariate generalized estimating equation models. Survival analysis was conducted for patients treated between 1998 and 2004 (n=7270) using the Kaplan-Meier method and Cox proportional hazards models. Results: At RC 41.9% of patients were upstaged, whereas 5.9% were downstaged. Upstaging was more common in females, the elderly, and in patients who underwent a more extensive lymphadenectomy. Downstaging was less common in patients treated at community centers, in the elderly, and in Hispanics. Receipt of preoperative chemotherapy was highly associated with downstaging. Five-year overall survival rates for patients with clinical stages 0, I, II, III, and IV were 67.2%, 62.9%, 50.4%, 36.9%, and 27.2%, respectively, whereas those for the same pathologic stages were 70.8%, 75.8%, 63.7%, 41.5%, and 24.7%, respectively. On multivariate analysis, upstaging was associated with increased 5-year mortality (hazard ratio [HR] 1.80, P<.001), but downstaging was not associated with survival (HR 0.88, P=.160). In contrast, more extensive lymphadenectomy was associated with decreased 5-year mortality (HR 0.76 for ≥10 lymph nodes examined, P<.001), as was treatment at an National Cancer Institute–designated cancer center (HR 0.90, P=.042). Conclusions: Clinical–pathologic stage discrepancy in BC patients is remarkably common across the United States. These findings should be considered when selecting patients for preoperative or nonoperative management strategies and when comparing the outcomes of bladder sparing approaches to RC.

  20. Predictors for length of hospital stay in patients with community-acquired Pneumonia: Results from a Swiss Multicenter study

    Directory of Open Access Journals (Sweden)

    Suter-Widmer Isabelle

    2012-05-01

    Full Text Available Abstract Background Length of hospital stay (LOS in patients with community-acquired pneumonia (CAP is variable and directly related to medical costs. Accurate estimation of LOS on admission and during follow-up may result in earlier and more efficient discharge strategies. Methods This is a prospective multicenter study including patients in emergency departments of 6 tertiary care hospitals in Switzerland between October 2006 and March 2008. Medical history, clinical data at presentation and health care insurance class were collected. We calculated univariate and multivariate cox regression models to assess the association of different characteristics with LOS. In a split sample analysis, we created two LOS prediction rules, first including only admission data, and second including also additional inpatient information. Results The mean LOS in the 875 included CAP patients was 9.8 days (95%CI 9.3-10.4. Older age, respiratory rate >20 pm, nursing home residence, chronic pulmonary disease, diabetes, multilobar CAP and the pneumonia severity index class were independently associated with longer LOS in the admission prediction model. When also considering follow-up information, low albumin levels, ICU transfer and development of CAP-associated complications were additional independent risk factors for prolonged LOS. Both weighted clinical prediction rules based on these factors showed a high separation of patients in Kaplan Meier Curves (p logrank and a good calibration when comparing predicted and observed results. Conclusions Within this study we identified different baseline and follow-up characteristics to be strong and independent predictors for LOS. If validated in future studies, these factors may help to optimize discharge strategies and thus shorten LOS in CAP patients.

  1. Rotational Acetabular Osteotomy for Pre- and Early Osteoarthritis Secondary to Dysplasia Provides Durable Results at 20 Years.

    Science.gov (United States)

    Yasunaga, Yuji; Ochi, Mitsuo; Yamasaki, Takuma; Shoji, Takeshi; Izumi, Sotaro

    2016-10-01

    Kaplan-Meier product-limited method and parametric survivorship analysis using the Cox proportional-hazards model was used to determine risk factors for radiographic OA progression. The mean clinical score improved very slightly, from 15 (SD, 0.8) to 18 (SD, 1.1) (95% confidence interval [CI], -2.9 to -2.0; p osteotomy of 20 (SD, 2.5) years. Radiographic indices were improved after surgery in both groups. Radiographic progression of OA occurred in 24 patients (25 hips). Kaplan-Meier survivorship analysis, with radiographic signs of progression of OA as the endpoint, predicted survival of 96% (95% CI, 89%-100%) at 10 years and 20 years in the pre-OA group. For the early-stage group, we found survivorship of 89% (95% CI, 83%-95%) at 10 years and 78% (95% CI, 69%-87%) at 20 years. We identified two factors associated with poor outcome: fair (rather than excellent and good) postoperative joint congruency (hazard ratio, 12.1; 95% CI, 3.8-39; p osteotomy is an effective surgical procedure for symptomatic dysplastic hips in pre- and early-stage OA, and it prevented radiographic OA progression and maintained hip function at a mean 20 years after surgery. Level IV, therapeutic study.

  2. Reirradiation for recurrent head and neck cancer with salvage interstitial pulsed-dose-rate brachytherapy. Long-term results

    Energy Technology Data Exchange (ETDEWEB)

    Strnad, Vratislav; Lotter, Michael; Kreppner, Stephan; Fietkau, Rainer [University Hospital Erlangen, Dept. of Radiation Oncology, Erlangen (Germany)

    2015-01-10

    To assess the long-term results of protocol-based interstitial pulsed-dose-rate (PDR) brachytherapy as reirradiation combined with simultaneous chemotherapy and interstitial hyperthermia in selected patients with recurrent head and neck tumors. A total of 104 patients with biopsy-proven recurrent head and neck cancer were treated with interstitial PDR brachytherapy. Salvage surgery had also been undergone by 53/104 (51 %) patients (R1 or R2 resection in > 80 % of patients). Salvage brachytherapy alone was administered in 81 patients (78 %), with a median total dose of 56.7 Gy. Salvage brachytherapy in combination with external beam radiotherapy (EBRT) was performed in 23/104 patients (32 %), using a median total dose of D{sub REF} = 24 Gy. Simultaneously to PDR brachytherapy, concomitant chemotherapy was administered in 58/104 (55.8 %) patients. A single session of interstitial hyperthermia was also used to treat 33/104 (31.7 %) patients. The analysis was performed after a median follow-up of 60 months. Calculated according to Kaplan-Meier, local tumor control rates after 2, 5, and 10 years were 92.5, 82.4, and 58.9 %, respectively. Comparing results of salvage PDR brachytherapy with or without simultaneous chemotherapy, the 10-year local control rates were 76 vs. 39 % (p= 0014), respectively. No other patient- or treatment-related parameters had a significant influence on treatment results. Soft tissue necrosis or bone necrosis developed in 18/104 (17.3 %) and 11/104 (9.6 %) patients, respectively, but only 3 % of patients required surgical treatment. PDR interstitial brachytherapy with simultaneous chemotherapy is a very effective and, in experienced hands, also a safe treatment modality in selected patients with head and neck cancer in previously irradiated areas. (orig.) [German] Es erfolgte die Analyse der Langzeitergebnisse einer protokollbasierten interstitiellen Brachytherapie (Re-Bestrahlung) mit simultaner Chemotherapie und interstitieller Hyperthermie

  3. Prognostic analysis of orthostatic intolerance using survival model in children

    Institute of Scientific and Technical Information of China (English)

    Li Yawen; Li Hongxia; Li Xueying; Li Xiaoming; Jin Hongfang

    2014-01-01

    Background Orthostatic intolerance (Ol) is a common disease at pediatric period which has a serious impact on physical and mental health of children.The purpose of this study was to investigate the effect of related factors on the prognosis of children with Ol.Methods The subjects were 170 children with Ol,including 71 males (41.8%) and 99 females (58.2%) with age from 6 to 17 (12.0±2.6) years.The effect of related factors on the prognosis of children was studied by using univariate analysis.Then,the impact of children's age,symptom score,duration,disease subtype,and treatment on patient's prognosis was studied via analysis of COX proportional conversion model.Results Among 170 cases,48 were diagnosed with vasovagal syncope,including 28 cases of vasoinhibitory type,16 cases of mixed type,and 4 cases of cardioinhibitory type; 115 cases were diagnosed with postural tachycardia syndrome and 7 cases with orthostatic hypotension.By using univariate analysis of Cox regression,the results showed that symptom score had a marked impact on the time of symptoms improvement of children after taking medication (P <0.05),while other univariates had no impact (P >0.05).Multivariate analysis using Cox proportional hazards regression model showed that the symptom score at diagnosis had a significant effect on holding time of symptoms improvement of children after taking medication (P <0.05).Kaplan-Meier curve showed that symptom-free survival was higher in children with symptom score equal to 1 than children with symptom score equal to or greater than 2 during follow-up (P <0.05).Conclusion Symptom score is an important factor affecting the time of symptom improvement after treatment for children with Ol.

  4. Duodenal surveillance improves the prognosis after duodenal cancer in familial adenomatous polyposis

    DEFF Research Database (Denmark)

    Bülow, Steffen; Christensen, Ib Jarle; Højen, Helle

    2012-01-01

    of cancer development. Method:  Follow-up of patients in a previous study with gastroduodenoscopy in 1990-2010. Statistical analysis included chi(2) test, actuarial method and Kaplan-Meier analysis. Results:  Among 304 patients, 261 (86%) had more than one endoscopy. The median follow-up was 14 years...

  5. Duodenal surveillance improves the prognosis after duodenal cancer in familial adenomatous polyposis

    DEFF Research Database (Denmark)

    Bülow, Steffen; Christensen, Ib Jarle; Højen, Helle

    2012-01-01

    of cancer development. Method: Follow-up of patients in a previous study with gastroduodenoscopy in 1990-2010. Statistical analysis included chi(2) test, actuarial method and Kaplan-Meier analysis. Results: Among 304 patients, 261 (86%) had more than one endoscopy. The median follow-up was 14 years...

  6. Hypoxic Prostate/Muscle PO{sub 2} Ratio Predicts for Outcome in Patients With Localized Prostate Cancer: Long-Term Results

    Energy Technology Data Exchange (ETDEWEB)

    Turaka, Aruna [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Buyyounouski, Mark K., E-mail: mark.buyyounouski@fccc.edu [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Hanlon, Alexandra L. [School of Nursing, University of Pennsylvania, Philadelphia, PA (United States); Horwitz, Eric M. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Greenberg, Richard E. [Department of Surgery, Fox Chase Cancer Center, Philadelphia, PA (United States); Movsas, Benjamin [Department of Radiation Oncology, Henry Ford Hospital, Detroit, MI (United States)

    2012-03-01

    Purpose: To correlate tumor oxygenation status with long-term biochemical outcome after prostate brachytherapy. Methods and Materials: Custom-made Eppendorf PO{sub 2} microelectrodes were used to obtain PO{sub 2} measurements from the prostate (P), focused on positive biopsy locations, and normal muscle tissue (M), as a control. A total of 11,516 measurements were obtained in 57 men with localized prostate cancer immediately before prostate brachytherapy was given. The Eppendorf histograms provided the median PO{sub 2}, mean PO{sub 2}, and % <5 mm Hg or <10 mm Hg. Biochemical failure (BF) was defined using both the former American Society of Therapeutic Radiation Oncology (ASTRO) (three consecutive raises) and the current Phoenix (prostate-specific antigen nadir + 2 ng/mL) definitions. A Cox proportional hazards regression model evaluated the influence of hypoxia using the P/M mean PO{sub 2} ratio on BF. Results: With a median follow-up time of 8 years, 12 men had ASTRO BF and 8 had Phoenix BF. On multivariate analysis, P/M PO{sub 2} ratio <0.10 emerged as the only significant predictor of ASTRO BF (p = 0.043). Hormonal therapy (p = 0.015) and P/M PO{sub 2} ratio <0.10 (p = 0.046) emerged as the only independent predictors of the Phoenix BF. Kaplan-Meier freedom from BF for P/M ratio <0.10 vs. {>=}0.10 at 8 years for ASTRO BF was 46% vs. 78% (p = 0.03) and for the Phoenix BF was 66% vs. 83% (p = 0.02). Conclusions: Hypoxia in prostate cancer (low mean P/M PO{sub 2} ratio) significantly predicts for poor long-term biochemical outcome, suggesting that novel hypoxic strategies should be investigated.

  7. Assessment of oncologic control obtained after open versus laparoscopic nephroureterectomy for upper urinary tract urothelial carcinomas (UUT-UCs): results from a large French multicenter collaborative study.

    Science.gov (United States)

    Ariane, Mehdi Mokhtar; Colin, Pierre; Ouzzane, Adil; Pignot, Geraldine; Audouin, Marie; Cornu, Jean-Nicolas; Albouy, Baptiste; Guillotreau, Julien; Neuzillet, Yann; Crouzet, Sébastien; Hurel, Sophie; Arroua, Frederic; Bigot, Pierre; Marchand, Charles; Fais, Pierre Olivier; de la Taille, Alexandre; Saint, Fabien; Ravier, Emmanuel; Matte, Alexandre; Guy, Laurent; Bruyère, Franck; Rouprêt, Morgan

    2012-01-01

    The purpose of this study was to compare the postsurgical survival of UUT-UC patients treated with ONU and LNU. Using a multi-institutional, national, retrospective database, we identified patients with UUT-UC who underwent radical nephroureterectomy by open access (ONU) or by the minimally invasive alternative (LNU). Survival curves were estimated using Kaplan-Meier method. A multivariate Cox model was used to evaluate the association between surgical approach and disease recurrence. Overall, 609 patients were included (ONU = 459 and LNU = 150). The median age was 69.8 years (range 61.9-76), and the male-to-female ratio was 2:1. Postoperative complications occurred in 80 patients, with no significant difference between ONU and LNU on the whole (P = 0.64). The median follow-up was 27 months. There was no difference between the 2 procedures in the 5-year CSS or 5-year RFS. Moreover, the 5-year CSS (P = 0.053) and 5-year RFS (P = 0.9) for cases with locally advanced disease (pT3/pT4) were similar between ONU and LNU. In the multivariate analysis, the surgical procedure used was not found to be associated with survival. The main limitation of the study is its retrospective design, which is the result of the rarity of the disease. There is no evidence that oncological outcomes for LNU are inferior to those for open surgery, provided that the appropriate precautionary measures are taken.

  8. Chest computed tomography scores are predictive of survival in patients with cystic fibrosis awaiting lung transplantation

    DEFF Research Database (Denmark)

    Loeve, Martine; Hop, Wim C. J.; de Bruijne, Marleen

    2012-01-01

    /inflammation" (INF), air trapping/hypoperfusion (AT), normal/hyperperfusion (NOR) and bulla/cysts (BUL). The volume of each component was computed using semi-automated software. Survival analysis included Kaplan-Meier curves, and Cox-regression models. Measurements and main results: 366 (186 males) out of 411...

  9. The prognostic value of lymph node metastases and tumour regression grade in rectal cancer patients treated with long-course preoperative chemoradiotherapy

    DEFF Research Database (Denmark)

    Lindebjerg, J; Spindler, Karen-Lise Garm; Ploen, J;

    2009-01-01

    to the tumour regression grade system and lymph node status in the surgical specimen was assessed. The prognostic value of clinico-pathological parameters was analysed using univariate analysis and Kaplan-Meier methods for comparison of groups. RESULTS: All patients responded to treatment and 47% had a major...

  10. EGF61A>G polymorphism as predictive marker of clinical outcome to first-line capecitabine and oxaliplatin in metastatic colorectal cancer

    DEFF Research Database (Denmark)

    Spindler, Karen-Lise Garm; Andersen, R F; Jensen, Lars Henrik;

    2010-01-01

    samples. Response was evaluated according to the RECIST. Survival analysis was described by the Kaplan-Meier method and log-rank testing. RESULTS: The overall response rate was 38% and the median overall survival 19.4 months. A favorable outcome was seen in patients with the EGF61A/G genotype compared...

  11. Anastrozole versus tamoxifen as adjuvant therapy for Japanese postmenopausal patients with hormone-responsive breast cancer: efficacy results of long-term follow-up data from the N-SAS BC 03 trial.

    Science.gov (United States)

    Aihara, Tomohiko; Yokota, Isao; Hozumi, Yasuo; Aogi, Kenjiro; Iwata, Hiroji; Tamura, Motoshi; Fukuuchi, Atsushi; Makino, Haruhiko; Kim, Ryungsa; Andoh, Masashi; Tsugawa, Koichiro; Ohno, Shinji; Yamaguchi, Takuhiro; Ohashi, Yasuo; Watanabe, Toru; Takatsuka, Yuichi; Mukai, Hirofumi

    2014-11-01

    Aromatase inhibitors are superior to tamoxifen as adjuvant therapy in postmenopausal patients with hormone-responsive breast cancer. We report the follow-up efficacy results from the N-SAS BC 03 trial (UMIN CTRID: C000000056) where anastrozole was compared with tamoxifen as adjuvant therapy in postmenopausal Japanese patients with hormone-responsive early breast cancer. The full analysis set contained 696 patients (anastrozole arm, n = 345; tamoxifen arm, n = 351). The log-rank test was used to compare the two groups in terms of disease-free survival (DFS) and relapse-free survival (RFS); Kaplan-Meier estimates were calculated. The treatment effects were estimated by Cox's proportional hazards model. To examine time-varying effect of hazard ratios, we estimated time-varying hazard ratios at time t [HR(t)] using data from time t up to 12 months. After a median follow-up of 98.5 months, hazard ratios (95% CIs) were 0.90 (0.65-1.24; log-rank p = 0.526) for DFS and 0.83 (0.56-1.23; log-rank p = 0.344) for RFS. Hazard ratios (95% CIs) for DFS and RFS up to 36 months were 0.69 (0.40-1.17) and 0.54 (0.27-1.06) and those after 36 months were 1.06 (0.70-1.59) and 1.05 (0.64-1.73), respectively. Time-varying hazard ratios for both DFS and RFS showed that hazard ratios were initially in favor of anastrozole and approached 1.0 at around 36 months. Superior efficacy of anastrozole to tamoxifen suggested by the initial analysis was not confirmed in the present analysis after a long-term follow-up period. Advantage of anastrozole was the greatest immediately after switching from tamoxifen and then decreased thereafter.

  12. Elevation of serum GGT and LDH levels, together with higher BCLC staging are associated with poor overall survival from hepatocellular carcinoma: a retrospective analysis.

    Science.gov (United States)

    Yang, Zongguo; Ye, Peiyan; Xu, Qingnian; Lu, Yunfei; Tang, Bozong; Wang, Qiang; Chen, Shishi; Chen, Xiaorong

    2015-06-01

    Serum biomarkers predicting prognosis have not been adequately explored in HCC patients. The aim of this study was to investigate prognostic significance of parameters of liver function, tumor markers, and other clinicopathological features in HCC patients. Medical records of HCC patients were retrospectively extracted and overall survival was evaluated with the Kaplan-Meier method. Significant difference was estimated with the Log rank method. Univariate and multivariate analyses were used for the study of significance of prognostic factor. A total of 273 HCC patients were included in this analysis. According to the Cox regression analysis and Kaplan-Meier event analysis, GGT and LDH levels of liver function tests were significantly associated with HCC overall survival. Elevated serum CEA level was a risk factor related to poor HCC overall survival. And advanced BCLC staging contributed to a lower overall survival in HCC patients. HCC could benefit from surgical resection, TACE, and radiotherapy. ROC curves demonstrated that different from CEA, elevated GGT and LDH could accurately predict HCC overall survival. In conclusion, serum GGT and LDH together with higher BCLC staging should be potential predictive factors for HCC overall survival.

  13. Survival Analysis of Drug Abuse Relapse in Addiction Treatment Centers

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    Kassani

    2015-09-01

    Full Text Available Background Drug abuse is a chronic and enduring phenomenon, which is among the important challenging public health problems. One of the main aspects in drug abuse is the relapse. Objectives The aims of this study were to estimate the time to relapse (survival rate and to evaluate some of its associated variables by survival analysis. Patients and Methods This research was conducted in four addiction treatment centers on 140 self-referred addicts in Ilam city, Iran, in 2012. Cluster sampling method was used for selecting the samples and data were collected by interview and referring to the subjects’ records. The gathered data were analyzed through the life table, Kaplan-Meier analysis, log rank test, and Cox regression. Results The relapse rate was 30.42%, mean and median of the time to relapse (survival time were 27.40 ± 1.63 months (CI 95%: 24.19 - 30.60 and 25 ± 2.25 months (CI 95%: 22.5 - 27.5, respectively. In the first six months, the cumulative survival rate was 83%, while in the 24th month it was 46% and the following time was consistent. Job status (OR = 2.64, marital status (OR = 1.55, family size (OR = 1.20 and age (OR = 0.23 were statistically significant in Cox regression model. Conclusions In the initial treatment, it seems necessary to supervise and monitor the treatment process through staff in addiction treatment centers together with the company of the addicts’ families to reduce relapse rate.

  14. Analysis of Survival Predictors in Patients with Lung Cancer and Brain Metastases

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    Shaohua CUI

    2015-07-01

    Full Text Available Background and objective The prognosis for patients with lung cancer and brain metastases remains poor, with approximately 6 months of survival, despite active measures after treatment. In this study, we determined and analyzed clinical parameters that affect the survival of patients with lung cancer and brain metastases to provide clinical guidance. Methods Lung cancer cases with brain metastases were retrospectively collected during 2002 and 2008 from Shanghai Chest Hospital, Shanghai Jiao Tong University. Kaplan-Meier method and Cox regression were performed for univariate and multivariate analyses, respectively, to explore independent predictors influencing the survival of patients with lung cancer and brain metastases. Results Age, Eastern Cooperative Oncology Group performance status (ECOG PS, metastasis interval, number of metastasis, treatment method, treatment period, symptoms of brain metastases, extracranial metastasis, and brain metastasis order were factors that affect the survival of patients with brain metastases as confirmed through the Kaplan-Meier method. Treatment periods and extracranial metastasis were independent survival predictors in patients with lung cancer and brain metastasis as indicated by Cox proportional hazard model. Conclusion Treatment periods and extracranial metastasis were independent predictors of survival of patients with lung cancer and brain metastasis. Treatment periods and extracranial metastasis were independent predictors of survival of patients with lung cancer and brain metastasis.

  15. Epidemiology and Survival Analysis of Jordanian Female Breast Cancer Patients Diagnosed from 1997 to 2002

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    Ghazi Sharkas

    2011-04-01

    Full Text Available Background: Breast cancer is the most common cancer among Jordanian women, yet survival data are scarce. This study aims to assess the observed five-year survival rate of breast cancer in Jordan from 1997 to 2002 and to determine factors that may influence survival. Methods: Data were obtained from the Jordan Cancer Registry (JCR, which is a population-based registry. From 1997-2002, 2121 patients diagnosed with breast cancer were registered in JCR. Relevant data were collected from JCR files, hospital medical records and histopathology reports. Patient's status, whether alive or dead, wasascertained from the Department of Civil Status using patients’ national numbers (ID. Statistical analysis was carried out using SPSS (version 10. Survival probabilities by age, morphology, grade, stage and other relevant variables were obtained with the Kaplan Meier method. Results: The overall five-year survival for breast cancer in Jordan, regardless of the stage or grade was 64.2%, meanwhile it was 58% in the group aged less than 30 years. The best survival was in the age group 40-49 years (69.3%. The survival for adenocarcinoma was 57.4% and for medullary carcinoma, it was 82%. The survival rate approximated 73.8% for well-differentiated, 55.6% for anaplastic, and 58% for poorly differentiated cancers. The five-year survival rate was 82.7% for stage I, 72.2% for stage II, 58.7% for stage III, and 34.6% for stage IV cancers.Conclusion: According to univariate analysis, stage, grade, age and laterality of breast cancer significantly influenced cancer survival. Cox regression analysis revealed that stage, grade and age factors correlated with prognosis, while laterality showed no significant effect on survival. Results demonstrated that overall survival was relatively poor. We hypothesized that this was due to low levels of awareness and lack of screening programs.

  16. Clinical outcome of patients with primary gliosarcoma treated with concomitant and adjuvant temozolomide: A single institutional analysis of 27 cases

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    G K Rath

    2015-01-01

    Full Text Available CONTEXT AND AIM: The prognosis of primary gliosarcoma (PGS remains dismal with current treatment modalities. We analyzed the outcome of PGS patients treated with concurrent and adjuvant temozolomide (TMZ. SETTINGS AND DESIGN: Retrospective single institutional analysis. MATERIALS AND METHODS: We retrospectively evaluated 27 patients of PGS treated with radiotherapy (RT and TMZ during 2007-2012. STATISTICAL ANALYSIS USED: Overall survival (OS was estimated by the use of Kaplan Meier method and toxicities were evaluate using common terminology criteria for adverse events version 2.0 (National Cancer Institute, USA. RESULTS: Median age at presentation and Karnofsky performance status was 45 years and 90 respectively and male: female ratio was 20:7. Patients received adjuvant RT to a total dose of 60 Gy at 2 Gy/fraction. All patients except 5 received adjuvant TMZ to a median number of 6 cycles. Grade 2 and 3 hematological toxicity was seen in 8% and 4% of patients respectively during concurrent RT. During adjuvant chemotherapy, 13.6% had Grade 3 thrombocytopenia and 9.5% had Grade 3 neutropenia. Median OS was 16.7 months (1 year and 2 year actuarial OS was 70.8% and 32.6% respectively. Adjuvant TMZ was associated with a better survival (median survival 21.21 vs. 11.93 months; P = 0.0046 on univariate analysis and also on multivariate analysis (hazard ratio 1.82, 95% confidence interval: 1.503-25.58; P = 0.012. CONCLUSIONS: The results of our study, largest series of patients with PGS treated with concurrent and adjuvant TMZ shows an impressive survival with acceptable toxicity. We suggest TMZ be included in the “standard of care” for this tumor.

  17. MULTIVARIATE ANALYSIS OF BONE METASTASES IN BREAST CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To investigate the risk factors of bone metastases in breast carcinoma. Methods: By cross sectional study, the data of 225 breast cancer patients who were inpatients in four hospitals in Hangzhou were analyzed. All patients underwent total body bone scan with single photon emission computed tomography (SPECT) at least once during 1995 to 2000. Results: All patients were followed-up to 294 months after operation, bone metastases were found in 113 cases, suspected bone metastases 3 cases, with a bone metastases rate of 50.9% (113/222). Multivariate analysis by Cox's proportional hazards regression model showed that there were four risk factors of bone metastases in breast cancer: (1) clinical stage, I(IV stages with a hazard ratio of bone metastases of 1.945, 95% confidence interval 1.396(2.710; (2) number of invaded axillary lymph nodes, with a hazard ratio of 1.039, 95% confidence interval 1.0142(1.068; (3) skeletal complications (yes vs. no), with a hazard ratio of bone metastases of 1.722, 95% confidence interval 1.060(2.796; (4) age at the time of surgery or diagnosis, with a hazard ratio of 2.048, 95% confidence interval 1.123(3.876 for patients of age 40(50 y versus patients bellow 40 y of age and 2.837, 95% confidence interval 1.473(5.465 for patients of age above 50 y versus patients of ages between 40 and 50. Kaplan-Meier curves showed that for patients with more than 5 invasive axillary lymph nodes, compared with those with 1(5, the bone metastasis rates increased significantly ((2 =6.3319, P=0.012). Conclusion: The clinical stage, number of metastatic axillary lymph nodes, age at the time of operation and skeletal complications are essential risk factors of bone metastases.

  18. Retrospective analysis of prognostic factors for sixty osteosarcoma patients with local recurrence

    Institute of Scientific and Technical Information of China (English)

    Jingjing Sha; Weixiang Qi; Haiyan Hu; Yuanjue Sun; Zan Shen; Yang Yao

    2013-01-01

    Objective: The aim of this study was to identify prognostic factors and imply the appropriate management for lo-cal recurrent osteosarcoma. Methods: The clinical records of 60 patients with local recurrence osteosarcoma were reviewed between January 2002 and December 2010. The mean followed-up time for these patients was 49.1 months (range 13 to 143 months). The factors of age, gender, tumor site, tumor size, surgical procedure, neoadjuvant chemotherapy, frequency of primary postoperative adjuvant chemotherapy, lung metastasis, metastasis of other sites (except for lung) and treatment after local recurrence were selected as the measurements for this analysis. Kaplan-Meier method was used to measure the overall survival and post-recurrence survival. The univariate analysis was used to determine the prognostic factors related with survival by Log-rank test. The COX proportional-hazard regression model was used to analyze the correlation between the prognostic factor and the survival. Results: The median post-recurrence survival and overall survival of 60 patients were 32 months (95% confidence interval: 16.2-47.8) and 55 months (95% confidence interval: 39.3–70.7) respectively. The 2- and 3-year cumulative survival rates were 81.7% and 55.4%, respectively. The Log-rank univariate analysis showed that age, gender, tumor size, metastasis of other sites (except for lung) and treatment after local recurrence were associated with the prognosis of osteosarcoma with local recurrence (P 0.05). Conclusion: The independent prognostic factors for local recurrent osteosarcoma were the metastasis of other site (except for lung) and the treatment after local recurrence. The aggressive surgical treatment for local recurrence and distant metastasis could effectively improve the survival of local recurrent osteosarcoma.

  19. HIV testing in the maternity ward and the start of breastfeeding: a survival analysis

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    Glaucia T. Possolli

    2015-08-01

    Full Text Available OBJECTIVE: The purpose of this study was to analyze the factors that influence of the time between birth and the beginning of breastfeeding, especially at the moment of the rapid HIV test results at hospital admission for delivery.METHODS: Cohort study of 932 pregnant women who underwent rapid HIV test admitted in the hospital for delivery in Baby-Friendly Hospitals. The survival curves of time from birth to the first feeding were estimated by the Kaplan-Meier method and the joint effect of independent variables by the Cox model with a hierarchical analysis. As the survival curves were not homogeneous among the five hospitals, hindering the principle of proportionality of risks, the data were divided into two groups according to the median time of onset of breastfeeding at birth in women undergoing rapid HIV testing.RESULTS: Hospitals with median time to breastfeeding onset at birth of up to 60 min were considered as early breastfeeding onset and those with higher medians were considered as late breastfeeding onset at birth. Risk factors common to hospitals considered to be with early and late breastfeeding onset at birth were: cesarean section (RR = 1.75 [95% CI: 1.38-2.22]; RR = 3.83 [95% CI: 3.03-4.85] and rapid test result after birth (RR = 1.45 [95% CI: 1.12-1.89]; RR = 1.65 [95% CI: 1.35-2.02], respectively; and hospitals with late onset: starting prenatal care in the third trimester (RR = 1.86 [95% CI: 1.16-2.97].CONCLUSIONS: The onset of breastfeeding is postponed, even in Baby-Friendly Hospitals, when the results of the rapid HIV test requested in the maternity are not available at the time of delivery.

  20. Survival Analysis and its Associated Factors of Beta Thalassemia Major in Hamadan Province

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    Reza Zamani

    2015-05-01

    Full Text Available Background: There currently is a lack of knowledge about the long-term survival of patients with beta thalassemia (BT, particularly in regions with low incidence of the disease. The aim of the present study was to determine the survival rate of the patients with BT major and the factors associated with the survival time. Methods: This retrospective cohort study was performed in Hamadan province, located in the west of Iran. The study included patients that referred to the provincial hospitals during 16 year period from 1997 to 2013. The follow up of each subject was calculated from the date of birth to the date of death. Demographic and clinical data were extracted from patients’ medical records using a checklist. Statistical analysis included the Kaplan-Meier method to analyze survivals, log-rank to compare curves between groups, and Cox regression for multivariate prognostic analysis. Results: A total of 133 patients with BT major were enrolled, 54.9% of whom were male and 66.2% were urban. The 10-, 20- and 30-year survival rate for all patients were 98.3%, 88.4% and 80.5%, respectively. Based on hazard ratio (HR, we found that accompanied diseases (P=0.01, blood type (P=0.03 and residency status (P=0.01 were significant predictors for the survival time of patients. Conclusion: The survival rate of BT patients has improved. Future researches such as prospective designs are required for the estimation of survival rate and to find other prognostic factors, which have reliable sources of data.

  1. Speed of updating online evidence based point of care summaries: prospective cohort analysis

    Science.gov (United States)

    Cinquini, Michela; Liberati, Alessandro; Moschetti, Ivan; Pecoraro, Valentina; Tagliabue, Ludovica; Moja, Lorenzo

    2011-01-01

    Objective To evaluate the ability of international point of care information summaries to update evidence relevant to medical practice. Design Prospective cohort bibliometric analysis. Setting Top five point of care information summaries (Clinical Evidence, EBMGuidelines, eMedicine, Dynamed, UpToDate) ranked for coverage of medical conditions, editorial quality, and evidence based methodology. Main outcome measures From June 2009 to May 2010 we measured the incidence of research findings relating to potentially eligible newsworthy evidence. As samples, we chose systematic reviews rated as relevant by international research networks (such as, Evidence-Based Medicine, ACP Journal Club, and the Cochrane Collaboration). Every month we assessed whether each sampled review was cited in at least one chapter of the five summaries. The cumulative updating rate was analysed with Kaplan-Meier curves. Results From April to December 2009, 128 reviews were retrieved; 53% (68) from the literature surveillance journals and 47% (60) from the Cochrane Library. At nine months, Dynamed had cited 87% of the sampled reviews, while the other summaries had cited less than 50%. The updating speed of Dynamed clearly led the others. For instance, the hazard ratios for citations in EBM Guidelines and Clinical Evidence versus the top performer were 0.22 (95% confidence interval 0.17 to 0.29) and 0.03 (0.01 to 0.05). Conclusions Point of care information summaries include evidence relevant to practice at different speeds. A qualitative analysis of updating mechanisms is needed to determine whether greater speed corresponds to more appropriate incorporation of new information. PMID:21948588

  2. Breastfeeding practices in a public health field practice area in Sri Lanka: a survival analysis

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    Agampodi Thilini C

    2007-10-01

    Full Text Available Abstract Background Exclusive breastfeeding up to the completion of the sixth month of age is the national infant feeding recommendation for Sri Lanka. The objective of the present study was to collect data on exclusive breastfeeding up to six months and to describe the association between exclusive breastfeeding and selected socio-demographic factors. Methods A clinic based cross-sectional study was conducted in the Medical Officer of Health area, Beruwala, Sri Lanka in June 2006. Mothers with infants aged 4 to 12 months, attending the 19 child welfare clinics in the area were included in the study. Infants with specific feeding problems (cleft lip and palate and primary lactose intolerance were excluded. Cluster sampling technique was used and consecutive infants fulfilling the inclusion criteria were enrolled. A total of 219 mothers participated in the study. The statistical tests used were survival analysis (Kaplan-Meier survival curves and Cox proportional Hazard model. Results All 219 mothers had initiated breastfeeding. The median duration of exclusive breastfeeding was four months (95% CI 3.75, 4.25. The rates of exclusive breastfeeding at 4 and 6 months were 61.6% (135/219 and 15.5% (24/155 respectively. Bivariate analysis showed that the Muslim ethnicity (p = 0.004, lower levels of parental education (p Conclusion The rate of breastfeeding initiation and exclusive breastfeeding up to the fourth month is very high in Medical Officer of Health area, Beruwala, Sri Lanka. However exclusive breastfeeding up to six months is still low and the prevalence of inappropriate feeding practices is high.

  3. Retrospective, monocentric analysis of late effects after total body irradiation (TBI) in adults

    Energy Technology Data Exchange (ETDEWEB)

    Boelling, Tobias [Universitaetsklinikum Muenster (Germany). Dept. of Radiotherapy; Paracelsus Clinic Osnabrueck (Germany). Dept. of Radiotherapy; Kreuziger, David Christoph; Ernst, Iris; Elsayed, Hassan; Willich, Normann [Universitaetsklinikum Muenster (Germany). Dept. of Radiotherapy

    2011-05-15

    Purpose: Total body irradiation (TBI) is a standard treatment modality within the multidisciplinary approach for allogeneous stem cell or bone marrow transplantation. However, surviving patients are at risk for developing a variety of late sequelae. This analysis aimed to retrospectively characterize late effects after TBI in adults treated in a single center. Patients and Methods: Patients {>=} 18 years treated with fractionated TBI (4-12 Gy) between 1996 and 2008 were included in this study. Treatment data were collected retrospectively from the treating departments. Late effects were evaluated using the clinic charts and/or were obtained from the general practitioners using a standardized questionnaire. Analyses were performed by calculation of the cumulative incidences using the Kaplan-Meier method and the log rank test. Results: A total of 308 patients {>=} 18 years were treated including a TBI of whom 78 patients were excluded from further analysis due to death within less than 1 year after TBI. Patients suffered from leukemia in most cases. Late toxicity follow-up was available in 120 patients (mean age 46.1 years; range, 18-70 years) after a mean follow-up of 23 months (range, 12-96 months). The cumulative incidences (CI) at 3 years were 28% for pulmonary event, 8% for pulmonary toxicity, 25% for kidney toxicity, 8% for cataract, 17% for bone toxicity, and 10% for secondary malignancy. The CI of bone toxicity was higher in female than in male patients (p = 0.019). Conclusion: Late effects after TBI in the context of allogeneous stem cell or bone marrow transplantation can frequently be observed. Regular follow-up examinations are advised for the early registration and treatment of adverse effects. (orig.)

  4. The dual-mobility POLARCUP: first results from a multicenter study.

    Science.gov (United States)

    Bauchu, Philippe; Bonnard, Olivier; Cyprès, Alain; Fiquet, Arnaud; Girardin, Philippe; Noyer, Daniel

    2008-12-01

    Dislocation is a leading cause of revision after total hip arthroplasty (THA). To address this risk, dual-mobility technology was developed, which features a mobile polyethylene liner locked onto a femoral head and articulating in a metallic acetabular shell. This study reports clinical outcome data after implantation of the third-generation POLARCUP Dual-Mobility System (Smith & Nephew Orthopaedics AG, Rotkreuz, Switzerland). Primary THA procedures were performed in 150 patients. At 7.1 years, cumulative cup survival according to Kaplan-Meier was 97.4%. The mean Postel-Merle d'Aubigne score improved from 8.9 to 17.1 during the investigation. Two cups were revised at 5.4 and 6.4 years because of aseptic loosening. No dislocations were observed during follow-up. The current results confirm excellent early to midterm clinical outcomes for the POLARCUP Dual-Mobility System.

  5. Breast-conserving treatment of early breast cancer; Results in a common trial

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    Pirtoli, L. (Siena Univ. (Italy). Unita Operativa di Radioterapia); Bellezza, A. (Siena Univ. (Italy). Unita Operativa di Radioterapia); Pepi, F. (Siena Univ. (Italy). Unita Operativa di Radioterapia); Tucci, E. (Siena Univ. (Italy). Unita Operativa di Radioterapia); Crociani, M. (Siena Univ. (Italy). Unita Operativa di Radioterapia); Crastolla, A.M. (Siena Univ. (Italy). Unita Operativa di Radioterapia); Farzad, M. (Siena Univ. (Italy). Unita Operativa di Radioterapia); Bindi, M. (Siena Univ. (Italy). Unita Operativa di Radioterapia)

    1993-01-01

    Results of large prospective trials, often based on selected series and optimal treatment techniques, indicate that breast conserving therapy is appropriate for most patients with early breast cancer. Questions remain regarding the therapeutic outcome in common practice. We report on a series of 206 consecutive, unselected patients treated with current radiotherapy procedures. The Kaplan-Meier evaluation showed 5- and 8-year survival rates (93%, 91%), distant disease-free survival rates (87%, 85%) and local relapse-free survival rates (90%, 88%) that were comparable to those of the conservative arms in reported randomised trials and to the data from retrospective studies reported by authoritative institutions. However, subanalysis according to prognostic factors such as menopausal status, age and axillary nodal status was of limited value, due to the small number of cases. (orig.).

  6. Survival analysis and risk factors for death in tuberculosis patients on directly observed treatment-short course

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    Pardeshi Geeta

    2009-05-01

    Full Text Available Background : Tuberculosis is a disease with a high case fatality of 4.65%. Objectives : To describe the survival pattern of patients on Directly Observed Treatment-Short course (DOTS according to categories, age and sex of patients. Settings : Tuberculosis unit (TU at District Tuberculosis Centre (DTC, Yavatmal, India Design : Retrospective cohort study. Materails and Methods : Data of patients registered for DOTS in the year 2004 were collected from the tuberculosis register. Statistical Analysis : Kaplan Meier plots and log rank tests to assess the survival pattern. Cox proportional hazards model for multivariate analysis. Results : A total of 716 patients were registered at the TU. The survival rates by the end of the intensive phase were 96%, 93% and 99% in categories I, II and III of DOTS, respectively. The cumulative survival rates were 93%, 88% and 96% in the three DOTS categories, respectively. There was a significant difference in the survival curves amongst the three DOTS categories (log rank statistic= 7.26, d.f..= 2, P=0 0.02 and amongst the different age groups [log rank statistic= 8.78, d.f.= 3, P= 0.012. There was no difference in the survival curves of male and female patients (log rank statistic= 0.05, d.f.= 1, P= 0.80 and according to type of disease (log rank statistic= 5.63, d.f.= 2, P= 0.05. On Cox proportional hazard analysis, age groups of 40 to 60 years [adjusted hazard ratio= 7.81 (1.002-60.87] and above 60 years [adjusted hazard ratio= 21.54 (2.57-180.32] were identified as significant risk factors for death. Conclusions : Age above 40 years is a significant risk factor for death in patients of tuberculosis. There was a significant difference in survival curves of the three DOTS categories and age groups.

  7. Long-Term Restoration of Anterior Shoulder Stability: A Retrospective Analysis of Arthroscopic Bankart Repair Versus Open Latarjet Procedure.

    Science.gov (United States)

    Zimmermann, Stefan M; Scheyerer, Max J; Farshad, Mazda; Catanzaro, Sabrina; Rahm, Stefan; Gerber, Christian

    2016-12-07

    Various operative techniques are used for treating recurrent anterior shoulder instability, and good mid-term results have been reported. The purpose of this study was to compare shoulder stability after treatment with the 2 commonly performed procedures, the arthroscopic Bankart soft-tissue repair and the open coracoid transfer according to Latarjet. A comparative, retrospective case-cohort analysis of 360 patients (364 shoulders) who had primary repair for recurrent anterior shoulder instability between 1998 and 2007 was performed. The minimum duration of follow-up was 6 years. Reoperations, overt recurrent instability (defined as recurrent dislocation or subluxation), apprehension, the subjective shoulder value (SSV), sports participation, and overall satisfaction were recorded. An open Latarjet procedure was performed in 93 shoulders, and an arthroscopic Bankart repair was done in 271 shoulders. Instability or apprehension persisted or recurred after 11% (10) of the 93 Latarjet procedures and after 41.7% (113) of the 271 arthroscopic Bankart procedures. Overt instability recurred after 3% of the Latarjet procedures and after 28.4% (77) of the Bankart procedures. In the Latarjet group, 3.2% of the patients were not satisfied with their result compared with 13.2% in the Bankart group (p = 0.007). Kaplan-Meier analysis of survivorship, with apprehension (p Latarjet procedure and the decreasing effectiveness of the arthroscopic Bankart repair over time. Twenty percent of the first recurrences after arthroscopic Bankart occurred no earlier than 91 months postoperatively, as opposed to the rare recurrences after osseous reconstruction, which occurred in the early postoperative period, with only rare late failures. In this retrospective cohort study, the arthroscopic Bankart procedure was inferior to the open Latarjet procedure for repair of recurrent anterior shoulder dislocation. The difference between the 2 procedures with respect to the quality of outcomes

  8. Integrated Analysis Identifies Molecular Signatures and Specific Prognostic Factors for Different Gastric Cancer Subtypes

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    Li Min

    2017-02-01

    Full Text Available BACKGROUND: Gastric cancer (GC is the fifth leading cause of cancer-related deaths worldwide. As an effective and easily performed method, microscopy-based Lauren classification has been widely accepted by gastrointestinal surgeons and pathologists for GC subtyping, but molecular characteristics of different Lauren subtypes were poorly revealed. METHODS: GSE62254 was used as a derivation cohort, and GSE15459 was used as a validation cohort. The difference between diffuse and intestinal GC on the gene expression level was measured. Gene ontology (GO enrichment analysis was performed for both subgroups. Hierarchical clustering and heatmap exhibition were also performed. Kaplan-Meier plot and Cox proportional hazards model were used to evaluate survival grouped by the given genes or hierarchical clusters. RESULTS: A total of 4598 genes were found differentially expressed between diffuse and intestinal GC. Immunity- and cell adhesion–related GOs were enriched for diffuse GC, whereas DNA repair– and cell cycle–related GOs were enriched for intestinal GC. We proposed a 40-gene signature (χ2 = 30.71, P < .001 that exhibits better discrimination for prognosis than Lauren classification (χ2 = 12.11, P = .002. FRZB [RR (95% CI = 1.824 (1.115-2.986, P = .017] and EFEMP1 [RR (95% CI = 1.537 (0.969-2.437, P = .067] were identified as independent prognostic factors only in diffuse GC but not in intestinal GC patients. KRT23 [RR (95% CI = 1.616 (0.938-2.785, P = .083] was identified as an independent prognostic factor only in intestinal GC patients but not in diffuse GC patients. Similar results were achieved in the validation cohort. CONCLUSION: We found that GCs with different Lauren classifications had different molecular characteristics and identified FRZB, EFEMP1, and KRT23 as subtype-specific prognostic factors for GC patients.

  9. Long-term survival of dental implants placed in the grafted maxillary sinus: systematic review and meta-analysis of treatment modalities.

    Directory of Open Access Journals (Sweden)

    Fabian Duttenhoefer

    Full Text Available BACKGROUND: A prevalent modality to increase the amount of available bone prior to implantation is grafting of the maxillary sinus. Multiple factors such as the surgical technique, moment of implant placement as well as grafting materials and membranes are known to affect implant survival. However, the role of different factor combinations and associated reciprocal effects remain unclear. Conventional statistical methods do not consider inconsistency of study designs and do not take covariables into account. Hence, a systematic research and meta-analysis was conducted to investigate the influence of various treatment modalities on implant survival in the grafted maxillary sinus. MATERIALS AND METHODS: A meta-analysis was conducted according to the PRISMA guidelines. Articles published from 1980 through January 2013 were electronically and manually searched in MEDLINE (Ovid, the Cochrane Register of Controlled Trials, the Database of Abstracts of Effects, and the Cochrane Database of Systematic Reviews. Clinical reports on single intervention sinus augmentation with root-form implants, a minimum of 10 patients and 6 months of loading were eligible for inclusion if implant survival was stated or calculable. Results were calculated by non-parametric univariate Kaplan-Meier analysis and Bayesian multivariate interval-censored Cox regression. RESULTS: A total of 122 publications on 16268 endosseous implants placed in grafted maxillary sinus were included. The treatment parameters surgical approach, grafting material and implant type showed no selective preference. However, application of membranes showed a significantly reduced hazard-ratio, independent of other co-factors. CONCLUSIONS: The use of membranes is the most significant factor to achieve long-term implant survival in sinus augmentation procedures. More data exceeding 3 years follow-up are needed to address prospective confounding and improve clinical evidence.

  10. Treatment and survival outcomes of small cell carcinoma of the esophagus: an analysis of the National Cancer Data Base.

    Science.gov (United States)

    Wong, Andrew T; Shao, Meng; Rineer, Justin; Osborn, Virginia; Schwartz, David; Schreiber, David

    2016-11-09

    Given the paucity of esophageal small cell carcinoma (SCC) cases, there are few large studies evaluating this disease. In this study, the National Cancer Data Base (NCDB) was utilized to analyze the clinical features, treatment, and survival of patients with esophageal SCC in a large, population-based dataset. We selected patients diagnosed with esophageal SCC from 1998 to 2011. Patients were identified as having no treatment, chemotherapy alone, radiation ± sequential chemotherapy, concurrent chemoradiation, and esophagectomy ± chemotherapy and/or radiation. Overall survival (OS) was analyzed using the Kaplan-Meier method and compared using the log-rank test. Multivariate Cox regression analysis was conducted to identify factors associated with OS. A total of 583 patients were identified. Most patients had stage IV disease (41.7%). Regarding treatment selection, chemoradiation was the most commonly utilized for patients with nonmetasatic disease, whereas chemotherapy alone was most common for metastatic patients. Esophagectomy (median survival 44.9 months with 3 year OS 50.5%) was associated with the best OS for patients with localized (node-negative) disease compared with chemotherapy alone (p < 0.001) or chemoradiation (p = 0.01). For locoregional (node-positive) disease, treatment with chemoradiation resulted in a median survival of 17.8 months and a 3 year OS 31.6%. On multivariate analysis, treatment with chemotherapy alone (p = 0.003) was associated with worse OS while esophagectomy (p = 0.04) was associated with improved OS compared to chemoradiation. Esophageal SCC is an aggressive malignancy with most patients presenting with metastatic disease. Either esophagectomy or chemoradiation as part of multimodality treatment appear to improve OS for selected patients with nonmetastatic disease.

  11. Analysis of time to event outcomes in randomized controlled trials by generalized additive models.

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    Christos Argyropoulos

    Full Text Available Randomized Controlled Trials almost invariably utilize the hazard ratio calculated with a Cox proportional hazard model as a treatment efficacy measure. Despite the widespread adoption of HRs, these provide a limited understanding of the treatment effect and may even provide a biased estimate when the assumption of proportional hazards in the Cox model is not verified by the trial data. Additional treatment effect measures on the survival probability or the time scale may be used to supplement HRs but a framework for the simultaneous generation of these measures is lacking.By splitting follow-up time at the nodes of a Gauss Lobatto numerical quadrature rule, techniques for Poisson Generalized Additive Models (PGAM can be adopted for flexible hazard modeling. Straightforward simulation post-estimation transforms PGAM estimates for the log hazard into estimates of the survival function. These in turn were used to calculate relative and absolute risks or even differences in restricted mean survival time between treatment arms. We illustrate our approach with extensive simulations and in two trials: IPASS (in which the proportionality of hazards was violated and HEMO a long duration study conducted under evolving standards of care on a heterogeneous patient population.PGAM can generate estimates of the survival function and the hazard ratio that are essentially identical to those obtained by Kaplan Meier curve analysis and the Cox model. PGAMs can simultaneously provide multiple measures of treatment efficacy after a single data pass. Furthermore, supported unadjusted (overall treatment effect but also subgroup and adjusted analyses, while incorporating multiple time scales and accounting for non-proportional hazards in survival data.By augmenting the HR conventionally reported, PGAMs have the potential to support the inferential goals of multiple stakeholders involved in the evaluation and appraisal of clinical trial results under proportional and

  12. Clinical outcome after pulmonary metastasectomy from primary hepatocellular carcinoma: Analysis of prognostic factors

    Institute of Scientific and Technical Information of China (English)

    Jong-Bum Kwon; Hyeon-Woo Lim; Khun Park; Young-Du Kim; Jong-Hee Seo; Seok-Whan Moon; Deog-Gon Cho; Yong-Whan Kim; Dong-Goo Kim; Seung-Kew Yoon

    2008-01-01

    AIM: To review the surgical outcomes in terms of the surgical indications and relevant prognostic factors.METHODS: Sixteen patients underwent therapeutic lung surgery between March 1999 and May 2006.The observation period was terminated on May 31,2007.The surgical outcomes and the clinicopathological factors were compared.RESULTS: There was no mortality or major morbidity encountered in this study.The mean follow-up period after metastasectomy was 26.7 + 28.2 (range:1-99 mo),and the median survival time was 20 mo.The 1- and 5-year survival rates were 56% and 26%,respectively.At the end of the follow-up,1 patient died from hepatic failure without recurrence,6 died from hepatic failure with a recurrent hepatocellular carcinoma (HCC),and 4 died from recurrent HCC with cachexia.Among several clinical factors,Kaplan-Meier analysis revealed that liver transplantation as a treatment for the primary lesion,grade of cell differentiation,and negative evidence HBV infection were independent predictive factors.On Cox's proportional hazard model,there were no significant factors affecting survival after pulmonary metastasectomy in patients with HCC.CONCLUSION: A metastasectomy should be performed before other treatments in selected patients.Although not significant,patients with liver transplantation of a primary HCC survived longer.Liver transplantation might be the most beneficial modality that can offer patients better survival.A multiinstitutional and collaborative study would be needed for identifying clinical prognostic factors predicting survival in patients with HCC and lung metastasis.

  13. An Asian population-based survival analysis of patients with distal esophageal and gastric cardia adenocarcinomas

    Institute of Scientific and Technical Information of China (English)

    ZHENG Bin; ZHENG Wei; ZHU Yong,; WU Wei-dong; CHEN Chun

    2012-01-01

    Background Gastroesophageal junction adenocarcinomas include adenocarcinomas of the distal esophagus(DE)and gastric cardia(GC).It is controversial whether these tumors are the same entity and whether they have the same survival rates.Patients with DE and GC adenocarcinomas have a similar survival rate in the US;however,data are lacking in Asian countries.Therefore,we conducted a retrospective study to understand the implications of the tumor location in the survival of Asian patients.Methods A total of 209 patients with pathologically confirmed DE and GC adenocarcinomas,from 2005 to 2007,were included in the study.We identified patients with adenocarcinomas of the DE(DE group,n=91)and GC(GC group)(n=118).We performed an unadjusted survival analysis using the Kaplan-Meier method,and used a Cox proportional hazards regression model to adjust for potential confounding covariates.Results We found no significant difference between the overall survival of the DE and GC groups.The 3-year survival rates were 44.8% and 53.0%,respectively,and the 5-year survival rates were 27.9% and 30.2%,respectively(P=0.162).We found no significant difference in early staging,advanced staging,different T staging,and different N staging,between the groups.Both advanced post-operative N staging and advanced AJCC staging had a significant adverse effect on survival.Conclusions Patients with DE and GC adenocarcinomas have similar survival rates in the Asian population.Both post-operative N staging and AJCC staging are prognostic factors.

  14. Analysis of elemental concentration censored distributions in breast malignant and breast benign neoplasm tissues

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    Kubala-Kukus, A. [Institute of Physics, Swietokrzyska Academy, Swietokrzyska 15, 25-406 Kielce (Poland); Holycross Cancer Centre, Artwinskiego 3, 25-734 Kielce (Poland)], E-mail: Aldona.Kubala-Kukus@pu.kielce.pl; Banas, D.; Braziewicz, J. [Institute of Physics, Swietokrzyska Academy, Swietokrzyska 15, 25-406 Kielce (Poland); Holycross Cancer Centre, Artwinskiego 3, 25-734 Kielce (Poland); Gozdz, S. [Holycross Cancer Centre, Artwinskiego 3, 25-734 Kielce (Poland); Majewska, U. [Institute of Physics, Swietokrzyska Academy, Swietokrzyska 15, 25-406 Kielce (Poland); Holycross Cancer Centre, Artwinskiego 3, 25-734 Kielce (Poland); Pajek, M. [Institute of Physics, Swietokrzyska Academy, Swietokrzyska 15, 25-406 Kielce (Poland)

    2007-07-15

    The total reflection X-ray fluorescence method was applied to study the trace element concentrations in human breast malignant and breast benign neoplasm tissues taken from the women who were patients of Holycross Cancer Centre in Kielce (Poland). These investigations were mainly focused on the development of new possibilities of cancer diagnosis and therapy monitoring. This systematic comparative study was based on relatively large ({approx} 100) population studied, namely 26 samples of breast malignant and 68 samples of breast benign neoplasm tissues. The concentrations, being in the range from a few ppb to 0.1%, were determined for thirteen elements (from P to Pb). The results were carefully analysed to investigate the concentration distribution of trace elements in the studied samples. The measurements of concentration of trace elements by total reflection X-ray fluorescence were limited, however, by the detection limit of the method. It was observed that for more than 50% of elements determined, the concentrations were not measured in all samples. These incomplete measurements were treated within the statistical concept called left-random censoring and for the estimation of the mean value and median of censored concentration distributions, the Kaplan-Meier estimator was used. For comparison of concentrations in two populations, the log-rank test was applied, which allows to compare the censored total reflection X-ray fluorescence data. Found statistically significant differences are discussed in more details. It is noted that described data analysis procedures should be the standard tool to analyze the censored concentrations of trace elements analysed by X-ray fluorescence methods.

  15. Analysis of elemental concentration censored distributions in breast malignant and breast benign neoplasm tissues

    Science.gov (United States)

    Kubala-Kukuś, A.; Banaś, D.; Braziewicz, J.; Góźdź, S.; Majewska, U.; Pajek, M.

    2007-07-01

    The total reflection X-ray fluorescence method was applied to study the trace element concentrations in human breast malignant and breast benign neoplasm tissues taken from the women who were patients of Holycross Cancer Centre in Kielce (Poland). These investigations were mainly focused on the development of new possibilities of cancer diagnosis and therapy monitoring. This systematic comparative study was based on relatively large (˜ 100) population studied, namely 26 samples of breast malignant and 68 samples of breast benign neoplasm tissues. The concentrations, being in the range from a few ppb to 0.1%, were determined for thirteen elements (from P to Pb). The results were carefully analysed to investigate the concentration distribution of trace elements in the studied samples. The measurements of concentration of trace elements by total reflection X-ray fluorescence were limited, however, by the detection limit of the method. It was observed that for more than 50% of elements determined, the concentrations were not measured in all samples. These incomplete measurements were treated within the statistical concept called left-random censoring and for the estimation of the mean value and median of censored concentration distributions, the Kaplan-Meier estimator was used. For comparison of concentrations in two populations, the log-rank test was applied, which allows to compare the censored total reflection X-ray fluorescence data. Found statistically significant differences are discussed in more details. It is noted that described data analysis procedures should be the standard tool to analyze the censored concentrations of trace elements analysed by X-ray fluorescence methods.

  16. Statistical analysis of water-quality data containing multiple detection limits II: S-language software for nonparametric distribution modeling and hypothesis testing

    Science.gov (United States)

    Lee, L.; Helsel, D.

    2007-01-01

    Analysis of low concentrations of trace contaminants in environmental media often results in left-censored data that are below some limit of analytical precision. Interpretation of values becomes complicated when there are multiple detection limits in the data-perhaps as a result of changing analytical precision over time. Parametric and semi-parametric methods, such as maximum likelihood estimation and robust regression on order statistics, can be employed to model distributions of multiply censored data and provide estimates of summary statistics. However, these methods are based on assumptions about the underlying distribution of data. Nonparametric methods provide an alternative that does not require such assumptions. A standard nonparametric method for estimating summary statistics of multiply-censored data is the Kaplan-Meier (K-M) method. This method has seen widespread usage in the medical sciences within a general framework termed "survival analysis" where it is employed with right-censored time-to-failure data. However, K-M methods are equally valid for the left-censored data common in the geosciences. Our S-language software provides an analytical framework based on K-M methods that is tailored to the needs of the earth and environmental sciences community. This includes routines for the generation of empirical cumulative distribution functions, prediction or exceedance probabilities, and related confidence limits computation. Additionally, our software contains K-M-based routines for nonparametric hypothesis testing among an unlimited number of grouping variables. A primary characteristic of K-M methods is that they do not perform extrapolation and interpolation. Thus, these routines cannot be used to model statistics beyond the observed data range or when linear interpolation is desired. For such applications, the aforementioned parametric and semi-parametric methods must be used.

  17. Radiotherapy of spinal cord gliomas. A retrospective mono-institutional analysis

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    Corradini, Stefanie; Hadi, Indrawati; Ganswindt, Ute; Belka, Claus; Niyazi, Maximilian [University of Munich, Department of Radiation Oncology, Munich (Germany); Hankel, Vinzent [Marienhospital Stuttgart, Department of Radiation Oncology, Stuttgart (Germany); Ertl, Lorenz [Staedtisches Klinikum Muenchen Harlaching, Department of Radiology, Neuroradiology, and Nuclear Medicine, Munich (Germany); University of Munich, Department of Neuroradiology, Munich (Germany)

    2016-03-15

    Due to the rarity of spinal cord gliomas, no consensus has been reached regarding the optimal treatment strategy. The aim of the present retrospective study was to identify patient and tumor characteristics and to evaluate the effectiveness of radiotherapy within this setting. Patients diagnosed with spinal cord gliomas between 2003 and 2013 and treated at the Department of Radiation Oncology, University of Munich, were retrospectively analyzed. Overall survival was estimated with the Kaplan-Meier method and univariate analysis was performed by log-rank testing. A total of 16 patients were identified. The cohort consisted of seven primary spinal cord gliomas and eight cases of metastases of cerebral gliomas. Median follow-up was 42 months and median total radiation dose was 45.0 Gy. In all, 62.5 % of patients received a simultaneous chemotherapy with temozolomide. The median overall survival was 6 months (95% CI: 0-27.5 months). Surgical resection of the tumor was a significant predictor of improved survival, compared with radiotherapy alone (p = 0.001). Patients with the diagnosis of a primary spinal cord glioma survived significantly longer than those presenting with a metastatic deposit from a cerebral glioma (p < 0.001). A statistically significant dose-response relationship at dose levels of ≥ 45 Gy vs. < 45 Gy could be derived (p < 0.001). Simultaneous chemotherapy did not influence survival outcome. Despite the aggressive treatment in the present study, the prognosis for spinal cord gliomas was still poor, with a median overall survival of 6 months. To the best of our knowledge, this is the largest study reporting the results of simultaneous chemoradiation in spinal cord gliomas. A combined chemoradiation treatment seems feasible and can be considered as a new treatment option in the management of spinal cord gliomas. (orig.) [German] Das spinale Gliom stellt eine aeusserst seltene Entitaet dar. Aktuell besteht daher kein Konsensus ueber die optimale

  18. Assessment of Various Risk Factors for Success of Delayed and Immediate Loaded Dental Implants: A Retrospective Analysis.

    Science.gov (United States)

    Prasant, M C; Thukral, Rishi; Kumar, Sachin; Sadrani, Sannishth M; Baxi, Harsh; Shah, Aditi

    2016-10-01

    Ever since its introduction in 1977, a minimum of few months of period is required for osseointegration to take place after dental implant surgery. With the passage of time and advancements in the fields of dental implant, this healing period is getting smaller and smaller. Immediate loading of dental implants is becoming a very popular procedure in the recent time. Hence, we retrospectively analyzed the various risk factors for the failure of delayed and immediate loaded dental implants. In the present study, retrospective analysis of all the patients was done who underwent dental implant surgeries either by immediate loading procedure or by delayed loading procedures. All the patients were divided broadly into two groups with one group containing patients in which delayed loaded dental implants were placed while other consisted of patients in whom immediate loaded dental implants were placed. All the patients in whom follow-up records were missing and who had past medical history of any systemic diseases were excluded from the present study. Evaluation of associated possible risk factors was done by classifying the predictable factors as primary and secondary factors. All the results were analyzed by Statistical Package for the Social Sciences (SPSS) software. Kaplan-Meier survival analyses and chi-square test were used for assessment of level of significance. In delayed and immediate group of dental implants, mean age of the patients was 54.2 and 54.8 years respectively. Statistically significant results were obtained while comparing the clinical parameters of the dental implants in both the groups while demographic parameters showed nonsignificant correlation. Significant higher risk of dental implant failure is associated with immediate loaded dental implants. Tobacco smoking, shorter implant size, and other risk factors play a significant role in predicting the success and failure of dental implants. Delayed loaded dental implant placement should be preferred

  19. Laparoscopic versus open radical cystectomy for elderly patients over 75-year-old: a single center comparative analysis.

    Directory of Open Access Journals (Sweden)

    Shuxiong Zeng

    Full Text Available PURPOSE: To explore the morbidity, mortality and oncological results of laparoscopic radical cystectomy (LRC in the elderly patients over 75-year-old in contrast with open radical cystectomy (ORC. MATERIALS AND METHODS: We analyzed 46 radical cystectomies from January 2009 to December 2013 in patients over 75-year-old in our institute, 21 patients in the LRC group and 25 in the ORC group. Demographic parameters, operative variables and perioperative outcome were retrospectively collected and analyzed between the two groups. Perioperative morbidity and mortality were categorized as early (within 90 days after surgery or late (more than 90 days according to the time of occurrence. RESULTS: Patients in both groups had comparable preoperative characteristics. A significant longer operative time (418 vs. 337 min, p = 0.018 and less estimated blood loss (400 vs. 500 ml p = 0.038 were observed in LRC group compared with ORC group. Infection and ileus were the most common early complications after surgery. Patients underwent ORC suffered from significantly more postoperative ileus (28.0% vs. 4.8%, P = 0.038 and infection (40% vs. 9.5%, P = 0.019 than LRC group within 90 days after surgery. The mortality rate was 4.7% (1/21 and 4% (1/25 for LRC group and ORC group respectively. At a median follow-up of 21 months (range 2-61 months, the Kaplan-Meier survival curves and log-rank analysis demonstrate that there were no significant differences between the LRC and ORC groups in the 3-year overall, cancer-specific, or recurrence-free survival rates. CONCLUSIONS: It is suggested that LRC should be recommended as the primary intervention to treat muscle invasive or high risk non-muscle invasive bladder cancer in elderly patients with a relative long life expectancy.

  20. Therapeutic effect and prognostic analysis of intensity-modulated radiotherapy for primary hepatocellular carcinoma with portal vein and/or inferior vena cava tumor thrombus

    Directory of Open Access Journals (Sweden)

    HUANG Long

    2015-06-01

    Full Text Available ObjectiveTo determine the efficacy and prognostic factors of intensity-modulated radiotherapy (IMRT for primary hepatocellular carcinoma (HCC with portal vein and/or inferior vena cava tumor thrombus. MethodsTwenty-three HCC patients with portal vein and/or inferior vena cava tumor thrombus received IMRT with an 8 MV linear accelerator at the Cancer Center of General Hospital of Armed Police Forces, Anhui Medical University, from April 2008 to August 2011. A single dose of 3 to 6 Gy was delivered at five fractions per week, with a total dose of 56 to 96 Gy and a median dose of 60 Gy. Survival time was recorded, and adverse reactions were evaluated. Survival rate calculation and survival analysis were performed using the Kaplan-Meier method. Comparison of categorical between two groups was made by chi-square test. ResultsOne patient did not complete radiotherapy due to upper gastrointestinal bleeding. Of 22 patients who completed IMRT, 4 achieved complete remission and 10 achieved partial remission, with an overall response rate of 63.7%. Our analysis showed that the type of tumor thrombus and tumor size were associated with tumor response rate and were significant prognostic factors (P<0.05. The median survival time was 13.4 months. The 1-, 2-, and 3-year survival rates were 59%, 27%, and 18%, respectively. The 22 patients who completed radiotherapy did not experience acute radiation injury or late adverse outcomes such as radiation-induced liver disease. ConclusionThis study suggests IMRT is a safe and effective treatment option for HCC patients with portal vein and/or inferior vena cava tumor thrombus.

  1. Total laparoscopic hepatectomy versus open hepatectomy in treatment of hepatocellular carcinoma in the left lateral lobe: a case-matched analysis

    Directory of Open Access Journals (Sweden)

    XIONG Yong

    2016-04-01

    Full Text Available ObjectiveTo investigate the safety, feasibility, and efficacy of total laparoscopic hepatectomy in the treatment of hepatocellular carcinoma (HCC in the left lateral lobe. MethodsA case-matched analysis was performed between 25 patients with HCC in the left lateral lobe confirmed by postoperative pathological examination, who were admitted to Panzhihua Central Hospital and underwent total laparoscopic left lobe resection (LLLR from April 2012 to April 2015, and 25 patients with HCC who underwent open left lobe resection (OLLR during the same period. The t-test was used for comparison of continuous data between the two groups, and the chi-square test or Fisher′s exact test was used for comparison of catagorical data between the two groups; the Kaplan-Meier method was used for survival analysis, and the log-rank test was used for comparison of survival curves. ResultsThe time of operation, number of patients undergoing intraoperative blood transfusion, and number of patients with R0 resection margin showed no significant differences between the LLLR group and the OLLR group, but intraoperative blood loss (216.4±15.39 ml vs 273.2±16.65 ml, mean hospital stay (6.92±0.29 min vs 10.32±052 min, and postoperative complications (5 cases vs 12 cases showed significant differences between the two groups (all P<0.05. The 1- and 3-year overall survival rates and progression-free survival showed no significant differences between the LLLR group and the OLLR group. ConclusionLLLR and OLLR have similar long-term efficacy in the treatment of HCC in the left lateral lobe, and LLLR has advantages in the aspects of intraoperative blood loss, postoperative complications, and length of hospital stay.

  2. Coculture of autologous limbal and conjunctival epithelial cells to treat severe ocular surface disorders: Long-term survival analysis

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    Sandhya V Subramaniam

    2013-01-01

    Full Text Available Background: Cultivated limbal epithelium for reconstruction of corneal surface is a well-established procedure; however, it is not adequate for damage which also extensively involves the conjunctiva. In severe cases of ocular surface damage that warrant additional conjunctival transplantation apart from cultivated limbal stem cell transplantation, we describe the long-term survival of a novel method of cocultivating autologous limbal and conjunctival epithelium on a single substrate. Materials and Methods: Forty eyes of 39 patients with severe limbal stem cell deficiency and conjunctival scarring or symblepharon underwent transplantation of autologous cocultivated epithelium on human amniotic membrane. A ring barrier was used to segregate the central limbal and peripheral conjunctival epithelia in vitro. Patients were followed up at regular intervals to assess stability of the ocular surface, defined by absence of conjunctivalization into the central 4 mm of the cornea and absence of diffuse fluorescein staining. Penetrating keratoplasty (PKP was subsequently performed, where indicated, in patients with surface stability. Results: The cumulative survival probability was 60% at 1 year and 45% at 4 years by Kaplan-Meier analysis (mean follow-up duration: 33 ± 29 months, range: 1-87 months. Best-corrected visual acuity improved to greater than 20/200 in 38% eyes at the last follow-up, compared with 5% eyes before surgery. Immunohistochemistry in five of the corneal buttons excised for PKP showed an epithelial phenotype similar to cornea in all five. Conclusions: Synchronous use of cultured limbal and conjunctival epithelium offers a feasible alternative and a simpler one-step surgical approach to treat severe ocular surface disorders involving limbus and conjunctiva.

  3. Repair or Replacement for Isolated Tricuspid Valve Pathology? Insights from a Surgical Analysis on Long-Term Survival

    Science.gov (United States)

    Farag, Mina; Arif, Rawa; Sabashnikov, Anton; Zeriouh, Mohamed; Popov, Aron-Frederik; Ruhparwar, Arjang; Schmack, Bastian; Dohmen, Pascal M.; Szabó, Gábor; Karck, Matthias; Weymann, Alexander

    2017-01-01

    Background Long-term follow-up data concerning isolated tricuspid valve pathology after replacement or reconstruction is limited. Current American Heart Association guidelines equally recommend repair and replacement when surgical intervention is indicated. Our aim was to investigate and compare operative mortality and long-term survival in patients undergoing isolated tricuspid valve repair surgery versus replacement. Material/Methods Between 1995 and 2011, 109 consecutive patients underwent surgical correction of tricuspid valve pathology at our institution for varying structural pathologies. A total of 41 (37.6%) patients underwent tricuspid annuloplasty/repair (TAP) with or without ring implantation, while 68 (62.3%) patients received tricuspid valve replacement (TVR) of whom 36 (53%) were mechanical and 32 (47%) were biological prostheses. Results Early survival at 30 days after surgery was 97.6% in the TAP group and 91.1% in the TVR group. After 6 months, 89.1% in the TAP group and 87.8% in the TVR group were alive. In terms of long-term survival, there was no further mortality observed after one year post surgery in both groups (Log Rank p=0.919, Breslow p=0.834, Tarone-Ware p=0.880) in the Kaplan-Meier Survival analysis. The 1-, 5-, and 8-year survival rates were 85.8% for TAP and 87.8% for TVR group. Conclusions Surgical repair of the tricuspid valve does not show survival benefit when compared to replacement. Hence valve replacement should be considered generously in patients with reasonable suspicion that regurgitation after repair will reoccur. PMID:28236633

  4. Gene expression analysis of glioblastomas identifies the major molecular basis for the prognostic benefit of younger age

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    Farooqi Haumith K

    2008-10-01

    Full Text Available Abstract Background Glioblastomas are the most common primary brain tumour in adults. While the prognosis for patients is poor, gene expression profiling has detected signatures that can sub-classify GBMs relative to histopathology and clinical variables. One category of GBM defined by a gene expression signature is termed ProNeural (PN, and has substantially longer patient survival relative to other gene expression-based subtypes of GBMs. Age of onset is a major predictor of the length of patient survival where younger patients survive longer than older patients. The reason for this survival advantage has not been clear. Methods We collected 267 GBM CEL files and normalized them relative to other microarrays of the same Affymetrix platform. 377 probesets on U133A and U133 Plus 2.0 arrays were used in a gene voting strategy with 177 probesets of matching genes on older U95Av2 arrays. Kaplan-Meier curves and Cox proportional hazard analyses were applied in distinguishing survival differences between expression subtypes and age. Results This meta-analysis of published data in addition to new data confirms the existence of four distinct GBM expression-signatures. Further, patients with PN subtype GBMs had longer survival, as expected. However, the age of the patient at diagnosis is not predictive of survival time when controlled for the PN subtype. Conclusion The survival benefit of younger age is nullified when patients are stratified by gene expression group. Thus, the main cause of the age effect in GBMs is the more frequent occurrence of PN GBMs in younger patients relative to older patients.

  5. Analysis of monotherapy prostate brachytherapy in patients with prostate cancer. Initial PSA and Gleason are important for recurrence?

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    Pedro Galego

    2015-04-01

    Full Text Available Purpose To evaluate the clinical outcome of a cohort of localized prostate cancer patients treate with 125-I permanent brachytherapy at the São José Hospital – CHLC, Lisbon. Materials and Methods A retrospective analysis was carried out on 429 patients with low and intermediate-risk of prostate adenocarcinoma, according to the recommendations of the EORTC, who underwent 125I brachytherapies in intraoperative dosimetry “real-time” system between September 2003 and September 2013. Results The mean follow-up was 71.98 months. Biochemical relapse of disease by rising PSA (Phoenix criterion was observed in 18 patients (4.2%. Through the application of Kaplan-Meier survival curves in this sample, the rate of survival at 6 years without biochemical relapse was higher than 95%. By Iog rank test comparing biochemical relapse with initial PSA (15-10 and <10 and Gleason values (7 and <7, there was no statistical difference (P=0.830 of the initial PSA in the probability of developing biochemical relapse. In relation to Gleason score, it was noted a statistical difference (P<0.05, demonstrating that patients with Gleason 7 are more likely to develop biochemical relapse. Conclusions Brachytherapy as monotherapy is at present an effective choice in the treatment of localized prostate adenocarcinoma. Biochemical relapses are minimal. The initial PSA showed no statistically difference in the rate of relapses, unlike the value Gleason, where it was demonstrated that patients with Gleason 7 have a higher probability of biochemical relapse. Cases with PSA bounce should be controlled before starting a salvage treatment.

  6. The influence of total nodes examined, number of positive nodes, and lymph node ratio on survival after surgical resection and adjuvant chemoradiation for pancreatic cancer: A secondary analysis of RTOG 9704

    Science.gov (United States)

    Showalter, Timothy N.; Winter, Kathryn A.; Berger, Adam C.; Regine, William F.; Abrams, Ross A.; Safran, Howard; Hoffman, John P.; Benson, Al B.; MacDonald, John S.; Willett, Christopher G.

    2010-01-01

    Purpose Lymph node status is an important predictor of survival in pancreatic cancer. We performed a secondary analysis of RTOG 9704, an adjuvant chemotherapy and chemoradiation trial, to determine the influence of lymph node factors-number of positive nodes (NPN), total nodes examined (TNE), and lymph node ratio (LNR-ratio of NPN to TNE)-on OS and disease-free survival (DFS). Patient and Methods Eligible patients from RTOG 9704 form the basis of this secondary analysis of lymph node parameters. Actuarial estimates for OS and DFS were calculated using Kaplan-Meier methods. Cox proportional hazards models were performed to evaluate associations of NPN, TNE, and LNR with OS and DFS. Multivariate Cox proportional hazards models were also performed. Results There were 538 patients enrolled in the RTOG 9704 trial. Of these, 445 patients were eligible with lymph nodes removed. Overall median NPN was 1 (min-max, 0-18). Increased NPN was associated with worse OS (HR=1.06, p=0.001) and DFS (HR=1.05, p=0.01). In multivariate analyses, both NPN and TNE were associated with OS and DFS. TNE > 12, and >15, were associated with increased OS for all patients, but not for node-negative patients (n =142). Increased LNR was associated with worse OS (HR=1.01, p<0.0001) and DFS (HR=1.006, p=0.002). Conclusion In patients who undergo surgical resection followed by adjuvant chemoradiation, TNE, NPN, and LNR are associated with OS and DFS. This secondary analysis of a prospective, cooperative group trial supports the influence of these lymph node parameters on outcomes after surgery and adjuvant therapy using contemporary techniques. PMID:20934270

  7. The Influence of Total Nodes Examined, Number of Positive Nodes, and Lymph Node Ratio on Survival After Surgical Resection and Adjuvant Chemoradiation for Pancreatic Cancer: A Secondary Analysis of RTOG 9704

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    Showalter, Timothy N. [Department of Radiation Oncology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA (United States); Winter, Kathryn A. [Radiation Therapy Oncology Group, RTOG Statistical Center, Philadelphia, PA (United States); Berger, Adam C., E-mail: adam.berger@jefferson.edu [Department of Surgery, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA (United States); Regine, William F. [Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, MD (United States); Abrams, Ross A. [Department of Radiation Oncology, Rush University Medical Center, Chicago, IL (United States); Safran, Howard [Department of Medicine, Miriam Hospital, Brown University Oncology Group, Providence, RI (United States); Hoffman, John P. [Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Benson, Al B. [Division of Hematology-Oncology, Northwestern University, Chicago, IL (United States); MacDonald, John S. [St. Vincent' s Cancer Care Center, New York, NY (United States); Willett, Christopher G. [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States)

    2011-12-01

    Purpose: Lymph node status is an important predictor of survival in pancreatic cancer. We performed a secondary analysis of Radiation Therapy Oncology Group (RTOG) 9704, an adjuvant chemotherapy and chemoradiation trial, to determine the influence of lymph node factors-number of positive nodes (NPN), total nodes examined (TNE), and lymph node ratio (LNR ratio of NPN to TNE)-on OS and disease-free survival (DFS). Patient and Methods: Eligible patients from RTOG 9704 form the basis of this secondary analysis of lymph node parameters. Actuarial estimates for OS and DFS were calculated using Kaplan-Meier methods. Cox proportional hazards models were performed to evaluate associations of NPN, TNE, and LNR with OS and DFS. Multivariate Cox proportional hazards models were also performed. Results: There were 538 patients enrolled in the RTOG 9704 trial. Of these, 445 patients were eligible with lymph nodes removed. Overall median NPN was 1 (min-max, 0-18). Increased NPN was associated with worse OS (HR = 1.06, p = 0.001) and DFS (HR = 1.05, p = 0.01). In multivariate analyses, both NPN and TNE were associated with OS and DFS. TNE > 12, and >15 were associated with increased OS for all patients, but not for node-negative patients (n = 142). Increased LNR was associated with worse OS (HR = 1.01, p < 0.0001) and DFS (HR = 1.006, p = 0.002). Conclusion: In patients who undergo surgical resection followed by adjuvant chemoradiation, TNE, NPN, and LNR are associated with OS and DFS. This secondary analysis of a prospective, cooperative group trial supports the influence of these lymph node parameters on outcomes after surgery and adjuvant therapy using contemporary techniques.

  8. Children who acquire HIV infection perinatally are at higher risk of early death than those acquiring infection through breastmilk: a meta-analysis.

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    Renaud Becquet

    Full Text Available BACKGROUND: Assumptions about survival of HIV-infected children in Africa without antiretroviral therapy need to be updated to inform ongoing UNAIDS modelling of paediatric HIV epidemics among children. Improved estimates of infant survival by timing of HIV-infection (perinatally or postnatally are thus needed. METHODOLOGY/PRINCIPAL FINDINGS: A pooled analysis was conducted of individual data of all available intervention cohorts and randomized trials on prevention of HIV mother-to-child transmission in Africa. Studies were right-censored at the time of infant antiretroviral initiation. Overall mortality rate per 1000 child-years of follow-up was calculated by selected maternal and infant characteristics. The Kaplan-Meier method was used to estimate survival curves by child's HIV infection status and timing of HIV infection. Individual data from 12 studies were pooled, with 12,112 children of HIV-infected women. Mortality rates per 1,000 child-years follow-up were 39.3 and 381.6 for HIV-uninfected and infected children respectively. One year after acquisition of HIV infection, an estimated 26% postnatally and 52% perinatally infected children would have died; and 4% uninfected children by age 1 year. Mortality was independently associated with maternal death (adjusted hazard ratio 2.2, 95%CI 1.6-3.0, maternal CD4<350 cells/ml (1.4, 1.1-1.7, postnatal (3.1, 2.1-4.1 or peri-partum HIV-infection (12.4, 10.1-15.3. CONCLUSIONS/RESULTS: These results update previous work and inform future UNAIDS modelling by providing survival estimates for HIV-infected untreated African children by timing of infection. We highlight the urgent need for the prevention of peri-partum and postnatal transmission and timely assessment of HIV infection in infants to initiate antiretroviral care and support for HIV-infected children.

  9. No Clinically Significant Changes in Pulmonary Function Following Stereotactic Body Radiation Therapy for Early- Stage Peripheral Non-Small Cell Lung Cancer: An Analysis of RTOG 0236

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    Stanic, Sinisa, E-mail: sinisa.stanic@carle.com [Carle Cancer Center and University of Illinois College of Medicine, Urbana, Illinois (United States); Paulus, Rebecca [Radiation Therapy Oncology Group Statistical Center, Philadelphia, Pennsylvania (United States); Timmerman, Robert D. [University of Texas Southwestern, Dallas, Texas (United States); Michalski, Jeff M. [Washington University, St. Louis, Missouri (United States); Barriger, Robert B. [Indiana University, Indianapolis, Indiana (United States); Bezjak, Andrea [Princess Margaret Cancer Center, Toronto, Ontario (Canada); Videtic, Gregory M.M. [Cleveland Clinic Foundation, Cleveland, Ohio (United States); Bradley, Jeffrey [Washington University, St. Louis, Missouri (United States)

    2014-04-01

    Purpose: To investigate pulmonary function test (PFT) results and arterial blood gas changes (complete PFT) following stereotactic body radiation therapy (SBRT) and to see whether baseline PFT correlates with lung toxicity and overall survival in medically inoperable patients receiving SBRT for early stage, peripheral, non-small cell lung cancer (NSCLC). Methods and Materials: During the 2-year follow-up, PFT data were collected for patients with T1-T2N0M0 peripheral NSCLC who received effectively 18 Gy × 3 in a phase 2 North American multicenter study (Radiation Therapy Oncology Group [RTOG] protocol 0236). Pulmonary toxicity was graded by using the RTOG SBRT pulmonary toxicity scale. Paired Wilcoxon signed rank test, logistic regression model, and Kaplan-Meier method were used for statistical analysis. Results: At 2 years, mean percentage predicted forced expiratory volume in the first second and diffusing capacity for carbon monoxide declines were 5.8% and 6.3%, respectively, with minimal changes in arterial blood gases and no significant decline in oxygen saturation. Baseline PFT was not predictive of any pulmonary toxicity following SBRT. Whole-lung V5 (the percentage of normal lung tissue receiving 5 Gy), V10, V20, and mean dose to the whole lung were almost identical between patients who developed pneumonitis and patients who were pneumonitis-free. Poor baseline PFT did not predict decreased overall survival. Patients with poor baseline PFT as the reason for medical inoperability had higher median and overall survival rates than patients with normal baseline PFT values but with cardiac morbidity. Conclusions: Poor baseline PFT did not appear to predict pulmonary toxicity or decreased overall survival after SBRT in this medically inoperable population. Poor baseline PFT alone should not be used to exclude patients with early stage lung cancer from treatment with SBRT.

  10. Worse prognosis in breast cancer patients can be predicted by immunohistochemical analysis of positive MMP-2 and negative estrogen and progesterone receptors

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    Edneia A. S. Ramos

    Full Text Available Summary Introduction: Breast cancer is the most cause of death, and approximately 90% of these deaths are due to metastases. Matrix metalloproteinase-2 (MMP-2 gelatinase activity is able to degrade a major constituent of the tumor microenvironment, type IV collagen. Two well-established proteins used as markers in clinical practice for breast cancer are the receptors for estrogen (ER and progesterone (PR. Although the presence of these receptors has been associated with a better prognosis, loss of these proteins can occur during tumor progression, with subsequent resistance to hormone therapy. Objective: To study the correlation among MMP-2, ER, and PR, as well as the establishment of the metastatic process in primary breast tumors. Method: Breast cancer samples (n=44 were analyzed by immunohistochemistry for MMP-2, ER, and PR. Results: We observed that 90% of patients who had metastases and died showed positive staining for MMP-2 (p=0.0082 for both. Using Kaplan-Meier analysis, we found that negative ER patients who were also positive for MMP-2 had even worse disease-free survival (DFS and overall survival (OS (p= 0.012 and p=0.005, respectively. Similar results were found in PR-negative patients for DFS (a trend p=0.077 and OS (p=0.038. Conclusion: Regardless of our small sample size (n=44, the data obtained strongly suggest that MMP-2 in combination with already well-established markers could help to predict the emergence of metastases and death in patients with breast cancer.

  11. Recurrence and Survival Outcomes After Anatomic Segmentectomy Versus Lobectomy for Clinical Stage I Non–Small-Cell Lung Cancer: A Propensity-Matched Analysis

    Science.gov (United States)

    Landreneau, Rodney J.; Normolle, Daniel P.; Christie, Neil A.; Awais, Omar; Wizorek, Joseph J.; Abbas, Ghulam; Pennathur, Arjun; Shende, Manisha; Weksler, Benny; Luketich, James D.; Schuchert, Matthew J.

    2014-01-01

    Purpose Although anatomic segmentectomy has been considered a compromised procedure by many surgeons, recent retrospective, single-institution series have demonstrated tumor recurrence and patient survival rates that approximate those achieved by lobectomy. The primary objective of this study was to use propensity score matching to compare outcomes after these anatomic resection approaches for stage I non–small-cell lung cancer. Patients and Methods A retrospective data set including 392 segmentectomy patients and 800 lobectomy patients was used to identify matched segmentectomy and lobectomy cohorts (n = 312 patients per group) using a propensity score matching algorithm that accounted for confounding effects of preoperative patient variables. Primary outcome variables included freedom from recurrence and overall survival. Factors affecting survival were assessed by Cox regression analysis and Kaplan-Meier estimates. Results Perioperative mortality was 1.2% in the segmentectomy group and 2.5% in the lobectomy group (P = .38). At a mean follow-up of 5.4 years, comparing segmentectomy with lobectomy, no differences were noted in locoregional (5.5% v 5.1%, respectively; P = 1.00), distant (14.8% v 11.6%, respectively; P = .29), or overall recurrence rates (20.2% v 16.7%, respectively; P = .30). Furthermore, when comparing segmentectomy with lobectomy, no significant differences were noted in 5-year freedom from recurrence (70% v 71%, respectively; P = .467) or 5-year survival (54% v 60%, respectively; P = .258). Segmentectomy was not found to be an independent predictor of recurrence (hazard ratio, 1.11; 95% CI, 0.87 to 1.40) or overall survival (hazard ratio, 1.17; 95% CI, 0.89 to 1.52). Conclusion In this large propensity-matched comparison, lobectomy was associated with modestly increased freedom from recurrence and overall survival, but the differences were not statistically significant. These results will need further validation by prospective, randomized

  12. 乳腺叶状肿瘤的临床预后分析%Prognostic analysis of benign, borderline and malignant phyllodes tumors of the breast

    Institute of Scientific and Technical Information of China (English)

    王慧; 王翔; 王成锋

    2015-01-01

    Objective To explore the prognosis of benign,borderline and malignant phyllodes tumors of the breast.Methods Data from 246 women with phyllodes tumors of the breast treated in the Cancer Hospital,Chinese Academy of Medical Sciences between January 2002 and December 2012,were collected and analyzed retrospectively.The patients were followed-up for a median of 48 months (range 1-138 months).Kaplan-Meier analysis and Cox proportional hazard model were used to analyze the factors affecting the disease-free survival.Results Among the 246 patients,65 were dropped out from the follow-up.56 patients had local recurrence,5 patients had distant metastasis,while one case had both local recurrence and distant metastasis.The median disease-free survival time was 39 months.Kaplan-Meier survival analysis revealed that fibroadenoma history and type of primary surgery were associated to the disease-free survival of phyllodes tumors of the breast (P<0.001,P=0.043),while histological type and primary tumor size had no significant relationship with the disease-free survival (P =0.083,P =0.974).The multivariate Cox proportional hazard model showed that type of primary surgery,fibroadenoma history and histological types are all independent factors affecting the disease-free survival (P =0.009,P =0.001 and P < 0.001).Conclusion Phyllodes tumors of the breast have a relatively good prognosis on the whole.Type of primary surgery,fibroadenoma history and histological type are independent factors predicting the disease-free survival of patients with phyllodes tumors of the breast.%目的 初步探讨乳腺叶状肿瘤患者的临床预后特点.方法 回顾性分析246例女性乳腺叶状肿瘤患者的临床资料,以Kaplan-Meier法和Cox比例风险模型分析影响患者无病生存的因素.结果 246例患者中,65例失访.56例出现局部复发,5例出现远处转移,1例局部复发伴远处转移.全组患者的中位无病生存时间为39个月.单因素分析结果显示

  13. Tetranectin positive expression in tumour tissue leads to longer survival in Danish women with ovarian cancer. Results from the 'Malova' ovarian cancer study

    DEFF Research Database (Denmark)

    Heeran, Mel C; Rask, Lene; Høgdall, Claus K

    2015-01-01

    of the disease. Using tissue arrays we analysed the expression levels in tissues from 166 women with borderline ovarian tumours (BOTs) and 592 women with ovarian cancer (OC). A panel of three antibodies was used for immunohistochemistry: a polyclonal and two monoclonal antibodies. Serum TN was measured using...... the polyclonal antibody A-371. Univariate survival analyses stratified for chemotherapy showed that positive tissue TN as demonstrated by the polyclonal antibody indicated a significantly longer overall survival (OS) (p = 0.0001) as well as cancer specific survival (CSS) (p ... found to imply longer OS (p antibodies failed to demonstrate any significant correlation with either survival type. Univariate Kaplan-Meier survival analysis performed on all OC cases showed a significantly longer OS (p = 0...

  14. Nm23/nucleoside diphosphate kinase-A as a potent prognostic marker in invasive pancreatic ductal carcinoma identified by proteomic analysis of laser micro-dissected formalin-fixed paraffin-embedded tissue

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    Takadate Tatsuyuki

    2012-06-01

    Full Text Available Abstract Background Pancreatic cancer is among the most lethal malignancies worldwide. This study aimed to identify a novel prognostic biomarker, facilitating treatment selection, using mass spectrometry (MS-based proteomic analysis with formalin-fixed paraffin-embedded (FFPE tissue. Results The two groups with poor prognosis (n = 4 and with better prognosis (n = 4 had been carefully chosen among 96 resected cases of pancreatic cancer during 1998 to 2007 in Tohoku University Hospital. Although those 2 groups had adjusted background (UICC-Stage IIB, Grade2, R0, gemcitabine adjuvant, there was a significant difference in postoperative mean survival time (poor 21.0 months, better 58.1 months, P = 0.0067. Cancerous epithelial cells collected from FFPE tissue sections by laser micro-dissection (LMD were processed for liquid chromatography-tandem mass spectrometry (LC-MS/MS. In total, 1099 unique proteins were identified and 6 proteins showed different expressions in the 2 groups by semi-quantitative comparison. Among these 6 proteins, we focused on Nm23/Nucleoside Diphosphate Kinase A (NDPK-A and immunohistochemically confirmed its expression in the cohort of 96 cases. Kaplan-Meier analysis showed high Nm23/NDPK-A expression to correlate with significantly worse overall survival (P = 0.0103. Moreover, in the multivariate Cox regression model, Nm23/NDPK-A over-expression remained an independent predictor of poor survival with a hazard ratio of 1.97 (95% CI 1.16-3.56, P = 0.0110. Conclusions We identified 6 candidate prognostic markers for postoperative pancreatic cancer using FFPE tissues and immunohistochemically demonstrated high Nm23/NDPK-A expression to be a useful prognostic marker for pancreatic cancer.

  15. Adjuvant radiation therapy is associated with improved overall survival in high-intermediate risk stage I endometrial cancer: A national cancer data base analysis.

    Science.gov (United States)

    Gupta, Vishal; McGunigal, Mary; Prasad-Hayes, Monica; Kalir, Tamara; Liu, Jerry

    2017-01-01

    Adjuvant radiation therapy (RT) was shown to improve local control in patients with high-intermediate risk (HIR) stage I endometrial cancer (EC) in randomized trials. Overall survival (OS) was not significantly different with adjuvant RT in these trials or subsequent meta-analyses; however, they were underpowered to assess OS. We used the National Cancer Data Base (NCDB) to examine the impact of adjuvant RT on OS in HIR EC patients. The NCDB was queried for patients diagnosed with FIGO (2009) Stage I endometrioid adenocarcinoma from 1998 to 2012 who underwent surgery±adjuvant RT. Per ASTRO guidelines, HIR risk was defined as stage IB and/or grade 3. Patients were excluded if: non-surgical primary therapy, RT>180days after surgery, unknown stage/grade/RT status, or RT to targets outside pelvis/vagina. Kaplan-Meier plots and Cox proportional hazards regression were used. 33,600 patients met criteria. 18,070 patients (53.8%) received surgery alone, 15,530 patients (46.2%) received surgery+adjuvant RT. Of patients who received adjuvant RT, 42.2% received external beam RT, 44.7% brachytherapy, and 13.1% received both. 5-year OS was 79.2% for the surgery alone group and 83.3% for the surgery+adjuvant RT (p<0.0001). On multivariate analysis, adjuvant RT was independently associated with improved OS vs. surgery alone (HR 0.7; 95% CI 0.8-0.9, p<0.0001). Our results show that surgery+adjuvant RT was associated with a statistically significant 4.1% improvement in 5-year OS vs. surgery alone in stage I HIR EC. This data along suggests that the improvement in local control with adjuvant RT leads to improved OS. Published by Elsevier Inc.

  16. Long-term local control achieved after hypofractionated stereotactic body radiotherapy for adrenal gland metastases: A retrospective analysis of 34 patients

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    Scorsetti, Marta; Alongi, Filippo [Radiotherapy and Radiosurgery Dept., IRCCS Istituto Clinico Humanitas, Humanitas Cancer Center, Rozzano, Milano (Italy)], Email: filippo.alongi@humanitas.it; Filippi, Andrea Riccardo [Radiation Oncology Unit, Dept. of Medical and Surgical Sciences, Univ. of Turin, Turin (Italy)] [and others

    2012-05-15

    Aims and background. To describe feasibility, tolerability and clinical outcomes of stereotactic body radiation therapy (SBRT) in the treatment of adrenal metastases in 34 consecutive cancer patients. Material and methods. Between March 2004 and July 2010, a total of 34 consecutive patients, accounting for 36 adrenal metastatic lesions, were treated with SBRT. SBRT treatments were delivered by a Linac Varian 600 with microMLC (3DLine, Elekta, Stockholm, Sweden) and a Linac ELEKTA Precise (Elekta). All 34 patients were clinically and radiologically evaluated during and after completion of SBRT. Following outcomes were taken into account: best clinical response at any time, local control, time to systemic progression, time to local progression, overall survival and toxicity. Survival was estimated by the Kaplan-Meier method and factor potentially affecting outcomes were analyzed with Cox regression analysis. Results. Total RT doses ranged from 20 Gy in 4 fractions to 45 Gy in 18 fractions (median dose: 32 Gy; median number of fractions: 4). All doses were prescribed to the 95% isodose line. No cases of Grade {>=} 3 toxicity were recorded. At a median follow-up time of 41 months (range, 12-75) 22 patients were alive. Three of 28 lesions (11%) showed complete response, 13/28 (46%) partial response, 10/28 (36%) stable disease and 2/28 (7%) progressed in the treated area. Local failure was observed in 13 cases. Actuarial local control rates at one and two years were 66% and 32%, respectively. Median time to local progression was 19 months. Median survival was 22 months. Conclusion. SBRT in adrenal gland metastasis is feasible without significant acute and late toxicities, with a good rate of local control. New SBRT fractionation schemes and the possibility to combine new systemic approaches should be investigated in order to further increase local control and reduce systemic disease progression.

  17. Outcome of patients with stage II and III nonseminomatous germ cell tumors: Results of a single center

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    Ataergin S

    2007-01-01

    Full Text Available Background: The prognostic factors in nonseminomatous germ cell tumors have been mainly derived from the analysis of stage I tumors. Aims: The aim of this study was to evaluate some prognostic factors and the outcome of patients with stage II and III nonseminomatous germ cell tumors according to risk groups treated between 1993 and 2002. Settings and Design: Patients were retrospectively classified as good, intermediate and poor risk groups according to International Germ Cell Cancer Consensus Group. Materials and Methods: Biopsy specimens of 58 patients with stage II and III nonseminomatous germ cell tumors were analyzed by means of tumor histopathology, primary localization site of the tumor, relapse sites, initial serum tumor marker levels, the presence of persistent serum tumor marker elevation and the patients′ outcome. Statistical Analysis :0 Kruskall Wallis test and Mann-Whitney U test were used to determine the differences between the groups. Kaplan-Meier method was used for survival analysis and log rank test was used to compare the survival probabilities of groups. Cox proportional hazard analysis was used to determine the prognostic factors in univariate and multivariate analysis. Results: Five-year overall and disease-free survival rates were calculated as 85% and 75% in stage II; 44% and 29% in stage III cases, respectively. Fifty-seven percent of patients were classified in good risk, 9% in intermediate risk and 27% in poor risk groups. Five-year overall survival rates were 97%, 75% and 7% ( P < 0.001 and disease-free survival rates were 83%, 34% and 7% ( P < 0.001 in good, intermediate and poor risk groups, respectively. Analysis of the prognostic factors revealed that the localization site of the primary tumor ( P < 0.001, the initial stage of disease ( P < 0.001, the initial serum AFP level (p: 0.001, the initial β -HCG level (p: 0.0048, the presence of yolk sac and choriocarcinoma components in tumor (p: 0.003 and p: 0

  18. Concomitant chemoradiotherapy versus induction chemotherapy followed by chemoradiotherapy as definitive, first line treatment of squamous cell carcinoma of the head and neck. A retrospective single center analysis

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    Balermpas, P.; Bauer, C.; Fraunholz, I.; Ottinger, A.; Fokas, E.; Roedel, C.; Weiss, C. [Goethe University Frankfurt, Department of Radiation Therapy and Oncology, Frankfurt am Main (Germany); Wagenblast, J.; Stoever, T. [Goethe University, Department of Otorhinolaryngology, Frankfurt am Main (Germany); Seitz, O. [Goethe University, Department of Oral Maxillofacial and Plastic Facial Surgery, Frankfurt am Main (Germany)

    2014-03-15

    Despite the lack of evidence to support its implementation in the clinical practice, induction chemotherapy (IC) before chemoradiotherapy (CRT) is often used in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN). We retrospectively examined the tolerability, feasibility, and clinical outcome of both concepts in a single center analysis. In all, 83 patients were treated between 2007 and 2010 with IC + CRT (n = 42) or CRT alone (n = 41). IC consisted of docetaxel, cisplatin and 5-fluorouracil (TPF), or cisplatin and 5-fluorouracil (PF). All patients were scheduled to receive 2 cycles of PF during concurrent CRT. Adverse events were assessed according to the common toxicity criteria of adverse events (CTCAE v. 3.0). Associations were tested using the χ{sup 2} test, and survival estimates were calculated according to Kaplan-Meier. The median follow-up was 30.35 months (range 2.66-61.25 months). At 2 years, the overall survival rate was significantly higher for primary CRT compared to IC + CRT group (74.8 % vs. 54 %, respectively; p = 0.041). Significantly more treatment-related overall grade 4 toxicities were documented in the IC + CRT group compared to the CRT group (42.9% vs. 9.8%; p = 0.001). Renal toxicity ≥ grade 2 occurred in 52.4 % vs. 7.3 % (p < 0.001), respectively. In all, 93 % of the patients with primary CRT compared to 71 % with IC + CRT received the planned full radiotherapy dose (p = 0.012). This is, to our knowledge, the largest retrospective study to compare IC + CRT with primary CRT. IC showed high acute toxicity, compromised the feasibility of concurrent CRT, and was associated with reduced overall survival rates compared to primary CRT. The lack of clinical benefit in conjunction with the increased toxicity does not support implementation of IC. (orig.) [German] Trotz fehlender Studienergebnisse, die den Einsatz einer Induktionschemotherapie (IC) vor einer simultanen Radiochemotherapie (RCT) in der klinischen

  19. Smoking as a risk factor of multiple sclerosis: results of cohort study in volyn region

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    Ольга Дмитрівна Шульга

    2016-01-01

    Full Text Available Smoking is the modified risk factor of the multiple sclerosis (MS development. In spite of the low smoking percentage in the population of Volyn region the rates of MS prevalence and morbidity is there the one of the highest in the country.Aim of research: to assess an influence of smoking in Volyn dwellers on the type of clinical course, progression quickness and the incapability degree in patients with MS.Materials and methods: According to the smoking status all patients were divided into three groups: smokers, ex-smokers, non-smokers. There were assessed age, sexual differences, the age of the debut of disease, neurological deficiency degree, the disease progression quickness between groups. Statistical analysis was carried out with the help of Microsoft Excel, SPSS program for Windows using the standard descriptive statistics, correlative and regressive analysis. For analysis of events achievement there were used the plural assessments of Kaplan-Meier. The comparison of survival functions in two groups was carried out using Cox and Wilkinson F-criterion.Results: There were examined 338 patients with multiple sclerosis from all districts of Volyn region among them – 220 (65,1 % women. The men-women ratio was 1,87:1. The mean age of patients was 47±12,18 years old, the age of the MS first symptoms appearance– 30±9,19 years old. The age of patients at the time of diagnosis– 33±9,4 years old. The mean grade on EDSS scale – 4±2,04. There was established that patients in the group of smokers were younger, the first symptoms appeared earlier compared with those who never smoked or stopped smoking (p<0,05. The disability level on EDSS scale was lower in the group of patients who never smoked (p=0,015. There was not revealed the statistically significant difference for the next rates: the type of clinical course, type of debut of disease and progression quickness of disease.Conclusion: The MS appears earlier in smoking patients. The

  20. Risk of Breast Cancer in Women with False-Positive Results according to Mammographic Features.

    Science.gov (United States)

    Castells, Xavier; Torá-Rocamora, Isabel; Posso, Margarita; Román, Marta; Vernet-Tomas, Maria; Rodríguez-Arana, Ana; Domingo, Laia; Vidal, Carmen; Baré, Marisa; Ferrer, Joana; Quintana, María Jesús; Sánchez, Mar; Natal, Carmen; Espinàs, Josep A; Saladié, Francina; Sala, María

    2016-08-01

    Purpose To assess the risk of breast cancer in women with false-positive screening results according to radiologic classification of mammographic features. Materials and Methods Review board approval was obtained, with waiver of informed consent. This retrospective cohort study included 521 200 women aged 50-69 years who underwent screening as part of the Spanish Breast Cancer Screening Program between 1994 and 2010 and who were observed until December 2012. Cox proportional hazards regression analysis was used to estimate the age-adjusted hazard ratio (HR) of breast cancer and the 95% confidence interval (CI) in women with false-positive mammograms as compared with women with negative mammograms. Separate models were adjusted for screen-detected and interval cancers and for screen-film and digital mammography. Time without a breast cancer diagnosis was plotted by using Kaplan-Meier curves. Results When compared with women with negative mammograms, the age-adjusted HR of cancer in women with false-positive results was 1.84 (95% CI: 1.73, 1.95; P < .001). The risk was higher in women who had calcifications, whether they were (HR, 2.73; 95% CI: 2.28, 3.28; P < .001) or were not (HR, 2.24; 95% CI: 2.02, 2.48; P < .001) associated with masses. Women in whom mammographic features showed changes in subsequent false-positive results were those who had the highest risk (HR, 9.13; 95% CI: 8.28, 10.07; P < .001). Conclusion Women with false-positive results had an increased risk of breast cancer, particularly women who had calcifications at mammography. Women who had more than one examination with false-positive findings and in whom the mammographic features changed over time had a highly increased risk of breast cancer. Previous mammographic features might yield useful information for further risk-prediction models and personalized follow-up screening protocols. (©) RSNA, 2016 Online supplemental material is available for this article.

  1. Long-term results of valgus osteotomy for terminal-stage osteoarthritis of the hip.

    Science.gov (United States)

    Ohsawa, Suguru

    2017-01-01

    Pauwels' femoral osteotomy is a classical and joint-preserving method for osteoarthritis of the hip caused by acetabular dysplasia and/or subluxation. However, its application for terminal-stage osteoarthritis of the hip, and the long-term results, have not yet been reported. We herein aim to investigate the long-term results of valgus osteotomy for terminal-stage osteoarthritis of the hip. Eighty-two hips of 75 patients (74 women and 1 man, mean age: 48.1 years) classified as having terminal-stage osteoarthritis by Kellgren and Laurence were indicated for valgus osteotomy from 1984 to 1993. Sixty-three hips of 57 patients were followed for more than 20 years (mean: 298 months). Follow-up rate was 77%. Preoperative mean hip score (Harris Hip Score) was 46.4 points. Thirty-two hips were later converted to total hip arthroplasty (THA) (mean: 185 months after surgery). Of the hips without conversion to THA, 31 hips scored 72.8 points on average, and 21 hips scored 70 or more points at the final follow-up. Kaplan-Meier survivorship analysis revealed that 40% of the hips, classified as non-atrophic type (according to Bombelli's classification) at the time of operation, maintained their joint space width for 20 years (endpoint: less than 1 mm at the weight-bearing segment, i.e., recurrence of osteoarthritis) and also revealed that 60% of the hips were not converted for 20 years after the initial operation (endpoint: conversion to THA). Cox's proportional hazard model revealed that those with the atrophic type had a hazard risk 24 times greater than those with the non-atrophic type of osteoarthritis. This is the first report of the long-term results of osteotomy for terminal-stage osteoarthritis of the hip showing satisfactory results with a lengthy follow-up period. Pauwels' valgus femoral osteotomy for terminal-stage osteoarthritis, excluding atrophic type, could be an acceptable alternative to THA.

  2. [Evaluation of anatomic and prognostic stages of breast cancer according to the 8th edition of the TNM staging system - Retrospective analysis based on data from deceased patients once diagnosed with breast cancer].

    Science.gov (United States)

    Zombori, Tamás; Lehóczky, Luca; Cserni, Bálint; Nyári, Tibor; Cserni, Gábor

    2017-09-01

    The 8th edition of the Tumor-Node-Metastasis (TNM) based staging of breast cancer introduces a prognostic stage influenced by biomarkers along the traditional T, N and M categories. To retrospectively assess stage influencing prognostic variables; and the anatomic and prognostic stages on the basis of the overall survival (OS) of a cohort of deceased patients once diagnosed with breast cancer. We included patients with known causes of death certified at the Bács-Kiskun County Teaching Hospital and having a history of breast cancer diagnosed on a resection specimen at the same institution. Prognostic factors were obtained from the histopathological reports. Statistics included one-way ANOVA, Dunn's post hoc test and Kaplan-Meier curve analyses. The 303 patients grouped as breast cancer related death (n = 168) or unrelated (n = 135) showed significant differences in most stage defining prognostic factors and the anatomic and prognostic stages. Significant differences in 5-year OS were observed between pT and pN categories, histological grades and estrogen receptor statuses. Except for stages I and II, significant differences were found between both different anatomic and prognostic stages (p<0.001). Stage IV is by definition uniform, but we identified survival differences between biomarker based subgroups: triple negative carcinomas had worse OS than estrogen receptor positive and HER2 negative carcinomas. Our analysis based on real survival data suggests that the prognostic stages separate patients according to OS similarly to the anatomic stages. The results validate the prognostic stages, but also suggest that separating stage IV disease according to biomarkers makes sense. Orv Hetil. 2017; 158(35): 1373-1381.

  3. Survival outcomes and effect of early vs. deferred cART among HIV-infected patients diagnosed at the time of an AIDS-defining event: a cohort analysis.

    Directory of Open Access Journals (Sweden)

    Jose M Miro

    Full Text Available OBJECTIVES: We analyzed clinical progression among persons diagnosed with HIV at the time of an AIDS-defining event, and assessed the impact on outcome of timing of combined antiretroviral treatment (cART. METHODS: Retrospective, European and Canadian multicohort study.. Patients were diagnosed with HIV from 1997-2004 and had clinical AIDS from 30 days before to 14 days after diagnosis. Clinical progression (new AIDS event, death was described using Kaplan-Meier analysis stratifying by type of AIDS event. Factors associated with progression were identified with multivariable Cox regression. Progression rates were compared between those starting early (<30 days after AIDS event or deferred (30-270 days after AIDS event cART. RESULTS: The median (interquartile range CD4 count and viral load (VL at diagnosis of the 584 patients were 42 (16, 119 cells/µL and 5.2 (4.5, 5.7 log(10 copies/mL. Clinical progression was observed in 165 (28.3% patients. Older age, a higher VL at diagnosis, and a diagnosis of non-Hodgkin lymphoma (NHL (vs. other AIDS events were independently associated with disease progression. Of 366 patients with an opportunistic infection, 178 (48.6% received early cART. There was no significant difference in clinical progression between those initiating cART early and those deferring treatment (adjusted hazard ratio 1.32 [95% confidence interval 0.87, 2.00], p = 0.20. CONCLUSIONS: Older patients and patients with high VL or NHL at diagnosis had a worse outcome. Our data suggest that earlier initiation of cART may be beneficial among HIV-infected patients diagnosed with clinical AIDS in our setting.

  4. Analysis of risk factors related to mortality of patients with community-acquired pneumonia due to methicillin-resistant Staphylococcus aureus%社区获得性耐甲氧西林金黄色葡萄球菌肺炎死亡相关危险因素分析

    Institute of Scientific and Technical Information of China (English)

    李洪涛; 张天托; 黄静; 朱家馨; 周宇麒; 吴本权

    2010-01-01

    Objective To describe the clinical features of reported cases of community-acquired pneumonia (CAP) due to methicillin-resistant Staphylococcus aureus (MRSA), and to evaluate the risk factors related to outcome. Methods A systematic search of databases from January 1995 to December 2009 was performed. Baseline characteristics of survivors and non-survivors in the hospital were compared with the χ2 test for categorical variables. Variables with P<0.2 were entered in Logistic regression. Survival analysis was estimated by the Kaplan-Meier method according to use of antimicrobials inhibiting toxin production. Results Fifty-two articles were identified reporting data on 74 patients, with 41.1% of total mortality, short duration of symptom onset to death [(6.1±11.0) days], and prolonged hospital admissions [(28.6±29.1) days]. Logistic regression analysis showed that influenza like symptoms (P=0.04), hemoptysis (P<0.01), leucopenia (P<0.01) were the risk factors associated with death, and using clindamycin or linezolid which could inhibit the Panton-Valentine leukocidin (PLV, P<0.01) was the factor associated with survival. Kaplan-Meier analysis indicated that the antibiotic therapies inhibiting toxin production were associated with improved outcome in these cases (χ2=21.59, P<0.01). Conclusion CAP due to MRSA is a severe disease with significant lethality. Empiric therapy of severe CAP with flu-like symptoms, hemoptysis and leucopenia should include coverage for MRSA. Targeted treatment with antimicrobials inhibiting toxin production appear to be more appropriate selection.%目的 揭示社区获得性耐甲氧西林金黄色葡萄球菌(CA-MRSA)肺炎临床特征及死亡相关危险因素.方法 系统检索1995年1月至2009年12月发表的中英文文献,对比分析CA-MRSA肺炎生存和死亡者的临床特征,对相关参数进行Logistic回归分析以探讨与死亡的关系.按照是否应用抑制杀白细胞素(PVL)治疗措施分层,对患

  5. Long-term results of open and endovascular revascularization of superficial femoral artery occlusive disease

    Science.gov (United States)

    Scali, Salvatore T.; Rzucidlo, Eva M.; Bjerke, Aja A.; Stone, David H.; Walsh, Daniel B.; Goodney, Philip P.; Chang, Catherine K.; Powell, Richard J.

    2017-01-01

    Background First-line treatment for patients with superficial femoral arterial (SFA) occlusive disease has yet to be determined. This study compared long-term outcomes between primary SFA stent placement and primary femoral-popliteal bypass. Periprocedural patient factors were examined to determine their effect on these results. Methods All femoral-popliteal bypasses and SFA interventions performed in consecutive patients with symptoms Rutherford 3 to 6 between 2001 and 2008 were reviewed. Time-dependent outcomes were analyzed using the Kaplan-Meier method and log-rank test. Cox proportional hazards were performed to determine predictors of graft patency. Multivariate analysis was completed to identify patient covariates most often associated with the primary therapy. Results A total of 152 limbs in 141 patients (66% male; mean age, 66 ± 22 years) underwent femoral-popliteal bypass, and 233 limbs in 204 patients (49% male; mean age, 70 ± 11 years) underwent SFA interventions. Four-year primary, primary-assisted, and secondary patency rates were 69%, 78%, and 83%, respectively, for bypass patients and 66%, 91%, and 95%, respectively, for SFA interventions. Six-year limb salvage was 80% for bypass vs 92% for stenting (P = .04). Critical limb ischemia (CLI) and renal insufficiency were predictors of bypass failure. Claudication was a predictor of success for SFA stenting. Three-year limb salvage rates for CLI patients undergoing surgery and SFA stenting were 83%. Amputation-free survival at 3 years for CLI patients was 55% for bypass and 59% for SFA interventions. Multivariate predictors (odds ratios and 95% confidence intervals) of covariates most frequently associated with first-line SFA stenting were TransAtlantic Inter-Society Consensus II A and B lesions (5.9 [3.4-9.1], P 70 years (2.1 [1.4-3.1], Ppatients were more likely to have nondiabetic status (5.6 [3.3-9.4], P patient-specific covariates, and anatomic lesion classification have significant association

  6. NTRK2基因 rs1187272位点多态性与精神分裂症的首发年龄关联分析%Association analysis of neurotrophic tyrosine kinase receptor type 2(NTRK2)gene polymorphisms with the age of onset ;in schizophrenic patients

    Institute of Scientific and Technical Information of China (English)

    戴兴海; 禹顺英; 易正辉; 胡国芹; 吕钦谕; 徐阿红; 介勇; 汪作为; 张晨; 毛云峰; 汤家一

    2015-01-01

    目的:探讨中国汉族人群神经营养性酪氨酸激酶2型受体(NTRK2)基因 rs1187272位点多态性与精神分裂症首发年龄的关联性。方法选取174例精神分裂患者为研究组,其中81例为早发性精神分裂症组(早发组),93例为非早发性精神分裂症组(非早发组);202例为正常对照(对照组)。采用 TaqMan 法,检测 NTRK2基因 rs1187272位点多态性,并使用生存分析对 rs1187272多态性与发病年龄的关联进行分析。结果(1)rs1187272等位基因及基因型分布频率在早发组与对照组之间、非早发组与对照组之间的差异有统计学意义(P <0.05),但在早发组与非早发组之间的差异无统计学意义(P >0.05)。(2)Kaplan-Meier 分析显示,研究组、早发组和非早发组危险等位基因 C 的频率与首发年龄无相关性(P >0.05)。结论在中国汉族人群中 NTRK2基因 rs1187272位点多态性与精神分裂症的首发年龄不相关。%Objective To investigate the association between polymorphism of rs1187272 in neurotrophic tyrosine kinase receptor type 2 (NTRK2)gene and the age of onset in schizophrenic patients.Methods Polymorphisms of rs1187272 in NTRK2 gene were genotyped by using TaqMan SNP genotyping assay in 174 schizophrenic patients (study group,consisted of 81 early-onset schizophrenics and 93 non early-onset schizophrenics)and 202 healthy controls (control group).The association between age of onset and rs1187272 polymorphism was evaluated by using survival analysis.Results (1)There were significant differences in allelic frequency and genotype frequency of rs1187272 between early-onset subgroup and control group,as well as between non early-onset subgroup and control group (P 0.05 ).(2 )Kaplan-Meier analysis indicated that the distribution of risk C allele was not significantly associated with age of onset in patients in study group,early-onset subgroup and non early

  7. Clinical results of Intracoronary Brachytherapy (ICBT) for multiple in-stent restenosis

    Energy Technology Data Exchange (ETDEWEB)

    Stadler, P. [Dept. of Radiotherapy and Radiation Oncology, Univ. Hospital Regensburg (Germany); Praxis Muehleninsel, Landshut-Muehldorf-Dingolfing (Germany); Schaefer, C.; Chaber, S.; Putnik, K.; Treutwein, M.; Koelbl, O. [Dept. of Radiotherapy and Radiation Oncology, Univ. Hospital Regensburg (Germany); Muders, F. [Dept. of Cardiology, Univ. Hospital Regensburg (Germany)

    2006-06-15

    Background and purpose: treatment of in-stent restenosis (ISR) with percutaneous coronary intervention (PCI) alone is often followed by early re-restenosis. The present study focused on the effect of intracoronary brachytherapy (ICBT) on multiple in-stent restenosis (MISR) after repeated PCI. Patients and methods: 40 patients (27 male, 13 female, age: 66 {+-} 9 years) with MISR (two to six ISRs, median three ISRs) were retrospectively analyzed. All patients were treated by using the Novoste {sup registered} Beta-Cath trademark 3.5F System after PCI. The target vessel received 18.4-25.3 Gy of radiation at a depth of 2 mm from the center of the source. The restenosis-free survival and overall survival were calculated by Kaplan-Meier analysis (log-rank). The time interval between last PCI without ICBT and the consecutive recurrence was compared with the follow-up time after PCI with ICBT. Results: the 3-year overall survival rate after ICBT was 93%. The 0.5-, 1-, 2-, and 3-year ISR-free survival rates after PCI + ICBT were 81%, 72%, 52%, and 38%, respectively. After PCI alone, the 0.5-, 1-, and 2-year ISR-free survival rates were 30%, 13%, and 0%, respectively. This difference was highly significant (p < 0.0001). Patients with more than three ISRs before ICBT had a better outcome (3-year ISR-free survival: 80%) than patients with only two or three ISRs before ICBT (3-year ISR-free survival: 25%; p < 0.05). Conclusion: ICBT is highly effective and safe in patients with ISR. The results of this study are in accordance with the WRIST and BETA-WRIST data. After 6 months both studies revealed an ISR-free survival rate of 86% (WRIST) and 66% (BETA-WRIST), respectively. The ISR rates in the own control group (70%) were comparable to the placebo groups in WRIST (68%) and BETA-WRIST (72%). Interestingly, patients with more than three ISRs before ICBT had the lowest ISR rate after ICBT. (orig.)

  8. Mobile spine chordoma: results of 166 patients from the AOSpine Knowledge Forum Tumor database

    Science.gov (United States)

    Gokaslan, Ziya L.; Zadnik, Patricia L.; Sciubba, Daniel M.; Germscheid, Niccole; Goodwin, C. Rory; Wolinsky, Jean-Paul; Bettegowda, Chetan; Groves, Mari L.; Luzzati, Alessandro; Rhines, Laurence D.; Fisher, Charles G.; Varga, Peter Pal; Dekutoski, Mark B.; Clarke, Michelle J.; Fehlings, Michael G.; Quraishi, Nasir A.; Chou, Dean; Reynolds, Jeremy J.; Williams, Richard P.; Kawahara, Norio; Boriani, Stefano

    2016-01-01

    Object A chordoma is an indolent primary spinal tumor that has devastating effects on the patient’s life. These lesions are chemoresistant, resistant to conventional radiotherapy, and moderately sensitive to proton therapy; however, en bloc resection remains the preferred treatment for optimizing patient outcomes. While multiple small and largely retrospective studies have investigated the outcomes following en bloc resection of chordomas in the sacrum, there have been few large-scale studies on patients with chordomas of the mobile spine. The goal of this study was to review the outcomes of surgically treated patients with mobile spine chordomas at multiple international centers with respect to local recurrence and survival. This multiinstitutional retrospective study collected data between 1988 and 2012 about prognosis-predicting factors, including various clinical characteristics and surgical techniques for mobile spine chordoma. Tumors were classified according to the Enneking principles and analyzed in 2 treatment cohorts: Enneking-appropriate (EA) and Enneking-inappropriate (EI) cohorts. Patients were categorized as EA when the final pathological assessment of the margin matched the Enneking recommendation; otherwise, they were categorized as EI. Methods Descriptive statistics were used to summarize the data (Student t-test, chi-square, and Fisher exact tests). Recurrence and survival data were analyzed using Kaplan-Meier survival curves, log-rank tests, and multivariate Cox proportional hazard modeling. Results A total of 166 patients (55 female and 111 male patients) with mobile spine chordoma were included. The median patient follow-up was 2.6 years (range 1 day to 22.5 years). Fifty-eight (41%) patients were EA and 84 (59%) patients were EI. The type of biopsy (p < 0.001), spinal location (p = 0.018), and if the patient received adjuvant therapy (p < 0.001) were significantly different between the 2 cohorts. Overall, 58 (35%) patients developed local

  9. Mid-term results of the BIOLOX delta ceramic-on-ceramic total hip arthroplasty.

    Science.gov (United States)

    Lee, Y K; Ha, Y C; Yoo, J-I; Jo, W L; Kim, K-C; Koo, K H

    2017-06-01

    We conducted a prospective study of a delta ceramic total hip arthroplasty (THA) to determine the rate of ceramic fracture, to characterise post-operative noise, and to evaluate the mid-term results and survivorship. Between March 2009 and March 2011, 274 patients (310 hips) underwent cementless THA using a delta ceramic femoral head and liner. At each follow-up, clinical and radiological outcomes were recorded. A Kaplan-Meier analysis was undertaken to estimate survival. Four patients (four hips) died and 18 patients (20 hips) were lost to follow-up within five years. The remaining 252 patients (286 hips) were followed for a mean of 66.5 months (60 to 84). There were 144 men (166 hips) and 108 women (120 hips) with a mean age of 49.7 years (16 to 83) at surgery. The mean pre-operative Harris Hip Score of 47.1 points improved to 93.8 points at final follow-up. Six patients reported squeaking in seven hips; however, none were audible. Radiolucent lines involving Gruen zones one and/or seven were seen in 52 hips (18.2%). No hip had detectable wear, focal osteolysis or signs of loosening. One hip was revised because of fracture of the ceramic liner, which occurred due to an undetected malseating of the ceramic liner at the time of surgery. One hip was revised for a periprosthetic fracture of the femur, and one hip was treated for periprosthetic joint infection. The six-year survivorship with re-operation for any reason as the endpoint was 99.0% (95% confidence interval 97.8% to 100%). The rate of delta ceramic fracture was 0.3% (one of 286). While ceramic head fracture was dominant in previous ceramic-on-ceramic THA, fracture of the delta ceramic liner due to malseating is a concern. Cite this article: Bone Joint J 2017;99-B:741-8. ©2017 The British Editorial Society of Bone & Joint Surgery.

  10. Prognostic value of preoperative absolute lymphocyte count in recurrent hepatocellular carcinoma following thermal ablation: a retrospective analysis.

    Science.gov (United States)

    Li, Xin; Han, Zhiyu; Cheng, Zhigang; Yu, Jie; Yu, Xiaoling; Liang, Ping

    2014-01-01

    To investigate the prognostic value of preoperative absolute lymphocyte count (ALC) in recurrent hepatocellular carcinoma (RHCC) following thermal ablation. We retrospectively analyzed the relationship between preoperative ALC and the clinicopathologic factors and long-term prognosis in 423 RHCC patients who underwent curative thermal ablation. Correlation analysis, receiver operating characteristic (ROC) calculation, Kaplan-Meier curves, and multivariate regression were used for statistical analysis. The median time to recurrence was 12 months for RHCC patients after thermal ablation. On multivariate Cox regression analysis, preoperative ALC was an independent risk factor for cancer recurrence, along with tumor differentiation and α-fetoprotein level. ALC ≥1.64×10(9)/L defined by ROC calculation was associated with prolonged survival (area under the curve 0.741, Pthermal ablation, which suggests that maintaining a high ALC in RHCC patients might improve cancer outcomes.

  11. Análisis de la esperanza de vida libre de discapacidad a lo largo de la biografía: de la madurez a la vejez Analysis of disability-free life expectancy over the lifespan: from maturity to old age

    Directory of Open Access Journals (Sweden)

    Miguel Ángel Escobar Bravo

    2012-08-01

    Full Text Available Objetivo: Determinar en qué etapas del curso de vida previo a los 70 años se acortan las expectativas de vida en salud. Método: Análisis longitudinal retrospectivo. La población a estudio es una cohorte de 1286 individuos de 70 a 74 años de edad que viven en áreas metropolitanas, no institucionalizados. La discapacidad se mide mediante el desarrollo de las actividades instrumentales de la vida diaria y las actividades básicas de la vida diaria. Se calcula la esperanza de vida libre de discapacidad y la probabilidad de supervivencia mediante Kaplan-Meier. Resultados: La incidencia de discapacidad básica aumenta a partir del tramo de 50 a 54 años de edad, y se acelera progresivamente hasta los 65 a 69 años, cuando la probabilidad de padecer discapacidad instrumental es ligeramente superior en los hombres que en las mujeres (0,23 en hombres y 0,19 en mujeres. La supervivencia sin discapacidad de las mujeres fue peor que la de los hombres, tanto para cualquier tipo de discapacidad (LogRank = 5,80; p = 0,016 como para la discapacidad básica (LogRank = 4,315; p = 0,038. Conclusiones: Se pone de manifiesto el importante peso que para la autonomía de la población masculina de estas edades tiene la falta de habilidad instrumental para cuestiones domésticas. Además, las mujeres ostentan un peor pronóstico de supervivencia sin discapacidad, tanto para cualquier tipo de discapacidad como para la discapacidad básica. Para ambos sexos, desde los 40 hasta los 60 años de edad, hay un ligero descenso de la supervivencia sin discapacidad, y a partir de esa edad el descenso se acelera notablemente.Objective: To determine the life stages in which disability-free life expectancy is shortened before the age of 70 years. Method: A retrospective longitudinal analysis was carried out in a cohort of 1,286 non-institutionalized people aged from 70 to 74 years old living in metropolitan areas. Disability was measured by instrumental and basic activities

  12. 生物钟周期基因2与胰腺导管腺癌预后的相关性分析%Correlation analysis between period circadian clock 2 gene and the prognosis of pancreatic ductal adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    曾玮; 刘孟刚; 刘宏鸣; 谢斌; 袁涛; 杨俊涛; 蓝翔; 陈平

    2014-01-01

    Objective To explore the prognosis related genes of pancreatic ductal adenocarcinoma (PDAC)and investigate the molecular regulation mechanism.Methods Gene expression data of 102 PDAC patients with complete clinical survival data were selected from gene expression database of National Center for Biotechnology Information.The 106 transcription regulation gene collection was collected from Transfac database.The 715 microRNA (miRNA)target regulation gene collection was selected according to PicTar and TargetScanS method.Biological pathway data obtained from the Kyoto Encyclopedia of Genes and Genomes (KEGG).The known cancer genes were collected from the cancer gene census (CGC) database.Univariate Cox proportional hazards model was used to analyze the correlation between gene expression data and survival time,then obtained survival related candidate genes from the whole genome. Then the enriched genes were analyzed by hypergeometric distribution algorithm from three databases. Multiple correction testing was performed by BH-FDR method (FDR < 0.05 ).Kaplan-Meier was performed for survival curve analysis of PDAC.Results The results of data of 102 PDAC patients analyzed by univariate Cox proportional hazards model indicated that 273 genes were significantly related to the survival time of patients (P <0.000 1 ).After 273 survival genes were enrichment analyzed in 106 transcription factor regulation gene collection,12 survival genes enriched transcription factor target gene sets were found.After 273 survival genes were enrichment analyzed in 715 miRNA target regulation gene collection,11 survival genes enriched miRNAs target sets were discovered.After 273 survival genes were enrichment analyzed in pathway data of KEGG,15 survival genes enriched pathways were obtained. Period circadian clock 2 (PER2 )was regulated by CCAAT/enhancer binding protein (CEBPA)at transcription level and regulated by miRNA-32 after transcription.The prognosis of PDAC was affected by circadian

  13. Interpretation of correlation analysis results

    OpenAIRE

    Kılıç, Selim

    2012-01-01

    Correlation analysis is used to quantify the degree of linear association between two variables. Correlation coefficient is showed as “r” and it may have values between (-) 1 and (+)1. The symbols (-) or (+) in front of “r coefficient” show the direction of correlation. The direction of association does not affect the strength of association. A “ r coefficient” which is equal or greater than 0.70 is accepted as a good association. Correlation coeefficient only remarks the strength of associat...

  14. Long-term results of abrasion arthroplasty for full-thickness cartilage lesions of the medial femoral condyle.

    Science.gov (United States)

    Sansone, Valerio; de Girolamo, Laura; Pascale, Walter; Melato, Marco; Pascale, Valerio

    2015-03-01

    To evaluate the long-term functional results of arthroscopic abrasion arthroplasty for the treatment of full-thickness cartilage lesions of the medial femoral condyle. Between 1990 and 1996, 75 consecutive patients with isolated chondral lesions of the medial femoral condyle were treated with arthroscopic chondral abrasion. A retrospective analysis of the clinical results of this cohort was performed. The patients were evaluated according to the Knee Society Score questionnaire preoperatively, at 10 years postoperatively, and at final long-term follow-up at a mean of 20 years. At final follow-up, they were also assessed according to the Western Ontario and McMaster Universities Osteoarthritis Index. Patients were divided according to the lesion size and by age, and the Kaplan-Meier survivorship function (with second operation taken as an endpoint) for the various groups was calculated. At a mean of final follow-up of 20 years (range, 16.94 to 23.94 years), a positive functional outcome (Knee Society Score ≥70 points or no reoperation) was recorded in 67.9% of the patients. Twenty-year survivorship in this cohort was 71.4% (95% confidence interval, 0.5690 to 0.8590). The survivorship was 89.5% for patients younger than 50 years and 55.7% for patients aged 50 years or older. The functional results for patients with lesions smaller than 4 cm(2) were significantly better than those for patients with lesions of 4 cm(2) or greater (P = .031). There were no statistical differences between patients with and without associated lesions at the time of surgery. Our hypothesis that there would be survivorship greater than 86% was disproved. However, arthroscopic abrasion arthroplasty can be a valid treatment for medial femoral condylar full-thickness defects of the knee, even in the long-term, particularly for younger patients and those with smaller lesions. Level IV, therapeutic case series. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier

  15. Long-term results and comparison of the three different high tibial osteotomy and fixation techniques in medial compartment arthrosis.

    Science.gov (United States)

    Polat, Gökhan; Balcı, Halil İbrahim; Çakmak, Mehmet Fevzi; Demirel, Mehmet; Şen, Cengiz; Aşık, Mehmet

    2017-03-16

    The purpose of this study is to report and analyze the long-term outcomes of the patients who underwent high tibial osteotomy (HTO) with three different techniques for the treatment of medial compartment arthrosis. A total of 187 patients (195 knees) who underwent HTO between 1990 and 2010 were retrospectively evaluated. Eighty-eight knees, opening-wedge osteotomy with Puddu plate (group A); 51 knees, transverse osteotomy below the tubercle with external fixator (group B); and 29 knees, closing-wedge osteotomy with staple fixation (group C) were included in the study. The patients (mean age 44.9 ± 10.6 years, mean follow-up of 12.4 ± 3.2 years) were called for final controls and survival rates of the knees, and functional evaluations of the patients were performed using Knee Society Score (KSS) and Hospital for Special Surgery (HSS) knee score assessments. In the comparison of the three groups, there were no differences regarding the mean age, preoperative arthrosis levels, or preoperative deformity analyses (n.s.). The main finding of these comparisons showed that the closing-wedge osteotomy has the greatest lateralization effect on mechanical axis deviation (MAD) (p = 0.024), the greatest valgization effect on medial proximal tibial angles (MPTA) (p = 0.026), and the lowest posterior tibial slope (PTS) angles (p = 0.032) in comparison to the other groups. There were no functional differences between the three groups in the long-term assessment of patients with KSS and HSS knee scores. According to the Kaplan-Meier survival analysis, the probability of the survival of the native knee joint after HTO was 93.4% in 5 years and 71.2% in 10 years in our study group. During the follow-up of the 168 knees, revision surgery with total knee replacement was needed in 27 knees (16%). The mean time from HTO to total knee replacement was 8.9 years in these patients. HTO has acceptable long-term clinical and functional results that should not be

  16. Prospective nationwide analysis of laparoscopic versus Lichtenstein repair of inguinal hernia

    DEFF Research Database (Denmark)

    Ware, P; Bay-Nielsen, M; Juul, P

    2005-01-01

    BACKGROUND: According to a Cochrane review, laparoscopic inguinal hernia repair compares favourably with open mesh repair, but few data exist from surgical practice outside departments with a special interest in hernia surgery. This study compared nationwide reoperation rates after laparoscopic...... and Lichtenstein repair, adjusting for factors predisposing to recurrence. METHODS: Some 3606 consecutive laparoscopic repairs were compared with 39 537 Lichtenstein repairs that were prospectively recorded in a nationwide registry between 1998 and 2003. Patients were subgrouped according to type of hernia......: primary or recurrent and unilateral or bilateral. Overall reoperation rates and 95 per cent confidence intervals were calculated. Long-term reoperation rates were estimated using the Kaplan-Meier method. RESULTS: The overall reoperation rates after laparoscopic and Lichtenstein repair of unilateral...

  17. Long-term analysis of oncological outcomes after laparoscopic radical cystectomy in Europe: results from a multicentre study by the European Association of Urology (EAU) section of Uro-technology.

    Science.gov (United States)

    Albisinni, Simone; Rassweiler, Jens; Abbou, Clement-Claude; Cathelineau, Xavier; Chlosta, Piotr; Fossion, Laurent; Gaboardi, Franco; Rimington, Peter; Salomon, Laurent; Sanchez-Salas, Rafael; Stolzenburg, Jens-Uwe; Teber, Dogu; van Velthoven, Roland

    2015-06-01

    To report long-term outcomes of laparoscopic radical cystectomy (LRC) in a multicentre European cohort, and explore feasibility and safety of LRC. This study was coordinated by European Association of Urology (EAU)-section of Uro-technology (ESUT) with nine centres enrolling 503 patients undergoing LRC for bladder cancer prospectively between 2000 and 2013. Data were retrospectively analysed. Descriptive statistics were used to explore peri- and postoperative characteristics of th ecohort. Kaplan-Meier curves were constructed to evaluate recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS). Outcomes were also stratified according to tumour stage, lymph node (LN) involvement and surgical margin status. Minor complications (Clavien I-II) occurred in 39% and major (IIIa-IVb) in 17%. In all, 10 (2%) postoperative deaths were recorded. The median (interquartile, IQR) LN retrieval was 14 (9-17) and positive surgical margins were detected in 29 (5.8%) patients. The median (mean, IQR) follow-up was 50 (60, 19-90), during which 134 (27%) recurrences were detected. Actuarial RFS, CSS and OS rates were 66%, 75% and 62% at 5 years and 62%, 55%, 38% at 10 years. Significant differences in RFS, CSS and OS were found according to tumour stage, LN involvement and margin status (log-rank P < 0.001). On multivariate Cox analysis, T stage and LN involvement (both P < 0.001) were significant predictors of RFS, CSS and OS. Positive margins were significant predictors of RFS (P = 0.016) and CSS (P = 0.043). In this European LRC multicentre study, the largest to date, long-term RFS, CSS and OS rates after LRC appear comparable to those reported in current open RC series. Further randomised controlled trials are necessary to assess the global impact of LRC. © 2014 The Authors. BJU International © 2014 BJU International.

  18. Oral fibrinogen-depleting agent lumbrokinase for secondary ischemic stroke prevention: results from a multicenter, randomized, parallel-group and controlled clinical trial

    Institute of Scientific and Technical Information of China (English)

    CAO Yong-jun; ZHANG Xia; WANG Wan-hua; ZHAI Wan-qing; QIAN Ju-fen; WANG Jian-sheng; CHEN Jun

    2013-01-01

    Background Elevated fibrinogen (Fg) level is a known risk factor for ischemic stroke.There are few clinical trials on oral fibrinogen-depleting therapies for secondary ischemic stroke prevention.We aimed to assess the effects of one-year therapy with oral lumbrokinase enteric-coated capsules on secondary ischemic stroke prevention.Methods This is a multicenter,randomized,parallel group and controlled study that began treatment in hospitalized patients with ischemic stroke and continued for 12 months.Patients were randomized to either the control group that received the standard stroke treatment or the fibrinogen-depleting group that received the standard stroke treatment plus enteric-coated lumbrokinase capsules.The NIH Stroke Scale scores (NIHSSs) and plasma Fg level were recorded.The carotid artery intima-media thickness (IMT) and status of plaques were examined through carotid ultrasound examination.Primary outcomes included all-cause mortality,any event of recurrent ischemic stroke/transient ischemic attack (TIA),hemorrhagic stroke,myocardial infarction and angina,and other noncerebral ischemia or hemorrhage.Kaplan-Meier survival analysis and the Long-rank test were used to compare total vascular end point incidence between the two groups.Comparison of median values between two groups was done by the Student t test,one-way analysis of variance (ANOVA),or non-parametric rank sum test.Results A total of 310 patients were enrolled,192 patients in the treatment group and 118 patients in the control group.Compared to the control group,the treatment group showed favorable outcomes in the Fg level,carotid IMT,the detection rate of vulnerable plaques,the volume of carotid plaques,NIHSS scores,and incidence of total vascular (6.78% and 2.08%,respectively) and cerebral vascular events (5.93% and 1.04%,respectively) (P <0.05).In the treatment group,the volume of carotid plaques was significantly related to the carotid IMT,the plaque diameter,width and number (P

  19. CT-based texture analysis potentially provides prognostic information complementary to interim fdg-pet for patients with hodgkin's and aggressive non-hodgkin's lymphomas

    Energy Technology Data Exchange (ETDEWEB)

    Ganeshan, B.; Miles, K.A.; Shortman, R.; Afaq, A.; Ardeshna, K.M.; Groves, A.M.; Kayani, I. [University College London, Institute of Nuclear Medicine, London (United Kingdom); Babikir, S. [International Atomic Energy Agency (IAEA), Human Health Division, Nuclear Medicine and Diagnostic Imaging Section, Vienna (Austria)

    2017-03-15

    The purpose of this study was to investigate the ability of computed tomography texture analysis (CTTA) to provide additional prognostic information in patients with Hodgkin's lymphoma (HL) and high-grade non-Hodgkin's lymphoma (NHL). This retrospective, pilot-study approved by the IRB comprised 45 lymphoma patients undergoing routine 18F-FDG-PET-CT. Progression-free survival (PFS) was determined from clinical follow-up (mean-duration: 40 months; range: 10-62 months). Non-contrast-enhanced low-dose CT images were submitted to CTTA comprising image filtration to highlight features of different sizes followed by histogram-analysis using kurtosis. Prognostic value of CTTA was compared to PET FDG-uptake value, tumour-stage, tumour-bulk, lymphoma-type, treatment-regime, and interim FDG-PET (iPET) status using Kaplan-Meier analysis. Cox regression analysis determined the independence of significantly prognostic imaging and clinical features. A total of 27 patients had aggressive NHL and 18 had HL. Mean PFS was 48.5 months. There was no significant difference in pre-treatment CTTA between the lymphoma sub-types. Kaplan-Meier analysis found pre-treatment CTTA (medium feature scale, p=0.010) and iPET status (p<0.001) to be significant predictors of PFS. Cox analysis revealed that an interaction between pre-treatment CTTA and iPET status was the only independent predictor of PFS (HR: 25.5, 95% CI: 5.4-120, p<0.001). Specifically, pre-treatment CTTA risk stratified patients with negative iPET. CTTA can potentially provide prognostic information complementary to iPET for patients with HL and aggressive NHL. (orig.)

  20. Survival analysis of women with cervical cancer treated at a referral hospital for oncology in Espírito Santo State, Brazil, 2000-2005 Análisis de la supervivencia de mujeres con cáncer de cuello de útero atendidas en un hospital oncológico de referencia en Espírito Santo, Brasil, desde 2000 a 2005 Análise da sobrevida de mulheres com câncer do colo do útero atendidas em hospital de referência para oncologia no Espírito Santo, Brasil, nos anos de 2000 a 2005

    Directory of Open Access Journals (Sweden)

    Maria Helena Costa Amorim

    2013-04-01

    Full Text Available Uterine cervical cancer is a leading cause of death from cancer in the female population worldwide. The aim of this study was to analyze survival of women with cervical cancer treated at the Santa Rita de Cássia Hospital/Women's Association for Cancer Education and Control (HSRC/AFECC in Espírito Santo State, Brazil, from 2000 to 2005 and to describe associated prognostic factors. This was a cohort study using retrospective secondary data with a sample of 964 cases. The Kaplan-Meier curve and Cox model were used to evaluate survival and for multiple logistic analysis. There were 421 deaths (43.6% during the minimum 5-year follow-up, with an overall 5-year survival of 58.8%. Risk factors were place of residence in the Serrana Region of the State (HR: 1.94; 95%CI: 1.09-3.45 and advanced staging. Women with stages III and IV at diagnosis showed an increased risk of 4.33 (95%CI: 3.00-6.24 and 15.40 (95%CI: 9.72-24.39, respectively, for lower survival when compared to stage I. The results show that early diagnosis and treatment are essential for reducing mortality from cervical cancer.El cáncer de cuello de útero corresponde a una de las principales causas de muerte por neoplasias en la población femenina mundial. El objetivo de este estudio fue analizar la supervivencia de mujeres con cáncer de cuello de útero, atendidas en el Hospital Santa Rita de Cássia/Asociación Femenina de Educación y Combate al Cáncer (HSRC/AFECC, durante el período de 2000 a 2005 y describir los factores pronósticos asociados. Se trata de un estudio de cohorte con utilización de datos secundarios retrospectivos, con una muestra de 964 casos. Se utilizaron la curva de Kaplan-Meier y el modelo de Cox para la evaluación de la supervivencia y para el análisis logístico múltiple. Se produjeron 421 (43,6% óbitos durante un período mínimo de 5 años de seguimiento, con una sobrevida global de 58,8% en 5 años. Se identificó como un riesgo la procedencia de

  1. Five Year Results of US Intergroup/RTOG 9704 With Postoperative CA 19-9 {<=}90 U/mL and Comparison to the CONKO-001 Trial

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    Berger, Adam C., E-mail: adam.berger@jefferson.edu [Thomas Jefferson University Hospital, Philadelphia, Pennsylvania (United States); Winter, Kathryn [RTOG Statistical Center, Philadelphia, Pennsylvania (United States); Hoffman, John P. [Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Regine, William F. [University of Maryland Medical Systems, Baltimore, Maryland (United States); Abrams, Ross A. [Rush University Medical Center, Chicago, Illinois (United States); Safran, Howard [Division of Hematology/Oncology, The Miriam Hospital, Providence, Rhode Island (United States); Freedman, Gary M. [Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Benson, Alan B. [Northwestern Memorial Hospital, Chicago, Illinois (United States); MacDonald, John [St. Vincent' s Comprehensive Cancer Center, New York, New York (United States); Willett, Christopher G. [Duke University Medical Center, Durham, North Carolina (United States)

    2012-11-01

    Purpose: Radiation Therapy Oncology Group (RTOG) trial 9704 was the largest randomized trial to use adjuvant chemoradiation therapy for patients with pancreatic cancer. This report analyzes 5-year survival by serum level of tumor marker CA 19-9 of {<=}90 vs >90 U/mL and compares results to the those of the CONKO-001 trial. Methods and Materials: CA 19-9 expression was analyzed as a dichotomized variable ({<=}90 vs >90 U/mL). Cox proportional hazard models were used to identify the impact of the CA 19-9 value on overall survival (OS). Actuarial estimates of OS were calculated using the Kaplan-Meier method. Results: Both univariate (hazard ratio [HR] = 3.2; 95% confidence interval [CI], 2.3-4.3, P<.0001) and multivariate (HR = 3.1; 95% CI, 2.2-4.2, P<.0001) analyses demonstrated a statistically significant decrease in OS for CA 19-9 serum level of {>=}90 U/mL. For patients in the gemcitabine (Gem) treatment arm with CA 19-9 <90 U/mL, median survival was 21 months. For patients with CA 19-9 {>=}90 U/mL, this number dropped to 10 months. In patients with pancreatic head tumors in the Gem treatment arm with RT quality assurance per protocol and CA 19-9 of <90 U/mL, median survival and 5-year rate were 24 months and 34%. In comparison, the median survival and 5-year OS rate for patients in the Gem arm of the CONKO trial were 22 months and 21%. Conclusions: This analysis demonstrates that patients with postresection CA 19-9 values {>=}90 U/mL had a significantly worse survival. Patients with pancreatic head tumors treated with Gem with CA 19-9 serum level of <90 U/mL and per protocol RT had favorable survival compared to that seen in the CONKO trial. CA 19-9 is a stratification factor for the current RTOG adjuvant pancreas trial (0848).

  2. Time Interval From Breast-Conserving Surgery to Breast Irradiation in Early Stage Node-Negative Breast Cancer: 17-Year Follow-Up Results and Patterns of Recurrence

    Energy Technology Data Exchange (ETDEWEB)

    Vujovic, Olga, E-mail: olga.vujovic@lhsc.on.ca [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Yu, Edward [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Cherian, Anil [Station Health Centre, Royal Air Force Lossiemouth, Moray (United Kingdom); Dar, A. Rashid [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Stitt, Larry [Department of Biometry, London Regional Cancer Program, London, Ontario (Canada); Perera, Francisco [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada)

    2015-02-01

    Purpose: A retrospectivechart review was conducted to determine whether the time interval from breast-conserving surgery to breast irradiation (surgery-radiation therapy interval) in early stage node-negative breast cancer had any detrimental effects on recurrence rates. Methods and Materials: There were 566 patients with T1 to T3, N0 breast cancer treated with breast-conserving surgery and breast irradiation and without adjuvant systemic treatment between 1985 and 1992. The surgery-to-radiation therapy intervals used for analysis were 0 to 8 weeks (201 patients), >8 to 12 weeks (233 patients), >12 to 16 weeks (91 patients), and >16 weeks (41 patients). Kaplan-Meier estimates of time to local recurrence, disease-free survival, distant disease-free survival, cause-specific survival, and overall survival rates were calculated. Results: Median follow-up was 17.4 years. Patients in all 4 time intervals were similar in terms of characteristics and pathologic features. There were no statistically significant differences among the 4 time groups in local recurrence (P=.67) or disease-free survival (P=.82). The local recurrence rates at 5, 10, and 15 years were 4.9%, 11.5%, and 15.0%, respectively. The distant disease relapse rates at 5, 10, and 15 years were 10.6%, 15.4%, and 18.5%, respectively. The disease-free failure rates at 5, 10, and 15 years were 20%, 32.3%, and 39.8%, respectively. Cause-specific survival rates at 5, 10, and 15 years were 92%, 84.6%, and 79.8%, respectively. The overall survival rates at 5, 10, and 15 years were 89.3%, 79.2%, and 66.9%, respectively. Conclusions: Surgery-radiation therapy intervals up to 16 weeks from breast-conserving surgery are not associated with any increased risk of recurrence in early stage node-negative breast cancer. There is a steady local recurrence rate of 1% per year with adjuvant radiation alone.

  3. Survival in HIV-infected patients after a cancer diagnosis in the cART Era: results of an italian multicenter study.

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    Daria Gotti

    Full Text Available OBJECTIVES: We studied survival and associated risk factors in an Italian nationwide cohort of HIV-infected individuals after an AIDS-defining cancer (ADC or non-AIDS-defining cancer (NADC diagnosis in the modern cART era. METHODS: Multi-center, retrospective, observational study of HIV patients included in the MASTER Italian Cohort with a cancer diagnosis from January 1998 to September 2012. Malignancies were divided into ADC or NADC on the basis of the Centre for Disease Control-1993 classification. Recurrence of cancer and metastases were excluded. Survivals were estimated according to the Kaplan-Meier method and compared according to the log-rank test. Statistically significant variables at univariate analysis were entered in a multivariate Cox regression model. RESULTS: Eight hundred and sixty-six cancer diagnoses were recorded among 13,388 subjects in the MASTER Database after 1998: 435 (51% were ADCs and 431 (49% were NADCs. Survival was more favorable after an ADC diagnosis than a NADC diagnosis (10-year survival: 62.7%±2.9% vs. 46%±4.2%; p = 0.017. Non-Hodgkin lymphoma had lower survival rates than patients with Kaposi sarcoma or cervical cancer (10-year survival: 48.2%±4.3% vs. 72.8%±4.0% vs. 78.5%±9.9%; p<0.001. Regarding NADCs, breast cancer showed better survival (10-year survival: 65.1%±14% than lung cancer (1-year survival: 28%±8.7%, liver cancer (5-year survival: 31.9%±6.4% or Hodgkin lymphoma (10-year survival: 24.8%±11.2%. Lower CD4+ count and intravenous drug use were significantly associated with decreased survival after ADCs or NADCs diagnosis. Exposure to cART was found to be associated with prolonged survival only in the case of ADCs. CONCLUSIONS: cART has improved survival in patients with an ADC diagnosis, whereas the prognosis after a diagnosis of NADCs is poor. Low CD4+ counts and intravenous drug use are risk factors for survival following a diagnosis of ADCs and Hodgkin lymphoma in the NADC group.

  4. Phase 1/2 Trials of Temozolomide, Motexafin Gadolinium, and 60-Gy Fractionated Radiation for Newly Diagnosed Supratentorial Glioblastoma Multiforme: Final Results of RTOG 0513

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    Brachman, David G., E-mail: david.brachman@dignityhealth.org [Arizona Oncology Services Foundation, Scottsdale, Arizona (United States); Barrow Neurological Institute, St. Joseph' s Hospital and Medical Center, Phoenix, Arizona (United States); Pugh, Stephanie L. [Radiation Therapy Oncology Group Statistical Center, Philadelphia, Pennsylvania (United States); Ashby, Lynn S. [Barrow Neurological Institute, St. Joseph' s Hospital and Medical Center, Phoenix, Arizona (United States); Thomas, Theresa A. [Arizona Oncology Services Foundation, Scottsdale, Arizona (United States); Dunbar, Erin M. [University of Florida College of Medicine, Gainesville, Florida (United States); Narayan, Samir [St. Joseph Mercy Hospital, Ann Arbor, Michigan (United States); Robins, H. Ian [University of Wisconsin Hospital, Madison, Wisconsin (United States); Bovi, Joseph A. [Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Rockhill, Jason K. [University of Washington Medical Center, Seattle, Washington (United States); Won, Minhee [Barrow Neurological Institute, St. Joseph' s Hospital and Medical Center, Phoenix, Arizona (United States); Curran, Walter P. [Emory University, Atlanta, Georgia (United States)

    2015-04-01

    Purpose: The purpose of phase 1 was to determine the maximum tolerated dose (MTD) of motexafin gadolinium (MGd) given concurrently with temozolomide (TMZ) and radiation therapy (RT) in patients with newly diagnosed supratentorial glioblastoma multiforme (GBM). Phase 2 determined whether this combination improved overall survival (OS) and progression-free survival (PFS) in GBM recursive partitioning analysis class III to V patients compared to therapies for recently published historical controls. Methods and Materials: Dose escalation in phase 1 progressed through 3 cohorts until 2 of 6 patients experienced dose-limiting toxicity or a dose of 5 mg/kg was reached. Once MTD was established, a 1-sided 1-sample log-rank test at significance level of .1 had 85% power to detect a median survival difference (13.69 vs 18.48 months) with 60 deaths over a 12-month accrual period and an additional 18 months of follow-up. OS and PFS were estimated using the Kaplan-Meier method. Results: In phase 1, 24 patients were enrolled. The MTD established was 5 mg/kg, given intravenously 5 days a week for the first 10 RT fractions, then 3 times a week for the duration of RT. The 7 patients enrolled in the third dose level and the 94 enrolled in phase 2 received this dose. Of these 101 patients, 87 were eligible and evaluable. Median survival time was 15.6 months (95% confidence interval [CI]: 12.9-17.6 months), not significantly different from that of the historical control (P=.36). Median PFS was 7.6 months (95% CI: 5.7-9.6 months). One patient (1%) experienced a grade 5 adverse event possibly related to therapy during the concurrent phase, and none experience toxicity during adjuvant TMZ therapy. Conclusions: Treatment was well tolerated, but median OS did not reach improvement specified by protocol compared to historical control, indicating that the combination of standard RT with TMZ and MGd did not achieve a significant survival advantage.

  5. Effects of preceding endoscopic mucosal resection on the efficacy and safety of radiofrequency ablation for treatment of Barrett's esophagus: results from the United States Radiofrequency Ablation Registry.

    Science.gov (United States)

    Li, N; Pasricha, S; Bulsiewicz, W J; Pruitt, R E; Komanduri, S; Wolfsen, H C; Chmielewski, G W; Corbett, F S; Chang, K J; Shaheen, N J

    2016-08-01

    The effects of preceding endoscopic mucosal resection (EMR) on the efficacy and safety of radiofrequency ablation (RFA) for treatment of nodular Barrett's esophagus (BE) is poorly understood. Prior studies have been limited to case series from individual tertiary care centers. We report the results of a large, multicenter registry. We assessed the effects of preceding EMR on the efficacy and safety of RFA for nodular BE with advanced neoplasia (high-grade dysplasia or intramucosal carcinoma) using the US RFA Registry, a nationwide study of BE patients treated with RFA at 148 institutions. Safety outcomes included stricture, gastrointestinal bleeding, and hospitalization. Efficacy outcomes included complete eradication of intestinal metaplasia (CEIM), complete eradication of dysplasia (CED), and number of RFA treatments needed to achieve CEIM. Analyses comparing patients with EMR before RFA to patients undergoing RFA alone were performed with Student's t-test, Chi-square test, logistic regression, and Kaplan-Meier analysis. Four hundred six patients were treated with EMR before RFA for nodular BE, and 857 patients were treated with RFA only for non-nodular BE. The total complication rates were 8.4% in the EMR-before-RFA group and 7.2% in the RFA-only group (P = 0.48). Rates of stricture, bleeding, and hospitalization were not significantly different between patients treated with EMR before RFA and patients treated with RFA alone. CEIM was achieved in 84% of patients treated with EMR before RFA, and 84% of patients treated with RFA only (P = 0.96). CED was achieved in 94% and 92% of patients in EMR-before-RFA and RFA-only group, respectively (P = 0.17). Durability of eradication did not differ between the groups. EMR-before-RFA for nodular BE with advanced neoplasia is effective and safe. The preceding EMR neither diminished the efficacy nor increased complication rate of RFA treatment compared to patients with advanced neoplasia who had RFA with no preceding EMR

  6. Risk factors and survival analysis of the esophageal cancer in the population of Jammu, India

    Directory of Open Access Journals (Sweden)

    S Sehgal

    2012-01-01

    Full Text Available Objective: To identify the risk factors of esophageal cancer and study their effect on the survival rates patients of Jammu region, India. Materials and Methods: Detailed information was collected on socio-demographic, dietary and clinico-pathological parameters for 200 case control pairs. Discrete (categorical data of 2 independent groups (control and cases were summarized in frequency (% and compared by using Chi-square (χ2 test. The mean age of two independent groups was compared by independent Student′s t-test. To find out potential risk factor (s, the variable (s found significant in univariate analysis were further subjected to multivariate logistic regression analysis. The association of potential risk factors with patients survival (3-year overall survival was done by Kaplan-Meier survival curve analysis using Log-rank test. A 2-tailed (a = 2 P < 0.05 was considered statistically significant. Results: Out of the 63 response parameters, seven were found highly significant on multivariate analysis. The mean (± SD age was 56.74 ± 10.76 years, the proportions of males were higher than females, mostly illiterate and lower income group. Among dietary characteristics, snuff was highest (OR = 3.86, 95% CI = 2.46-6.08 followed by salt tea (OR = 2.53, 95% CI = 1.49-4.29, smoking (OR = 1.97, 95% CI = 1.18-3.30, sundried food (OR = 1.77, 95% CI = 1.10-2.85 and red chilly (OR = 1.76, 95% CI = 1.07-2.89. Probability of survival lowered significantly (P < 0.05 or P < 0.01 or P < 0.001 in those consuming tobacco in the form of snuff (Log-rank c 2 = 24.62, P = 0.000 and smoking (Log-rank c 2 = 5.20, P = 0.023 as compared to those who did not take these. Conclusions: The analysis finally established snuff (smokeless tobacco as the most powerful risk factor of esophageal cancer in Jammu region, followed by the salt tea, smoking and the sundried food.

  7. Single-Fraction Versus 5-Fraction Radiation Therapy for Metastatic Epidural Spinal Cord Compression in Patients With Limited Survival Prognoses: Results of a Matched-Pair Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Rades, Dirk, E-mail: Rades.Dirk@gmx.net [Department of Radiation Oncology, University Hospital Lubeck, Lubeck (Germany); Huttenlocher, Stefan [Department of Radiation Oncology, University Hospital Lubeck, Lubeck (Germany); Šegedin, Barbara; Perpar, Ana [Department of Radiotherapy, Institute of Oncology Ljubljana, Ljubljana (Slovenia); Conde, Antonio J.; Garcia, Raquel [Department of Radiation Oncology, Consorcio Hospital Provincial de Castellón, Castellón (Spain); Veninga, Theo [Department of Radiation Oncology, Dr Bernard Verbeeten Institute, Tilburg (Netherlands); Stalpers, Lukas J.A. [Department of Radiation Oncology, Academic Medical Center, Amsterdam (Netherlands); Cacicedo, Jon [Department of Radiation Oncology, Cruces University Hospital, Barakaldo, Vizcaya (Spain); Rudat, Volker [Department of Radiation Oncology, Saad Specialist Hospital, Al Khobar (Saudi Arabia); Schild, Steven E. [Department of Radiation Oncology, Mayo Clinic, Scottsdale, Arizona (United States)

    2015-10-01

    Purpose: This study compared single-fraction to multi-fraction short-course radiation therapy (RT) for symptomatic metastatic epidural spinal cord compression (MESCC) in patients with limited survival prognosis. Methods and Materials: A total of 121 patients who received 8 Gy × 1 fraction were matched (1:1) to 121 patients treated with 4 Gy × 5 fractions for 10 factors including age, sex, performance status, primary tumor type, number of involved vertebrae, other bone metastases, visceral metastases, interval between tumor diagnosis and MESCC, pre-RT ambulatory status, and time developing motor deficits prior to RT. Endpoints included in-field repeated RT (reRT) for MESCC, overall survival (OS), and impact of RT on motor function. Univariate analyses were performed with the Kaplan-Meier method and log-rank test for in-field reRT for MESCC and OS and with the ordered-logit model for effect of RT on motor function. Results: Doses of 8 Gy × 1 fraction and 4 Gy × 5 fractions were not significantly different with respect to the need for in-field reRT for MESCC (P=.11) at 6 months (18% vs 9%, respectively) and 12 months (30% vs 22%, respectively). The RT regimen also had no significant impact on OS (P=.65) and post-RT motor function (P=.21). OS rates at 6 and 12 months were 24% and 9%, respectively, after 8 Gy × 1 fraction versus 25% and 13%, respectively, after 4 Gy × 5 fractions. Improvement of motor function was observed in 17% of patients after 8 Gy × 1 fraction and 23% after 4 Gy × 5 fractions, respectively. Conclusions: There were no significant differences with respect to need for in-field reRT for MESCC, OS, and motor function by dose fractionation regimen. Thus, 8 Gy × 1 fraction may be a reasonable option for patients with survival prognosis of a few months.

  8. Targeting Uric Acid and the Inhibition of Progression to End-Stage Renal Disease--A Propensity Score Analysis.

    Directory of Open Access Journals (Sweden)

    Shunya Uchida

    Full Text Available The role of uric acid (UA in the progression of chronic kidney disease (CKD remains controversial due to the unavoidable cause and result relationship. This study was aimed to clarify the independent impact of UA on the subsequent risk of end-stage renal disease (ESRD by a propensity score analysis.A retrospective CKD cohort was used (n = 803. Baseline 23 covariates were subjected to a multivariate binary logistic regression with the targeted time-averaged UA of 6.0, 6.5 or 7.0 mg/dL. The participants trimmed 2.5 percentile from the extreme ends of the cohort underwent propensity score analyses consisting of matching, stratification on quintile and covariate adjustment. Covariate balances after 1:1 matching without replacement were tested for by paired analysis and standardized differences. A stratified Cox regression and a Cox regression adjusted for logit of propensity scores were examined.After propensity score matching, the higher UA showed elevated hazard ratios (HRs by Kaplan-Meier analysis (≥ 6.0 mg/dL, HR 4.53, 95%CI 1.79-11.43; ≥ 6.5 mg/dL, HR 3.39, 95%CI 1.55-7.42; ≥ 7.0 mg/dL, HR 2.19, 95%CI 1.28-3.75. The number needed to treat was 8 to 9 over 5 years. A stratified Cox regression likewise showed significant crude HRs (≥ 6.0 mg/dL, HR 3.63, 95%CI 1.25-10.58; ≥ 6.5 mg/dL, HR 3.46, 95%CI 1.56-7.68; ≥ 7.0 mg/dL, HR 2.05, 95%CI 1.21-3.48. Adjusted HR lost its significance at 6.0 mg/dL. The adjustment for the logit of the propensity scores showed the similar results but with worse model fittings than the stratification method. Upon further adjustment for other covariates the significance was attained at 6.5 mg/dL.Three different methods of the propensity score analysis showed consistent results that the higher UA accelerates the progression to the subsequent ESRD. A stratified Cox regression outperforms other methods in generalizability and adjusting for residual bias. Serum UA should be targeted less than 6.5 mg/dL.

  9. Prognostic analysis of refractory anaemia in adult myelodysplastic syndromes

    Institute of Scientific and Technical Information of China (English)

    WANG Xiao-qin; CHEN Zi-xing; CHEN Shu-chang; LIN Guo-wei; JI Mei-rong; LIANG Jian-ying; LIU Dun-dan; LI De-gao; MA Yan

    2008-01-01

    Background Patients with myelodysplastic syndrome (MDS) display a very diverse pattem. In this study, we investigated prognostic factors and survival rate in adult patients with MDS refractory anaemia (MDS-RA) diagnosed according to French-American-British classification and evaluated the International Prognostic Scoring System (IPSS) for Chinese patients.Methods A multi-center study on diagnosis of MDS-RA was conducted to charactedze the clinical features of Chinese MDS patients. The morphological criteria for the diagnosis of MDS-RA were first standardized. Clinical data of 307 MDS-RA patients collected from Shanghai, Suzhou and Beijing from 1995 to 2006 were analyzed using Kaplan-Meier curve, log rank and Cox regression model.Results The median age of 307 MDS-RA cases was 52 years. The frequency of 2 or 3 lineage cytopenias was 85.6%. Abnormal karyotype occurred in 35.7% of 235 patients. There were 165 cases (70.2%) in the good IPSS cytogenetic subgroup, 44 cases (18.7%) intermediate and 26 cases (11.1%) poor. IPSS showed 20 (8.5%) categodzed as low dsk,195 cases (83.0%) as intermediate-I risk and 20 cases (8.5%) as intermediate-ll dsk. The 1-, 2-, 3-, 4- and 5-year survival rates were 90.8%, 85.7%, 82.9%, 74.9% and 71.2% respectively. Fifteen cases (4.9%) transformed to acute myeloid leukaemia (median time 15.9 months, range 3-102 months). Lower white blood ceil count (<1.5x109/L), platelet count (<30x109/L) and cytogenetic abnormalities were independent prognostic factors by multivariate analysis, but age (≥65 years), IPSS cytogenetic subgroup and IPSS risk subgroup were not independent prognostic factors associated with survival time.Conclusions Chinese patients were younger, and had lower incidence of cytogenetic abnormalities, more severe cytopenias but a more favourable prognosis than Western patients. The major prognostic factors were lower white blood cell count, lower platelet count and fewer abnormal karyotypes. The intemational prognostic scodng

  10. Left ventricular dyssynchrony assessed by gated SPECT phase analysis is an independent predictor of death in patients with advanced coronary artery disease and reduced left ventricular function not undergoing cardiac resynchronization therapy

    Energy Technology Data Exchange (ETDEWEB)

    Uebleis, Christopher; Hellweger, Stefan; Lehner, Sebastian; Haug, Alexander; Bartenstein, Peter; Cumming, Paul; Hacker, Marcus [Ludwig-Maximilians University, Department of Nuclear Medicine, Munich (Germany); Laubender, Ruediger Paul [Ludwig-Maximilians University, Institute of Medical Informatics, Biometry, and Epidemiology (IBE), Munich (Germany); Becker, Alexander [Ludwig-Maximilians University, Medical Department I, Munich (Germany); Sohn, Hae-Young [Ludwig-Maximilians University, Medical Department Innenstadt, Munich (Germany); Van Kriekinge, Serge D.; Slomka, Piotr J. [Cedars-Sinai Medical Center, Los Angeles, CA (United States); UCLA, David Geffen School of Medicine, Los Angeles, CA (United States)

    2012-10-15

    Left ventricular (LV) mechanical dyssynchrony (LVMD) was assessed by gated single-photon emission CT myocardial perfusion imaging (MPI) as an independent predictor of death from any cause in patients with known coronary artery disease (CAD) and reduced LV function. Between 2001 and 2010, 135 patients (64 {+-} 11 years of age, 84 % men) with known CAD, reduced LV ejection fraction (LVEF, 38 {+-} 15 %) and without an implanted cardiac resynchronization therapy device underwent gated MPI at rest. LV functional evaluation, which included phase analysis, was conducted to identify patients with LVMD. Kaplan-Meier survival curves were calculated for death of any cause during a mean follow-up of 2.0 {+-} 1.7 years. Uni- and multivariate Cox proportional hazards regression models were calculated to identify independent predictors of death from any cause. Of the 135 patients, 30 (22 %) died during follow-up (18 cardiac deaths and 12 deaths from other causes). Kaplan-Meier curves showed a significantly shorter survival time in the patients with severely reduced LVEF (<30 %, n = 45) or with LVMD (n = 81, log-rank test P <0.005). Cox models identified LVMD, LVEF <30 % and a total perfusion deficit at rest of {>=}20 % as independent predictors of death from any cause. While patients with LVEF <30 % in conjunction with LVMD had similar survival times irrespective of whether they had early revascularization or medical therapy, those patients with LVEF {>=}30% and LVMD who underwent revascularization had significantly longer survival. In patients with known CAD and reduced LV function, dyssynchrony of the LV is an independent predictor of death from any cause. (orig.)

  11. Lung cancer associated hypercalcemia: An analysis of factors influencing survival and prognosis in 34 cases

    Directory of Open Access Journals (Sweden)

    Su-jie ZHANG

    2012-06-01

    Full Text Available Objectives  To explore the factors influencing survival time in lung cancer associated hypercalcemia patients. Methods  Thirty-four patients with pathologically confirmed lung cancer complicated with hypercalcemia, who were treated at the Department of Oncology in General Hospital of PLA from Jan. 2001 to Dec. 2010, were enrolled in this study. The clinical data analyzed included sex, age, pathological type of the malignancies, organ metastasis (bone, lung, liver, kidney, brain, number of distal metastatic site, mental status, interval between final diagnosis of lung cancer and of hypercalcemia, peak value of blood calcium during the disease course, treatment methods and so on. Survival analysis was performed with the Kaplan-Meier method and Cox analysis with statistic software SPSS 18.0 to identify the potential prognostic factors. Results  The highest blood calcium level ranged from 2.77 to 4.87mmol/L, and the median value was 2.94mmol/L. The patients' survival time after diagnosis of hypercalcemia varied from 1 day to 1067 days, and the median survival time was 92 days. With the log-rank test, age above 50 years old, hypercalcemia occurring over 90 days after diagnosis of cancer, central nervous system symptoms and renal metastasis were predictors for poor survival (P=0.048, P=0.001, P=0.000, P=0.003. In the COX proportional hazard model analysis, age above 50 years old, hypercalcemia occurring over 90 days after cancer diagnosis, central nervous system symptoms and renal metastasis were significant prognostic factors for poor survival (HR=11.483, P=0.006; HR=4.371, P=0.002; HR=6.064, P=0.026; HR=8.502, P=0.011. Conclusions  Patients with lung cancer associated hypercalcemia have a shorter survival time and poor prognosis. Age above 50 years old, hypercalcemia occurring over 90 days after cancer diagnosis, central nervous system symptoms and renal metastasis are significant factors of poor prognosis.

  12. TU-CD-BRB-08: Radiomic Analysis of FDG-PET Identifies Novel Prognostic Imaging Biomarkers in Locally Advanced Pancreatic Cancer Patients Treated with SBRT

    Energy Technology Data Exchange (ETDEWEB)

    Cui, Y; Shirato, H [Hokkaido University, Global Institute for Collaborative Research and Educat, Sapporo, Hokkaido (Japan); Song, J; Pollom, E; Chang, D; Koong, A [Stanford University, Palo Alto, CA (United States); Li, R [Hokkaido University, Global Institute for Collaborative Research and Educat, Sapporo, Hokkaido (Japan); Stanford University, Palo Alto, CA (United States)

    2015-06-15

    Purpose: This study aims to identify novel prognostic imaging biomarkers in locally advanced pancreatic cancer (LAPC) using quantitative, high-throughput image analysis. Methods: 86 patients with LAPC receiving chemotherapy followed by SBRT were retrospectively studied. All patients had a baseline FDG-PET scan prior to SBRT. For each patient, we extracted 435 PET imaging features of five types: statistical, morphological, textural, histogram, and wavelet. These features went through redundancy checks, robustness analysis, as well as a prescreening process based on their concordance indices with respect to the relevant outcomes. We then performed principle component analysis on the remaining features (number ranged from 10 to 16), and fitted a Cox proportional hazard regression model using the first 3 principle components. Kaplan-Meier analysis was used to assess the ability to distinguish high versus low-risk patients separated by median predicted survival. To avoid overfitting, all evaluations were based on leave-one-out cross validation (LOOCV), in which each holdout patient was assigned to a risk group according to the model obtained from a separate training set. Results: For predicting overall survival (OS), the most dominant imaging features were wavelet coefficients. There was a statistically significant difference in OS between patients with predicted high and low-risk based on LOOCV (hazard ratio: 2.26, p<0.001). Similar imaging features were also strongly associated with local progression-free survival (LPFS) (hazard ratio: 1.53, p=0.026) on LOOCV. In comparison, neither SUVmax nor TLG was associated with LPFS (p=0.103, p=0.433) (Table 1). Results for progression-free survival and distant progression-free survival showed similar trends. Conclusion: Radiomic analysis identified novel imaging features that showed improved prognostic value over conventional methods. These features characterize the degree of intra-tumor heterogeneity reflected on FDG

  13. Surgical Management of Adolescents and Young Adults With Gastrointestinal Stromal Tumors: A US Population-Based Analysis.

    Science.gov (United States)

    Fero, Katherine E; Coe, Taylor M; Fanta, Paul T; Tang, Chih-Min; Murphy, James D; Sicklick, Jason K

    2017-05-01

    There is a dearth of population-based evidence regarding outcomes of the adolescent and young adult (AYA) population with gastrointestinal stromal tumors (GISTs). To describe a large cohort of AYA patients with GISTs and investigate the effect of surgery on GIST-specific survival (GSS) and overall survival (OS). This retrospective cohort study of 392 AYA patients and 5373 older adult (OA) patients in the Surveillance, Epidemiology, and End Results (SEER) database with GISTs histologically diagnosed from January 1, 2001, through December 31, 2013, with follow-up through December 31, 2015, compared the baseline characteristics of AYA (13-39 years old) and OA (≥40 years old) patients and among AYA patients stratified by operative management. Kaplan-Meier estimates were used for OS analyses. Cumulative incidence functions were used for GSS analysis. The effect of surgery on survival was evaluated with a multivariable Fine-Gray regression model. Tumor resection. GIST-specific survival and OS. This study included 392 AYA and 5373 OA patients diagnosed with GISTs (207 [52.8%] male AYA patients, 2767 [51.5%] male OA patients, 277 [70.7%] white AYA patients, and 3661 [68.1%] white OA patients). Compared with the OA patients, more AYA patients had small-intestine GISTs (139 [35.5%] vs 1465 [27.3%], P = .008) and were managed operatively (332 [84.7%] vs 4212 [78.4%], P = .003). Multivariable analysis of AYA patients found that nonoperative management was associated with a more than 2-fold increased risk of death from GISTs (subdistribution hazard ratio, 2.27; 95% CI, 1.21-2.25; P = .01). On subset analysis of 349 AYA patients with tumors of the stomach and small intestine, small-intestine location was associated with improved survival (OS: 91.1% vs 77.2%, P = .01; GSS: 91.8% vs 78.0%, P = .008). On subset analysis of 91 AYA patients with metastatic disease, operative management was associated with improved survival (OS: 69.5% vs 53.7%, P = .04; GSS

  14. Recursive Partitioning Analysis Index Is Predictive for Overall Survival in Patients Undergoing Spine Stereotactic Body Radiation Therapy for Spinal Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Chao, Samuel T., E-mail: chaos@ccf.org [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Brain Tumor and Neuro-oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Koyfman, Shlomo A.; Woody, Neil [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Angelov, Lilyana [Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Brain Tumor and Neuro-oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Soeder, Sherry L. [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Brain Tumor and Neuro-oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Reddy, Chandana A. [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Rybicki, Lisa A. [Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Djemil, Toufik [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Suh, John H. [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Brain Tumor and Neuro-oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio 44195 (United States); Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio 44195 (United States)

    2012-04-01

    Purpose: To generate a prognostic index using recursive partitioning analysis (RPA) for patients undergoing spine stereotactic body radiation therapy (sSBRT) for spinal metastases (sMet). Methods and Materials: From an institutional review board-approved database, 174 patients were treated for sMet with sSBRT between February 2006 and August 2009. Median dose was 14 Gy (range, 8-24 Gy), typically in a single fraction (range, 1-5). Kaplan-Meier analysis was performed to detect any correlation between survival and histology. Histologies were divided into favorable (breast and prostate), radioresistant (renal cell, melanoma and sarcoma), and other (all other histologies). RPA was performed to identify any association of the following variables with overall survival (OS) following sSBRT: histology, gender, age, Karnofsky performance status (KPS), control of primary, extraosseous metastases, time from primary diagnosis (TPD), dose of sSBRT ({<=}14 Gy vs. >14 Gy), extent of spine disease (epidural only, bone and epidural, bone only), upfront or salvage treatment, presence of paraspinal extension, and previous surgery. Results: Median follow-up was 8.9 months. Median OS time from sSBRT was 10.7 months. Median OS intervals for favorable histologies were 14 months, 11.2 months for radioresistant histologies, and 7.3 months for other histologies (p = 0.02). RPA analysis resulted in three classes (p < 0.0001). Class 1 was defined as TPD of >30 months and KPS of >70; Class 2 was TPD of >30 months and KPS of {<=}70 or a TPD of {<=}30 months and age <70 years old; Class 3 was TPD of {<=}30 months and age {>=}70 years old. Median OS was 21.1 months for Class 1 (n = 59), 8.7 months for Class 2 (n = 104), and 2.4 months for Class 3 (n = 11). Conclusion: sSBRT patients treated for sMet have a wide variability in OS. We developed an RPA classification system that is predictive of OS. While many patients are treated for palliation of pain or to avoid symptomatic progression, this

  15. Secondary Analysis for Results Tracking Database

    Data.gov (United States)

    US Agency for International Development — The Secondary Analysis and Results Tracking (SART) activity provides support for the development of two databases to manage secondary and third-party data, data...

  16. Analysis of Clinical Manifestations and Prognosis of 92 Cases with Non-Hodgkin's Lymphoma

    Institute of Scientific and Technical Information of China (English)

    Xianlin Duan; Ming Jiang

    2008-01-01

    OBJECTIVE To analyze the risk factors and influence of various treatments on the prognosis of non-Hodgkin's lymphoma(NHL).METHODS Clinical data of 92 patients with NHL from our hospital were retrOspectjvely reviewed.Kaplan-Meier statistics were used to analyze the differences in survival times of the patients receiving various treatments.Cox regression model was employed for analyzing the prognostic factors.RESULTS Among our patients,the 2 and 5-year disease-free survivals (DFS)were respectively 68% and 51%.The 5-year cancer-specific survival (CSS)was 55%.Mono-factorial analysis showed that the main independent prognostic factors included Ann Arbor Staging,B symptoms,lactate dehydrogenase(LDH),the international prognostic index(IPI)and age.Concerning the IPI,the 5-year CSS for the low-risk factors(0~1),lower-moderate risk(2),higher-moderate(3)and high-risk(4~5)were respectively 60%,62%,42% and 33%.Analysis of the prognoses,based on treatment of the patients with different stages,was as follows:the 5-year survival rates of the Stage-Ⅰ and Ⅱ patients,receiving surgery or chemotherapy alone,or a combined therapy,were respectively 19%,72% and 68%,showing that the survival rates of the group with a combined therapy and the chemotherapy alone were superior to the group with surgery alone;the 5-year survival rates of the Stage-Ⅲ and Ⅳ patients,receiving surgery or chemotherapy alone or a combined therapy,were respectively 50%,35% and 60%,indicating that the survival rate of the group with a combined therapy was superior compared to the group with chemotherapy alone.CONCLUSION Long-term survival of non-Hodgkin's lymphoma patients is closely related with multiple factors.Rational detection and assessment of the risk factors may prolong the living time of the patients.Different methods of treatment can influence the patient's prognosis.Correct evaluation of the prognostic factors,and rational and effective therapy can prolong the patient's survival.

  17. Failure analysis of satellite subsystems to define suitable de-orbit devices

    Science.gov (United States)

    Palla, Chiara; Peroni, Moreno; Kingston, Jennifer

    2016-11-01

    Space missions in Low Earth Orbit (LEO) are severely affected by the build-up of orbital debris. A key practice, to be compliant with IADC (Inter-Agency Space Debris Coordination Committee) mitigation guidelines, is the removal of space systems that interfere with the LEO region not later than 25 years after the End of Mission. It is important to note that the current guidelines are not generally legally binding, even if different Space Agencies are now looking at the compliance for their missions. If the guidelines will change in law, it will be mandatory to have a postmission disposal strategy for all satellites, including micro and smaller classes. A potential increased number of these satellites is confirmed by different projections, in particular in the commercial sector. Micro and smaller spacecraft are, in general, not provided with propulsion capabilities to achieve a controlled re-entry, so they need different de-orbit disposal methods. When considering the utility of different debris mitigation methods, it is useful to understand which spacecraft subsystems are most likely to fail and how this may affect the operation of a de-orbit system. This also helps the consideration of which components are the most relevant or should be redundant depending on the satellite mass class. This work is based on a sample of LEO and MEO satellites launched between January 2000 and December 2014 with mass lower than 1000 kg. Failure analysis of satellite subsystems is performed by means of the Kaplan-Meier survival analysis; the parametric fits are conducted with Weibull distributions. The study is carried out by using the satellite database SpaceTrak™ which provides anomalies, failures, and trends information for spacecraft subsystems and launch vehicles. The database identifies five states for each satellite subsystem: three degraded states, one fully operational state, and one failed state (complete failure). The results obtained can guide the identification of the

  18. Acute lymphoblastic leukemia in children and adolescents: prognostic factors and analysis of survival

    Directory of Open Access Journals (Sweden)

    Daniel Willian Lustosa de Sousa

    2015-08-01

    Full Text Available OBJECTIVE: To describe the clinical and laboratory features of children and adolescents with acute lymphoblastic leukemia treated at three referral centers in Ceará and evaluate prognostic factors for survival, including age, gender, presenting white blood cell count, immunophenotype, DNA index and early response to treatment.METHODS: Seventy-six under 19-year-old patients with newly diagnosed acute lymphoblastic leukemia treated with the Grupo Brasileiro de Tratamento de Leucemia da Infância - acute lymphoblastic leukemia-93 and -99 protocols between September 2007 and December 2009 were analyzed. The diagnosis was based on cytological, immunophenotypic and cytogenetic criteria. Associations between variables, prognostic factors and response to treatment were analyzed using the chi-square test and Fisher's exact test. Overall and event-free survival were estimated by Kaplan-Meier analysis and compared using the log-rank test. A Cox proportional hazards model was used to identify independent prognostic factors.RESULTS: The average age at diagnosis was 6.3 ± 0.5 years and males were predominant (65%. The most frequently observed clinical features were hepatomegaly, splenomegaly and lymphadenopathy. Central nervous system involvement and mediastinal enlargement occurred in 6.6% and 11.8%, respectively. B-acute lymphoblastic leukemia was more common (89.5% than T-acute lymphoblastic leukemia. A DNA index >1.16 was found in 19% of patients and was associated with favorable prognosis. On Day 8 of induction therapy, 95% of the patients had lymphoblast counts <1000/µL and white blood cell counts <5.0 Ã- 109/L. The remission induction rate was 95%, the induction mortality rate was 2.6% and overall survival was 72%.CONCLUSION: The prognostic factors identified are compatible with the literature. The 5-year overall and event-free survival rates were lower than those reported for developed countries. As shown by the multivariate analysis, age

  19. Analysis of the Role of PET/CT SUVmax in Prognosis and Its Correlation with 
Clinicopathological Characteristics in Resectable Lung Squamous Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Hongliang REN

    2016-04-01

    Full Text Available Background and objective Lung cancer is the leading cause of cancer death in men and women in the world, more than one-half of cases are diagnosed at a advanced stage, and the overall 5-year survival rate for lung cancer is 18%. Lung cancer is divided into non-small cell lung carcinoma (NSCLC and small cell lung carcinoma (SCLC. Approximately 80%-85% of cases are NSCLC which includes three main types: adenocarcinoma (40%, squamous cell carcinoma (SCC (20%-30%, and large cell carcinoma (10%. Although therapies that target driver mutations in adenocarcinomas are showing some promise, they are proving ineffective in smoking-related SCC. We need pay more attention to the diagnosis and treatment of SCC. 18F-FDG positron emission tomography (PET/computed tomography (CT has emerged as an accurate staging modality in lung cancer diagnosis. The aim of this study is to investigate the role of maximum standardized uptake value (SUVmax on PET-CT in prognosis and its correlation with clinicopathological characteristics in resectable SCC. Methods One hundred and eighty-two resectable SCC patients who underwent PET/CT imaging between May 2005 and October 2014 were enrolled into this retrospectively study. All the enrolled patients had underwent pulmonary resection with mediastinal lymph node dissection without preoperative chemotherapy or radiotherapy. Survival outcomes were analyzed using the Kaplan-Meier method and multivariate Cox proportional hazards model. Correlation between SUVmax and clinicopathological factors was analysed using Pearson correlation analysis and Spearman rank correlation analysis. Results The patients were divided into two groups on the basis of SUVmax 13.0 as cutoff value, and patients with SUVmax more than 13.0 had shorter median overall survival than patients less than 13.0 in univariate analysis (56 months vs 87 months; P=0.022. There was remarkable correlation between SUVmax and gender, tumor size, tumor-node-metastasis (TNM stage

  20. The use of automated quantitative analysis to evaluate epithelial-to-mesenchymal transition associated proteins in clear cell renal cell carcinoma.

    Directory of Open Access Journals (Sweden)

    Fiach C O'Mahony

    Full Text Available BACKGROUND: Epithelial-to-mesenchymal transition (EMT has recently been implicated in the initiation and progression of renal cell carcinoma (RCC. Some mRNA gene expression studies have suggested a link between the EMT phenotype and poorer clinical outcome from RCC. This study evaluated expression of EMT-associated proteins in RCC using in situ automated quantitative analysis immunofluorescence (AQUA and compared expression levels with clinical outcome. METHODS/PRINCIPAL FINDINGS: Unsupervised hierarchical cluster analysis of pre-existing RCC gene expression array data (GSE16449 from 36 patients revealed the presence of an EMT transcriptional signature in RCC [E-cadherin high/SLUG low/SNAIL low]. As automated immunofluorescence technology is dependent on accurate definition of the tumour cells in which measurements take place is critical, extensive optimisation was carried out resulting in a novel pan-cadherin based tumour mask that distinguishes renal cancer cells from stromal components. 61 patients with ccRCC and clinical follow-up were subsequently assessed for expression of EMT-associated proteins (WT1, SNAIL, SLUG, E-cadherin and phospho-β-catenin on tissue microarrays. Using Kaplan-Meier analysis both SLUG (p = 0.029 and SNAIL (p = 0.024 (log rank Mantel-Cox were significantly associated with prolonged progression free survival (PFS. Using Cox regression univariate and multivariate analysis none of the biomarkers were significantly correlated with outcome. 14 of the 61 patients expressed the gene expression analysis predicted EMT-protein signature [E-cadherin high/SLUG low/SNAIL low], which was not found to be associated to PFS when measured at the protein level. A combination of high expression of SNAIL and low stage was able to stratify patients with greater significance (p = 0.001 then either variable alone (high SNAIL p = 0.024, low stage p = 0.029. CONCLUSIONS: AQUA has been shown to have the potential to

  1. Risk Factors for Neovascular Glaucoma After Proton Beam Therapy of Uveal Melanoma: A Detailed Analysis of Tumor and Dose–Volume Parameters

    Energy Technology Data Exchange (ETDEWEB)

    Mishra, Kavita K., E-mail: kmishra@radonc.ucsf.edu [Department of Radiation Oncology, University of California, San Francisco, San Francisco, California (United States); Daftari, Inder K.; Weinberg, Vivian [Department of Radiation Oncology, University of California, San Francisco, San Francisco, California (United States); Cole, Tia [The Tumori Foundation, San Francisco, California (United States); Quivey, Jeanne M.; Castro, Joseph R.; Phillips, Theodore L. [Department of Radiation Oncology, University of California, San Francisco, San Francisco, California (United States); Char, Devron H. [The Tumori Foundation, San Francisco, California (United States)

    2013-10-01

    Purpose: To determine neovascular glaucoma (NVG) incidence and identify contributing tumor and dosing factors in uveal melanoma patients treated with proton beam radiation therapy (PBRT). Methods and Materials: A total of 704 PBRT patients treated by a single surgeon (DHC) for uveal melanoma (1996-2010) were reviewed for NVG in our prospectively maintained database. All patients received 56 GyE in 4 fractions. Median follow-up was 58.3 months. Analyses included the Kaplan-Meier method to estimate NVG distributions, univariate log–rank tests, and Cox's proportional hazards multivariate analysis using likelihood ratio tests to identify independent risk factors of NVG among patient, tumor, and dose–volume histogram parameters. Results: The 5-year PBRT NVG rate was 12.7% (95% confidence interval [CI] 10.2%-15.9%). The 5-year rate of enucleation due to NVG was 4.9% (95% CI 3.4%-7.2%). Univariately, the NVG rate increased significantly with larger tumor diameter (P<.0001), greater height (P<.0001), higher T stage (P<.0001), and closer proximity to the disc (P=.002). Dose–volume histogram analysis revealed that if >30% of the lens or ciliary body received ≥50% dose (≥28 GyE), there was a higher probability of NVG (P<.0001 for both). Furthermore, if 100% of the disc or macula received ≥28 GyE, the NVG rate was higher (P<.0001 and P=.03, respectively). If both anterior and posterior doses were above specified cut points, NVG risk was highest (P<.0001). Multivariate analysis confirmed significant independent risk factors to include tumor height (P<.0001), age (P<.0001), %disc treated to ≥50% Dose (<100% vs 100%) (P=.0007), larger tumor diameter (P=.01), %lens treated to ≥90% Dose (0 vs >0%-30% vs >30%) (P=.01), and optic nerve length treated to ≥90% Dose (≤1 mm vs >1 mm) (P=.02). Conclusions: Our current PBRT patients experience a low rate of NVG and resultant enucleation compared with historical data. The present analysis shows that tumor height

  2. Breast conserving treatment of breast carcinoma T2 ({<=} 4 cm) and T3 by neoadjuvant chemotherapy, quadrantectomy, high dose rate brachytherapy as a boost, external beam radiotherapy and adjuvant chemotherapy: local control and overall survival analysis; Tratamento conservador do cancer de mama T2 ({<=} 4 cm) e T3 por quimioterapia neoadjuvante, quadrantectomia, braquiterapia com alta taxa de dose como reforco de dose, teleterapia complementar e quimioterapia adjuvante: analise de controle local e sobrevida global

    Energy Technology Data Exchange (ETDEWEB)

    Soares, Celia Regina; Miziara Filho, Miguel Abrao; Fogaroli, Ricardo Cesar; Baraldi, Helena Espindola; Pellizzon, Antonio Cassio Assis; Pelosi, Edilson Lopes [Instituto do Cancer Dr. Arnaldo Vieira de Carvalho (ICAVC), Sao Paulo, SP (Brazil). Servico de Radioterapia], e-mail: celiarsoares@terra.com.br; Fristachi, Carlos Elias [Instituto do Cancer Dr. Arnaldo Vieira de Carvalho (ICAVC), Sao Paulo, SP (Brazil). Servico de Onco-Ginecologia e Mastologia; Paes, Roberto Pinto [Instituto do Cancer Dr. Arnaldo Vieira de Carvalho (ICAVC), Sao Paulo, SP (Brazil)

    2008-12-15

    Objective: to assess the treatment of breast cancer T2 ({<=} 4 cm) and T3 through neoadjuvant chemotherapy, quadrantectomy and high dose rate brachytherapy as a boost, complementary radiotherapy and adjuvant chemotherapy, considering local control and overall survival. Material and method: this clinical prospective descriptive study was based on the evaluation of 88 patients ranging from 30 to 70 years old, with infiltrating ductal carcinoma, clinical stage IIb and IIIa, responsive to the neoadjuvant chemotherapy, treated from June/1995 to December/2006. Median follow-up was 58 months. Using clinical methods the tumor was evaluated before and after three or four cycles of chemotherapy based on anthracyclines. Overall survival and local control were assessed according to Kaplan-Meier methodology. Results: Local control and overall survival in five years were 90% and 73.5%, respectively. Conclusion: local control and overall survival were comparable to other forms of treatment. (author)

  3. Retrospective analysis of prognostic factors in 205 patients with laryngeal squamous cell carcinoma who underwent surgical treatment.

    Directory of Open Access Journals (Sweden)

    Si-Yi Zhang

    Full Text Available OBJECTIVES: To investigate the most important factors affecting the prognosis of the patients with squamous cell carcinoma (SCC of the larynx. METHODS: Based on the clinical and follow-up data, 205 patients with SCC of the larynx receiving total laryngectomy, partial laryngectomy, or CO2 laser surgery in GuangDong General Hospital were retrospectively analyzed. A survival analysis was performed by the Kaplan-Meier method and a multivariable analysis of prognostic factors was carried out using the Cox proportional hazard model. RESULTS: Subtypes of carcinoma included 69.8% glottic and 30.2% supraglottic. Most patients were in N0 stage (77.6%, and 22.4% patients were in N1∼N3 stage. Over half of the patients were in T1∼T2 stage (55.1%, 20.0% in T3, and 24.9% in T4. Mean follow-up duration was 49.2 months. The survival rates 1, 2, and 3 years after the surgery were 99.0%, 91.7%, and 81.5%, respectively. The survival rate for those patients with clinical stage IV was significantly lower than for those with clinical stage I and II (p<0.001 and p = 0.013, respectively. The disease-free progression rates 1, 2, and 3 years after the surgery were 83.9%, 74.6%, and 71.2%, respectively. Futhermore, those patients with a Charlson score of 1 to 2 and ≥3 had higher risk of mortality than those with a Charlson score of 0 (hazard ratios of 1.8 and 2.41 p = 0.042 and p = 0.008. Multivariable analysis revealed that clinical stage, surgical margin, and comorbidity were significantly associated with both mortality and disease-free progression. CONCLUSION: The surgical resection margin, clinical stage, and comorbidity were independent factors affecting the laryngeal cancer prognosis. The survival rates were lower for patients with advanced laryngeal cancer, positive surgical margins, or severe comorbidity, suggesting the importance of early diagnosis, early treatment, negative surgical margins, and conditions of comorbidity.

  4. 138例Ⅳ期胃癌患者预后因素分析%Prognostic factors analysis of 138 patients with stage Ⅳ gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Zhixiang Zhuang; Yufeng Lu; Liqin Shen

    2010-01-01

    Objective:We evaluated the prognostic factors of patients with stage Ⅳ gastric cancer.Methods:In the current retrospective study,138 patients of stage Ⅰ gastric cancer treated with platinum-based chemotherapy were analyzed.Survival rate was estimated by using Kaplan-Meier method.The prognostic factors were analyzed using univariate(Log rank)and multivariate(Cox model)analysis methods.Results:Univariate analysis showed and multivariate analysis showed that poor performance status(P = 0.001),weight loss(P=0.001),depth of invasion(P = 0.000),presence of peritoneal metastasis(P=0.005),more than 1 metastatic site(P = 0.029)and elevated total bilirubin(P=0.018)were confirmed as independent prognostic factors.According to the outcomes of the Cox model analysis,a formula of the prognostic index was developed.According to the values of PI,16 patients were categorized as the good risk group,28 patients were categorized as the moderate risk group and 8 patients were categorized as the poor risk group,respectively.The survival ratios of 6 months,12months and 24 months of the good risk group were 75.00%,50.00%,25.00%,respectively.The survival ratios of 6 month,1-year and 2-year of the moderate risk group were 71.79%,28.57%,7.14%,respectively.While the survival ratios of 6 month,12 months and 24 months of the poor risk group were 50%,0,0,respectively.The overall survival ratios of the 3 groups were compared in pairs.Conclusion:Poor performance status,depth of invasion,elevated total bilirubin,more than 1 metastatic site,presence of peritoneal metastasis,weight loss were the independent prognostic factors.A formula of the prognostic index was developed,and it could help clinicians and patients in clinical decision-making and treatment tailoring based on the estimated prognosis.

  5. Second-line Chemotherapy and Its Survival Analysis of 181 Patients with
Extensive-stage Small Cell Lung Cancer in a Single Institute

    Directory of Open Access Journals (Sweden)

    Manjiao MA

    2013-11-01

    Full Text Available Background and objective Small cell lung cancer (SCLC is the most malignant neuroendocrine tumor and sensitive to chemotherapy and radiotherapy. However, most patients who receive first-line chemotherapy will relapse within one to two years. Once recurrent, it indicates poor prognosis. Currently, the standard first-line chemotherapy regimen of extensive-stage SCLC is platinum combined etoposide regimen while the standard second-line chemotherapy regimen is open to debate. The aim of this study is to analysis the prognostic factors of second-line chemotherapy in extensive-stage SCLC and to compare the differences of objective response rate, side effects and survival among different second-line chemotherapy regimens. Methods 181 patients who were diagnosed as extensive-stage SCLC and received second-line chemotherapy were collected. χ2 test was used to analysis the differences of enumeration data and between different groups. Kaplan-Meier method was used to calculate the overall survival (OS and progression-free survival (PFS. Univariate analysis and Cox regression analysis were used to detect the prognostic factors. Objective response rate was evaluated by RECIST criteria and side effects were evaluated by WHO criteria. Results The patients who received second-line chemotherapy can be divided into 6 groups, namly group A (CE/EP regimen 27 cases, group B (regimens containing TPT 44 cases, group C (regimens containing CPT-11 33 cases, group D (regimens containing TAX/DXL 20 cases, group E (regimens containing IFO 28 cases and group F (other regimens 29 cases. The median OS in second-line chemotherapy as 7.0 months and was relevant with smoking history (P=0.004, ECOG PS (P<0.001, liver metastasis (P=0.019 and bone metastasis (P=0.028 independently. The median PFS in second-line chemotherapy as 3.0 months and was relevant with smoking history (P=0.034, ECOG PS (P=0.011 and bone metastasis (P=0.005. The response rate among six regimens was

  6. Textural analysis of pre-therapeutic [18F]-FET-PET and its correlation with tumor grade and patient survival in high-grade gliomas

    Energy Technology Data Exchange (ETDEWEB)

    Pyka, Thomas; Hiob, Daniela; Wester, Hans-Juergen [Klinikum Rechts der Isar der TU Muenchen, Department of Nuclear Medicine, Munich (Germany); Gempt, Jens; Ringel, Florian; Meyer, Bernhard [Klinikum Rechts der Isar der TU Muenchen, Neurosurgic Department, Munich (Germany); Schlegel, Juergen [Klinikum Rechts der Isar der TU Muenchen, Institute of Pathology and Neuropathology, Munich (Germany); Bette, Stefanie [Klinikum Rechts der Isar der TU Muenchen, Neuroradiologic department, Munich (Germany); Foerster, Stefan [Klinikum Rechts der Isar der TU Muenchen, Department of Nuclear Medicine, Munich (Germany); Klinikum Rechts der Isar der TU Muenchen, TUM Neuroimaging Center (TUM-NIC), Munich (Germany)

    2016-01-15

    Amino acid positron emission tomography (PET) with [18F]-fluoroethyl-L-tyrosine (FET) is well established in the diagnostic work-up of malignant brain tumors. Analysis of FET-PET data using tumor-to-background ratios (TBR) has been shown to be highly valuable for the detection of viable hypermetabolic brain tumor tissue; however, it has not proven equally useful for tumor grading. Recently, textural features in 18-fluorodeoxyglucose-PET have been proposed as a method to quantify the heterogeneity of glucose metabolism in a variety of tumor entities. Herein we evaluate whether textural FET-PET features are of utility for grading and prognostication in patients with high-grade gliomas. One hundred thirteen patients (70 men, 43 women) with histologically proven high-grade gliomas were included in this retrospective study. All patients received static FET-PET scans prior to first-line therapy. TBR (max and mean), volumetric parameters and textural parameters based on gray-level neighborhood difference matrices were derived from static FET-PET images. Receiver operating characteristic (ROC) and discriminant function analyses were used to assess the value for tumor grading. Kaplan-Meier curves and univariate and multivariate Cox regression were employed for analysis of progression-free and overall survival. All FET-PET textural parameters showed the ability to differentiate between World Health Organization (WHO) grade III and IV tumors (p < 0.001; AUC 0.775). Further improvement in discriminatory power was possible through a combination of texture and metabolic tumor volume, classifying 85 % of tumors correctly (AUC 0.830). TBR and volumetric parameters alone were correlated with tumor grade, but showed lower AUC values (0.644 and 0.710, respectively). Furthermore, a correlation of FET-PET texture but not TBR was shown with patient PFS and OS, proving significant in multivariate analysis as well. Volumetric parameters were predictive for OS, but this correlation did not

  7. Impact of Bone-targeted Therapies in Chemotherapy-naïve Metastatic Castration-resistant Prostate Cancer Patients Treated with Abiraterone Acetate: Post Hoc Analysis of Study COU-AA-302

    Science.gov (United States)

    Saad, Fred; Shore, Neal; Van Poppel, Hendrik; Rathkopf, Dana E.; Smith, Matthew R.; de Bono, Johann S.; Logothetis, Christopher J.; de Souza, Paul; Fizazi, Karim; Mulders, Peter F.A.; Mainwaring, Paul; Hainsworth, John D.; Beer, Tomasz M.; North, Scott; Fradet, Yves; Griffin, Thomas A.; De Porre, Peter; Londhe, Anil; Kheoh, Thian; Small, Eric J.; Scher, Howard I.; Molina, Arturo; Ryan, Charles J.

    2016-01-01

    Background Metastatic castration-resistant prostate cancer (mCRPC) often involves bone, and bone-targeted therapy (BTT) has become part of the overall treatment strategy. Objective Investigation of outcomes for concomitant BTT in a post hoc analysis of the COU-AA-302 trial, which demonstrated an overall clinical benefit of abiraterone acetate (AA) plus prednisone over placebo plus prednisone in asymptomatic or mildly symptomatic chemotherapy-naïve mCRPC patients. Design, setting, and participants This report describes the third interim analysis (prespecified at 55% overall survival [OS] events) for the COU-AA-302 trial. Intervention Patients were grouped by concomitant BTT use or no BTT use. Outcome measurements and statistical analysis Radiographic progression-free survival and OS were coprimary end points. This report describes the third interim analysis (prespecified at 55% OS events) and involves patients treated with or without concomitant BTT during the COU-AA-302 study. Median follow-up for OS was 27.1 mo. Median time-to-event variables with 95% confidence intervals (CIs) were estimated using the Kaplan-Meier method. Adjusted hazard ratios (HRs), 95% CIs, and p values for concomitant BTT versus no BTT were obtained via Cox models. Results and limitations While the post hoc nature of the analysis is a limitation, superiority of AA and prednisone versus prednisone alone was demonstrated for clinical outcomes with or without BTT use. Compared with no BTT use, concomitant BTT significantly improved OS (HR 0.75; p = 0.01) and increased the time to ECOG deterioration (HR 0.75; p < 0.001) and time to opiate use for cancer-related pain (HR 0.80; p = 0.036). The safety profile of concomitant BTT with AA was similar to that reported for AA in the overall intent-to-treat population. Osteonecrosis of the jaw (all grade 1/2) with concomitant BTT use was reported in <3% of patients. Conclusions AA with concomitant BTT was safe and well tolerated in men with chemotherapy

  8. P13.10SURGICAL TREATMENT FOR GLIOBLASTOMA MULTIFORME: OUTCOME AND ANALYSIS OF PROGNOSTIC FACTORS ESPECIALLY ORIENTED TO THE EXTENT OF SURGICAL RESECTION

    Science.gov (United States)

    Di Somma, L.; Iacoangeli, M.; Alvaro, L.; Di Rienzo, A.; Liverotti, V.; Della Costanza, M.; Brunozzi, D.; Polonara, G.; Scarpelli, M.; Scerrati, M.

    2014-01-01

    INTRODUCTION: The prognosis of Glioblastoma Multiforme (GBM) remains poor despite recent therapeutic advances. The surgical treatment of GBM (supported by functional imaging, neuronavigation and electrophysiological monitoring) remains a fundamental step. The methylation of the enzyme O6-methylguanine-DNA methyltransefrase (MGMT) seems to improve the effectiveness of alkylating agents on this tumour, but other factors can influence the survival. An evaluation of all prognostic factors is essential to individuate subgroups of patients for a better selection of different treatment modalities. Our study confirms the prognostic values of both new recognized factors (MGMT presence, IDH1, news schedule of TM2 etc.) and the well-recognized prognostic factors particularly to the extent of surgical removal with the help of new technologies and in the era where people is asking more and more a better quality of life. METHODS: We retrospectively analysed 172 operated patients (115 males and 57 females), 55 of which located in eloquent areas, between March 2008 and December 2012. For each patient age, sex, preoperative clinical evaluation (Karnofsky score, KPS), tumour location, extent of surgical removal, genetic and epigenetic profile (MGMT, IDH1,etc) and postoperative treatments were recorded. We used Kaplan Meier method for the univariate analysis and the Cox regression for the multivariate one. Surgical strategy was always planned for a total tumour resection, when allowed by the intrinsic characteristics of the tumour using the so called “extracapsular “ technique. RESULTS: Overall median survival time after surgery was 10 months. At univariate analysis the gross total removal (p70 (p<0,0001) and radiotherapy (p<0,0001) improve survivals. Deep structures involved or multifocal lesions (p<0,0001) resulted as negative factors in term of the quod vitam prognosis, whereas lesions arising in insula, deep structures or in primary motor cortex worse the quod valitudinem

  9. SORAFENIB FOR OLDER PATIENTS WITH RENAL CELL CARCINOMA: SUBSET ANALYSIS FROM A RANDOMIZED TRIAL

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    T. Eisen

    2014-08-01

    Full Text Available Background. The perception that older cancer patients may be at higher risk than younger patients of toxic effects from cancer therapy but may obtain less clinical benefit from it may be based on the underrepresentation of older patients in clinical trials and the known toxic effects of cytotoxic chemotherapy. It is not known how older patients respond to targeted therapy.Methods.  This retrospective subgroup analysis of data from the phase 3, randomized Treatment Approach in Renal Cancer Global Evaluation Trial examined the safety and efficacy of sorafenib in older (age ≥ 70 years, n = 115 and younger patients (age <70 years, n = 787 who received treatment for advanced renal cell carcinoma. Patient demographics and progression-free survival were recorded. Best tumor response, clinical benefit rate (defined as complete response plus partial response plus stable disease, time to self-reported health status deterioration, and toxic effects were assessed by descriptive statistics. Health-related quality of life was assessed with a Cox proportion- al hazards model. Kaplan - Meier analyses were used to summarize time-to-event data.Results. Median progression-free survival was similar in sorafenib-treated younger patients (23.9 weeks; hazard ratio [HR] for progression compared with placebo = 0.55, 95% confidence interval [CI] = 0.47 to 0.66 and older patients (26.3 weeks; HR = 0.43, 95% CI = 0.26 to 0.69. Clinical benefit rates among younger and older sorafenib-treated patients were also similar (83.5% and 84.3%, respectively and were superior to those of younger and older placebo-treated patients (53.8% and 62.2%, respectively. Adverse events were predictable and manageable regardless of age. Sorafenib treatment delayed the time to self-reported health status deterioration among both older patients (121 days with sorafenib vs 85 days with placebo; HR = 0.66, 95% CI = 0.43 to 1.03 and younger patients (90 days with sorafenib vs 52 days with placebo

  10. SORAFENIB FOR OLDER PATIENTS WITH RENAL CELL CARCINOMA: SUBSET ANALYSIS FROM A RANDOMIZED TRIAL

    Directory of Open Access Journals (Sweden)

    T. Eisen

    2009-01-01

    Full Text Available Background. The perception that older cancer patients may be at higher risk than younger patients of toxic effects from cancer therapy but may obtain less clinical benefit from it may be based on the underrepresentation of older patients in clinical trials and the known toxic effects of cytotoxic chemotherapy. It is not known how older patients respond to targeted therapy.Methods.  This retrospective subgroup analysis of data from the phase 3, randomized Treatment Approach in Renal Cancer Global Evaluation Trial examined the safety and efficacy of sorafenib in older (age ≥ 70 years, n = 115 and younger patients (age <70 years, n = 787 who received treatment for advanced renal cell carcinoma. Patient demographics and progression-free survival were recorded. Best tumor response, clinical benefit rate (defined as complete response plus partial response plus stable disease, time to self-reported health status deterioration, and toxic effects were assessed by descriptive statistics. Health-related quality of life was assessed with a Cox proportion- al hazards model. Kaplan - Meier analyses were used to summarize time-to-event data.Results. Median progression-free survival was similar in sorafenib-treated younger patients (23.9 weeks; hazard ratio [HR] for progression compared with placebo = 0.55, 95% confidence interval [CI] = 0.47 to 0.66 and older patients (26.3 weeks; HR = 0.43, 95% CI = 0.26 to 0.69. Clinical benefit rates among younger and older sorafenib-treated patients were also similar (83.5% and 84.3%, respectively and were superior to those of younger and older placebo-treated patients (53.8% and 62.2%, respectively. Adverse events were predictable and manageable regardless of age. Sorafenib treatment delayed the time to self-reported health status deterioration among both older patients (121 days with sorafenib vs 85 days with placebo; HR = 0.66, 95% CI = 0.43 to 1.03 and younger patients (90 days with sorafenib vs 52 days with placebo

  11. Multivariate Analysis of the Factors Associated With Sexual Intercourse, Marriage, and Paternity of Hypospadias Patients.

    Science.gov (United States)

    Kanematsu, Akihiro; Higuchi, Yoshihide; Tanaka, Shiro; Hashimoto, Takahiko; Nojima, Michio; Yamamoto, Shingo

    2016-10-01

    Patients with hypospadias are treated surgically during childhood, which has the intention of enabling a satisfactory sexual life in adulthood. However, it is unclear whether patients with corrected hypospadias can lead a satisfactory sexual life and sustain a marital relationship and produce offspring. To evaluate factors associated with achievement of sexual intercourse, marriage, and paternity in patients with hypospadias who have reached adulthood. Self-completion questionnaires were mailed in April 2012 to patients with hypospadias at least 18 years old who had been treated at our institution during childhood from 1973 through 1998 by a single surgeon and the same surgical policy. Assessments included the International Prostate Symptom Score, the International Index for Erectile Function-5, and non-validated questions related to current social and physical status and sexual, marital, and paternity experiences. Candidate factors were extracted from patients' neonatal data, surgical findings and results, and current physical and social status obtained by the questionnaires. Candidate factors associated with heterosexual intercourse, marriage, and paternity experiences were analyzed using univariate and multivariate proportional hazard models and log-rank test of Kaplan-Meier curves. Of the 518 patients contacted, 108 (age = 18-50 years, median = 28 years) met the inclusion criteria. Two- and one-stage repairs were performed as the initial treatment in 79 and 12, respectively, and 17 of the analyzed cases were reoperations for patients initially treated elsewhere. Fifty-seven patients had the milder type (31 glandular, 26 penile), 36 had the proximal type (13 penoscrotal, 23 scrotal-perineal), and 15 had an unknown type. Multivariate analyses by Cox proportional hazard model and log-rank tests confirmed that experience of sexual intercourse was associated with the milder type of hypospadias (P = .025 and .0076 respectively), marriage was associated with stable

  12. Perioperative and long-term outcome of thymectomy for myasthenia gravis: comparison of surgical approaches and prognostic analysis

    Institute of Scientific and Technical Information of China (English)

    LIU Cheng-wu; LUO Meng; MEI Jian-dong; ZHU Yun-ke; PU Qiang; MA Lin; CHE Guo-wei

    2013-01-01

    Background Thymectomy is an established treatment for myasthenia gravis (MG),and video-assisted thoracoscopic surgery (VATS) thymectomy has become an acceptable surgical procedure.This study aimed to compare the results of VATS thymectomy and open thymectomy and to identify the prognostic factors after thymectomy.Methods The clinical data of 187 consecutive thymectomies performed between July 2000 and December 2009 were retrospectively reviewed; 75 open thymectomies and 112 VATS thymectomies.Clinical efficacy and variables influencing outcome were assessed by Kaplan-Meier survival curves and Cox proportional hazards regression analysis.Results The operative blood loss in the VATS group was significantly less than that in the open group ((62.14±55.43)ml vs.(137.87±165.25) ml,P <0.05).The postoperative crisis rate increased with the severity of preoperative MG and the prescription dose of anticholinesterase.Complete follow-up information of patients more than 12 months after the thymectomy was obtained on 151 cases,89 cases from the VATS group and 62 cases from the open group,with a mean follow-up period of 59.3 months,range from 12 to 117 months.Complete stable remission (CSR) was the end point for evaluation of the treatment results.The overall five-year CSR rate was 57.5% Two good prognostic factors were identified; preoperative prescription of anticholinesterase alone (P=0.035) and non-thymomatous MG (P=0.003).The five-year CSR rate of the ocular type of MG reached a high level of 67.4%.Conclusions Thymectomy can achieve good long-term CSR in MG,and VATS is an ideal alternative method.High-dose prescription of anticholinesterase and the advanced stage by Myasthenia Gravis Foundation of America (MGFA) classification have higher risks of postoperative crisis.Preoperative prescription of anticholinesterase alone and non-thymomatous MG are good prognostic factors.Thymectomy should also be considered for the ocular type of MG.

  13. The Impact of Normal Range of Serum Phosphorus on the Incidence of End-Stage Renal Disease by A Propensity Score Analysis.

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    Wen Xiu Chang

    Full Text Available Although hyperphosphatemia is deemed a risk factor of the progression of chronic kidney disease (CKD, it remains unclear whether the normal range of serum phosphorus likewise deteriorates CKD. A propensity score analysis was applied to examine the causal effect of the normal range of serum phosphorus on the incidence of end-stage renal disease (ESRD.A retrospective CKD cohort of 803 participants in a single institution was analyzed. Propensity score was estimated using 22 baseline covariates by multivariate binary logistic regression for the different thresholds of time-averaged phosphorus (TA-P in the normal range of serum phosphorus incremented by 0.1 mg/dL from 3.3 to 4.5 mg/dL.The incidence rate of ESRD was 33.9 per 1,000 person-years over median follow-up of 4.3 years. Total patients showed the mean baseline phosphorus of 3.37 mg/dL and were divided to quartile. The higher quartile was associated with the parameters consistent with the advancement of CKD. A stratified Cox regression showed the highest hazard ratio (HR at TA-P 3.4 mg/dL (HR 17.60, 95% CI 3.92-78.98 adjusted for baseline covariates such as sex, age, diabetic nephropathy, estimated GFR, serum albumin, Na-Cl, phosphorus, LDL-C and proteinuria. Adjusted HRs remained high up to TA-P 4.2 mg/dL (HR 2.22, 95% CI 1.33-3.71. After propensity score matching conducted at the thresholds of TA-P 3.4, 3.6, 3.8 and 4.0 mg/dL, the higher levels of TA-P showed the higher HRs by Kaplan-Meier analysis (p < 0.05 by stratified log-rank test. The numbers needed to treat were calculated as 3.9 to 5.3 over 5 years.The propensity score analysis shows that even the normal range of serum phosphorus clearly accelerates CKD progression to ESRD. Our results encourage clinicians to target serum phosphorus to inhibit CKD progression in the manner of 'the lower the better.'

  14. TSAP6在胃癌组织中的表达及预后分析%TSAP6 expression in gastric cancer and prognostic analysis

    Institute of Scientific and Technical Information of China (English)

    初侃; 李医明; 朱海峰; 冷晗; 蔡相军

    2013-01-01

    Objective:To investigate the clinical significance of tumor suppressor-activated pathway 6 (TSAP6)expression in gastric cancers and its prognostic impact.Methods:The expression of TSAP6 in 128 paired gastric cance specimens including adjacent normal tissues were detected by real-time PCR,Western-blot and immunohistochemical (IHC)method.The relationship among the TSAP6 expression,pathological data and prognostic factors were analyzed.Results..In univariate analysis,the TSAP6 expression in gastric cancer patients with distant metastasis,invasive organs,lymph node metastasis and surgical methods were significantly different(P < 0.05),not with gender,age,tumor size,number,medical history,family history and the pathological type.TSAP6 was an independent prognostic factor in gastric cancer by Kaplan-Meier survival analysis,logistic regression analysis and Cox regression model.Conclusion:Low TSAP6 expression in gastric cancer is associated with unfavorable prognosis.It may play an important role in gastric carcinogenesis.%目的:探讨抑癌基因激活途径-6(tumor suppressor-activated pathway 6,TSAP6)在胃癌中的表达及临床意义.方法:应用实时荧光定量PCR(Real time PCR)、Western blot和免疫组化方法检测128例胃癌组织及其癌旁组织中TSAP6表达情况,并对临床病理资料和预后因素进行分析比较.结果:单因素分析显示:TSAP6的表达与胃癌患者的远处转移、合并其他脏器转移、淋巴结转移及手术方式密切相关(P<0.05),而与性别、年龄、肿瘤大小、肿瘤数目、既往史、家族史和病理分型无关.在Kaplan-Meier生存分析、Logistic回归分析及Cox回归模型中,TSAP6是胃癌预后的独立因素.结论::TSAP6低表达水平的胃癌患者预后差,并对肿瘤发生、发展起重要作用.

  15. Relativity Concept Inventory: Development, Analysis, and Results

    Science.gov (United States)

    Aslanides, J. S.; Savage, C. M.

    2013-01-01

    We report on a concept inventory for special relativity: the development process, data analysis methods, and results from an introductory relativity class. The Relativity Concept Inventory tests understanding of relativistic concepts. An unusual feature is confidence testing for each question. This can provide additional information; for example,…

  16. Relativity Concept Inventory: Development, Analysis, and Results

    Science.gov (United States)

    Aslanides, J. S.; Savage, C. M.

    2013-01-01

    We report on a concept inventory for special relativity: the development process, data analysis methods, and results from an introductory relativity class. The Relativity Concept Inventory tests understanding of relativistic concepts. An unusual feature is confidence testing for each question. This can provide additional information; for example,…

  17. Prognostic factors of analysis on patients with nonoperative treatment of intracerebral hemorrhage in basal ganglia%非手术治疗自发性基底节区脑出血预后因素分析

    Institute of Scientific and Technical Information of China (English)

    周焜; 黄冠又; 梁郸; 乔志立; 陈冲; 王恒福; 饶正西; 王诚; 卓志平

    2013-01-01

    Objective To investigate the factors influencing prognosis of nonoperative treatment of intracerebral hemorrhage in basal ganglia. Methods The clinical data and survival status of 109 patients with intracerebral hemorrhage in basal ganglia who were admitted to Neurosurgery of Guiyang Second People' s Hospital during the period from April 2005 to June 2012 were reviewed retrospectively. The survival analysis was analyzed with Kaplan-Meier method. The univariate analysis was used to determine the prognositic factors related with survival rate by Log-rank test. Multivariate factors for the survival rates were analyzed using the Cox proportional hazards regression model. Results Univariate analysis revealed that GOS scale, GCS scale, hypertension, hemorrhage volume, intraventricu-lar hemorrhage, pulmonary infection and glucose were the factors influencing prognostic factors of hypertensive brainstem hemorrhage. Multivariate analysis showed that GCS scale, hemorrhage volume and glucose were independent prognostic factors. Conclusions GCS scale, hemorrhage volume and glucose were important prognostic factors of intracerebral hemorrhage in basal ganglia.%目的 探讨非手术治疗自发性基底节区出血预后相关的因素.方法 回顾性分析贵阳市第二人民医院神经外科2005年4月至2012年6月收治的109例随访资料完整的患者,采用Kaplan-Meier法进行单因素分析.Log-rank法进行生存率显著性检验,Cox比例风险回归模型作多因素分析.结果 单因素分析显示入院时GOS评分、GCS评分、高血压、出血量、出血破入脑室、肺部感染及血糖与预后有关联.多因素分析显示GCS评分、出血量和血糖是自发性基底节区出血预后相关的独立危险因素.结论 发病时GCS评分、出血量和血糖水平是影响患者预后的重要因素.

  18. Application of Parametric Models of Survival Analysis in Determining the Cancer Influencing Factors in Patients with Thyroid Nodules

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    J Yazdani Charati

    2015-06-01

    Full Text Available Background & aim: One of the most common clinical problems among individuals is thyroid nodule diseases which are characterized by one or more nodules in the thyroid and are usually benign. It can be said that thyroid cancer is the most common endocrine cancer worldwide. This study aimed to determine the risk factors for cancer in patients with thyroid nodule in Mazandaran province,Iran, using parametric survival analysis. Methods: In the present historical cohort study, 26,730 patients with thyroid nodules who were referred to health care centers from July 2002 to March 2008 were identified. Parametric log-normal and log-logistic models were compared with and without taking frailty into account. The criterion for comparing models was Akaike's criterion. All calculations were performed with the SPSS software and the significance level was considered 0.05. Results: The mean time of the conversion of thyroid nodules to cancer in patients was found to be 29.32 months. Using Kaplan-Meier method, survival rates of one year, five years and ten years of nodule conversion to cancer was calculated 94.6, 88.6 and respectively. According to the log rank test age (p=0.03, hypothyroidism (p=0.01, bilateral nodules (p <0.001, a multi-nodular goiter (p <0.001, TSH hormone (p <0.001, T4 hormones (p = 0.005, cholesterol (p = 0.03, creatinin levels (p = 0.001 a significant relationship was seen. Based on the Akaike's criterion, the lognormal model which takes frailty into account best fits to the data. Conclusion: Based on the log-normal model with frailty, It can be concluded that the thyroid nodule patients with abnormal TSH hormone are 6.55 times more likely to develop risk of thyroid cancer than patients who had normal TSH hormone overall. This model also indicated that patients who had heart palpitations are 5.52 times more likely to develop risk of cancer than patients who did not have heart palpitations.

  19. Dose-Volume Analysis of Predictors for Gastrointestinal Toxicity After Concurrent Full-Dose Gemcitabine and Radiotherapy for Locally Advanced Pancreatic Adenocarcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Huang Jiayi [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Robertson, John M., E-mail: jrobertson@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Ye Hong [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Margolis, Jeffrey; Nadeau, Laura [Division of Medical Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Yan Di [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)

    2012-07-15

    Purpose: To identify dosimetric predictors for the development of gastrointestinal (GI) toxicity in patients with locally advanced pancreatic adenocarcinoma (LAPC) treated with concurrent full-dose gemcitabine and radiotherapy (GemRT). Methods and Materials: From June 2002 to June 2009, 46 LAPC patients treated with definitive GemRT were retrospectively analyzed. The stomach and duodenum were retrospectively contoured separately to determine their dose-volume histogram (DVH) parameters. GI toxicity was defined as Grade 3 or higher GI toxicity. The follow-up time was calculated from the start of RT to the date of death or last contact. Univariate analysis (UVA) and multivariate analysis (MVA) using Kaplan-Meier and Cox regression models were performed to identify risk factors associated with GI toxicity. The receiver operating characteristic curve and the area under the receiver operating characteristic curve (AUC) were used to determine the best DVH parameter to predict for GI toxicity. Results: Of the patients, 28 (61%) received concurrent gemcitabine alone, and 18 (39%) had concurrent gemcitabine with daily erlotinib. On UVA, only the V{sub 20Gy} to V{sub 35Gy} of duodenum were significantly associated with GI toxicity (all p {<=} 0.05). On MVA, the V{sub 25Gy} of duodenum and the use of erlotinib were independent risk factors for GI toxicity (p = 0.006 and 0.02, respectively). For the entire cohort, the V{sub 25Gy} of duodenum is the best predictor for GI toxicity (AUC = 0.717), and the 12-month GI toxicity rate was 8% vs. 48% for V{sub 25Gy} {<=} 45% and V{sub 25Gy} > 45%, respectively (p = 0.03). However, excluding the erlotinib group, the V{sub 35Gy} is the best predictor (AUC = 0.725), and the 12-month GI toxicity rate was 0% vs. 41% for V{sub 35Gy} {<=} 20% and V{sub 35Gy} > 20%, respectively (p = 0.04). Conclusions: DVH parameters of duodenum may predict Grade 3 GI toxicity after GemRT for LAPC. Concurrent use of erlotinib during GemRT may increase GI

  20. Mid-term results after implantation of rotating-hinge knee prostheses: primary versus revision

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    Turgay Efe

    2012-12-01

    Full Text Available The aim of the study was to evaluate the mid-term clinical results and survivorship of a rotating-hinge knee prosthesis (LINK® Endo-Model in difficult primary and complex revision situations. Results after primary implantation were compared with those of revision procedures. Forty-nine prostheses in 45 patients were reviewed clinically during follow up. Twenty-one of these were implanted in primary and 28 in revision situations. Outcome was evaluated using commonly used scores (Knee Society, UCLA Activity, Lequesne and a visual analog scale after a mean follow up of 56±37 months for 49 prostheses. Implant survival was analyzed using the Kaplan-Meier method. There were no significant differences in clinical examination and evaluation scores between the two groups (P>0.05. Survival rates at final follow up were 95% after primary implantation and 76% in revision procedures. The risk of prosthesis loss (odds ratio 5.7 was significantly higher after revision procedures (P=0.004. These data suggest that rotating-hinge knee prostheses provided good clinical and functional results in selected cases of advanced primary gonarthrosis associated with severe bone loss, ligamentous instability or comminuted fractures. They also provide good results in revision situations. However, the failure rate was significantly higher in cases of revision surgery.

  1. Early and midterm results of kissing stent technique in the management of aortoiliac obstructive disease.

    Science.gov (United States)

    Pulli, Raffaele; Dorigo, Walter; Fargion, Aaron; Angiletta, Domenico; Azas, Leonidas; Pratesi, Giovanni; Alessi Innocenti, Alessandro; Pratesi, Carlo

    2015-04-01

    To retrospectively analyze the early and the midterm results of endovascular management of aortoiliac obstructive disease with the kissing stent technique. From January 2005 to September 2012, 229 consecutive endovascular interventions for aortoiliac obstructive disease were performed; data from all the interventions were prospectively collected in a dedicated database. In 41 patients, the kissing stent technique at the level of aortic bifurcation was performed (group 1), whereas in the remaining 188 it was not (group 2). Perioperative results were compared with chi-squared test. Follow-up results were analyzed with Kaplan-Meier curves and compared with log-rank test. Trans-Atlantic Inter-Society Consensus II C and D lesions were present in 66% of patients in group 1 and in 28.5% in group 2 (P kissing stent technique provided satisfactory results in patients with obstructive aortoiliac diseases, without an increase in immediate and midterm complications, representing an effective solution in complex anatomies. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Blind analysis results of the TWIST experiment

    CERN Document Server

    Hillairet, A; Bueno, J F; Davydov, Y I; Depommier, P; Faszer, W; Fujiwara, M C; Gagliardi, C A; Gaponenko, A; Grossheim, A; Gill, D R; Gumplinger, P; Hasinoff, M D; Henderson, R S; Hu, J; Koetke, D D; MacDonald, R P; Marshall, G M; Mathie, E W; Mischke, R E; Olchanski, K; Olin, A; Openshaw, R; Poutissou, J -M; Poutissou, R; Selivanov, V; Sheffer, G; Shin, B; Stanislaus, T D S; Tacik, R; Tribble, R E

    2010-01-01

    The TRIUMF Weak Interaction Symmetry Test (TWIST) experiment was designed to test the standard model at high precision in the purely leptonic decay of polarized muons. A general four-fermion interaction model is used to describe the muon decay. TWIST measures three of the four muon decay parameters of this model, $\\rho$, $\\delta$ and $P_{\\mu}^{\\pi} \\xi$, from the shape of the momentum-angle spectrum. The results of this model independent approach are compared to the standard model predictions and used to constrain new physics. Our collaboration has finalized the blind analysis of the final experimental data taken in 2006 and 2007. This analysis mostly reached our goal of a precision of an order of magnitude improvement over the pre-TWIST measurements.

  3. Breastfeeding training for health professionals and resultant changes in breastfeeding duration

    Directory of Open Access Journals (Sweden)

    José Augusto de Aguiar Carrazedo Taddei

    2000-11-01

    Full Text Available CONTEXT: Promotion of breastfeeding in Brazilian maternity hospitals. OBJECTIVE: To quantify changes in the breastfeeding duration among mothers served by hospitals exposed to the Wellstart-SLC course, comparing them with changes among mothers attended by institutions not exposed to this course. DESIGN: Randomized Institutional Trial. SETTING: The effects of training on breastfeeding duration was assessed in eight Brazilian hospitals assigned at random to either an exposed group (staff attending the Wellstart-SLC course or a control group. SAMPLE: For each of the eight study hospitals, two cohorts of about 50 children were visited at home at one and six months after birth. The first cohort (n = 494 was composed of babies born in the month prior to exposure to the Wellstart-SLC course, and the second cohort (n = 476 was composed of babies born six months subsequent to this exposure. MAIN MEASUREMENTS: Kaplan-Meier curves were plotted to describe the weaning process and log-rank tests were used to assess statistical differences among survival curves. Hazard ratio (HR estimates were calculated by fitting Cox proportional hazard regression models to the data. RESULTS: The increases in estimated, adjusted rates for children born in hospitals with trained personnel were 29% (HR = 0.71 and 20% (HR = 0.80 for exclusive and full breastfeeding, respectively. No changes were identified for total breastfeeding. CONCLUSION: This randomized trial supports a growing body of evidence that training hospital health professionals in breastfeeding promotion and protection results in an increase in breastfeeding duration.

  4. Results after surgical treatment of liver metastases in patients with high-grade gastroenteropancreatic neuroendocrine carcinomas

    DEFF Research Database (Denmark)

    Galleberg, R. B.; Knigge, U; Tiensuu Janson, E.

    2017-01-01

    . The aim of this study was to evaluate the results of curatively intended resection/radiofrequency ablation (RFA) of liver metastases in patients with metastatic GEP-NEC. Methods: 32 patients with a diagnosis of high-grade gastroenteropancreatic neuroendocrine neoplasm (Ki-67 > 20%) and with intended...... curative resection/RFA of liver metastases, were identified among 840 patients from two Nordic GEP-NEC registries. Tumor morphology (well vs poor differentiation) was reassessed. Overall survival (OS) and progression-free survival (PFS) was assessed by Kaplan-Meier analyses for the entire cohort...... and for subgroups. Results: Median OS after resection/RFA of liver metastases was 35.9 months (95%-CI: 20.6-51.3) with a five-year OS of 43%. The median PFS was 8.4 months (95%-CI: 3.9-13). Four patients (13%) were disease-free after 5 years. Two patients had well-differentiated morphology (NET G3) and 20 patients...

  5. Repetitive transarterial chemoembolization (TACE) of liver metastases from renal cell carcinoma: Local control and survival results

    Energy Technology Data Exchange (ETDEWEB)

    Nabil, Mohamed [Johann Wolfgang Goethe University, Institute of Diagnostic and Interventional Radiology, Frankfurt am Main (Germany); Klinikum der Johann Wolfgang Goethe-Universitaet, Institut fuer Diagnostische und Interventionelle Radiologie, Frankfurt am Main (Germany); Gruber, Tatjana; Zangos, Stephan; Vogl, Thomas J. [Johann Wolfgang Goethe University, Institute of Diagnostic and Interventional Radiology, Frankfurt am Main (Germany); Yakoub, Danny [Imperial College London, St Mary' s Hospital, Department of Biosurgery and Surgical Technology, London (United Kingdom); Ackermann, Hanns [Johann Wolfgang Goethe University, Department of Biostatistics and Medical Information, Frankfurt am Main (Germany)

    2008-07-15

    The purpose was to evaluate the effectiveness of transarterial chemoembolization (TACE) in local tumor control and survival in patients with hepatic metastases from renal cell carcinoma (RCC). Prospective evaluation of TACE treatment outcome in 22 patients recruited from 1999 and 2005 was performed. The chemotherapeutic agent used was mitomycin only in 45% of the patients and mitomycin together with gemcitabine in the other 55%. The embolizing materials used in all of the patients were iodized oil (lipiodol) and degradable starch microspheres. Local response was evaluated by MRI and judged according to Response Evaluation Criteria in Solid Tumors (RECIST). Mean and median survival and survival probability after diagnosis and treatment were both calculated by Kaplan-Meier method. Partial response was achieved in 13.7%, stable disease in 59% and progressive disease in 27.3% of patients. Survival time from the diagnosis of metastases ranged from 18 to 307 months and from 2.2 to 35 months from the start of TACE treatment. The median and mean survival times from the date of diagnosis were 68.6 and 102.9 months, respectively. The median and mean survival times from the start of TACE were 8.2 and 11.7 months, respectively. Survival probability from the start of treatment was 31% after 1 year and 6% after 2 years. TACE can result in a favorable local tumor response in patients with hepatic metastases from RCC, but survival results are still limited. (orig.)

  6. HULC and H19 Played Different Roles in Overall and Disease-Free Survival from Hepatocellular Carcinoma after Curative Hepatectomy: A Preliminary Analysis from Gene Expression Omnibus

    Directory of Open Access Journals (Sweden)

    Zongguo Yang

    2015-01-01

    Full Text Available Objective. This study aimed to evaluate the relationships between long noncoding RNAs (lncRNAs in tumor tissues and hepatocellular carcinoma (HCC aggressiveness and survival. Methods. We correlated the lncRNAs in tumor tissues with HCC survival and clinicopathological features based on Gene Expression Omnibus expression profile GSE36376. Results. Eight lncRNAs and 240 HCC patients were included. Cox regression analysis indicated that HULC was a positive factor for HCC overall survival (HR = 0.885, 95% CI = 0.797–0.983, and P=0.023 and disease-free survival time (HR = 0.913, 95% CI = 0.835–0.998, and P=0.045. H19 and UCA1 were both demonstrated to be risk factors of HCC disease-free survival in multivariate Cox model (HR = 1.071, 95% CI = 1.01–1.137, and P=0.022 and HR = 2.4, 95% CI = 1.092–5.273, and P=0.029, resp.. But Kaplan-Meier method showed no significant association between UCA1 and HCC disease-free survival (log rank P=0.616. Logistic regression demonstrated that H19 was overexpressed in HBV-infected patients (OR = 1.14, 95% CI = 1.008–1.29, and P=0.037. HULC had a significant association with vascular invasion (OR = 0.648, 95% CI = 0.523–0.803, and P<0.001. H19 and MEG3 were both considered to be risk factors for high AFP level (OR = 1.45, 95% CI = 1.277–1.646, and P<0.001 and OR = 1.613, 95% CI = 1.1–2.365, and P=0.014, resp.. Conclusions. Contributing to decreased susceptibility to vascular invasion, upregulation of HULC in tumor tissues was positively associated with HCC survival. In contrast, H19 overexpression might be risk factor for HCC aggressiveness and poor outcomes.

  7. Hemithoracic Intensity Modulated Radiation Therapy After Pleurectomy/Decortication for Malignant Pleural Mesothelioma: Toxicity, Patterns of Failure, and a Matched Survival Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Chance, William W. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Rice, David C. [Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Allen, Pamela K. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Tsao, Anne S. [Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Fontanilla, Hiral P. [Princeton Radiation Oncology, Monroe Township, New Jersey (United States); Liao, Zhongxing; Chang, Joe Y.; Tang, Chad; Pan, Hubert Y.; Welsh, James W. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Mehran, Reza J. [Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Gomez, Daniel R., E-mail: dgomez@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2015-01-01

    Purpose: To investigate safety, efficacy, and recurrence after hemithoracic intensity modulated radiation therapy after pleurectomy/decortication (PD-IMRT) and after extrapleural pneumonectomy (EPP-IMRT). Methods and Materials: In 2009-2013, 24 patients with mesothelioma underwent PD-IMRT to the involved hemithorax to a dose of 45 Gy, with an optional integrated boost; 22 also received chemotherapy. Toxicity was scored with the Common Terminology Criteria for Adverse Events v4.0. Pulmonary function was compared at baseline, after surgery, and after IMRT. Kaplan-Meier analysis was used to calculate overall survival (OS), progression-free survival (PFS), time to locoregional failure, and time to distant metastasis. Failures were in-field, marginal, or out of field. Outcomes were compared with those of 24 patients, matched for age, nodal status, performance status, and chemotherapy, who had received EPP-IMRT. Results: Median follow-up time was 12.2 months. Grade 3 toxicity rates were 8% skin and 8% pulmonary. Pulmonary function declined from baseline to after surgery (by 21% for forced vital capacity, 16% for forced expiratory volume in 1 second, and 19% for lung diffusion of carbon monoxide [P for all = .01]) and declined still further after IMRT (by 31% for forced vital capacity [P=.02], 25% for forced expiratory volume in 1 second [P=.01], and 30% for lung diffusion of carbon monoxide [P=.01]). The OS and PFS rates were 76% and 67%, respectively, at 1 year and 56% and 34% at 2 years. Median OS (28.4 vs 14.2 months, P=.04) and median PFS (16.4 vs 8.2 months, P=.01) favored PD-IMRT versus EPP-IMRT. No differences were found in grade 4-5 toxicity (0 of 24 vs 3 of 24, P=.23), median time to locoregional failure (18.7 months vs not reached, P not calculable), or median time to distant metastasis (18.8 vs 11.8 months, P=.12). Conclusions: Hemithoracic intensity modulated radiation therapy after pleurectomy/decortication produced little high-grade toxicity but

  8. Charm Dalitz Plot Analysis Formalism and Results

    CERN Document Server

    Asner, David M

    2004-01-01

    Charm meson decay dynamics have been studied extensively over the last decade. We describe the Dalitz-plot analysis technique which has been applied by many experiments to three-body D0, D+ and Ds decays. We discuss experimental results from Mark II, Mark III, E687, E691, ARGUS, E791, FOCUS, CLEO and BABAR. These studies probe a variety of physics including doubly-Cabibbo suppressed decays, searches for CP violation, the properties of established light mesons and the properties of pipi and Kpi S-wave states.

  9. EXPENDITURE ANALYSIS - PRE DIAGNOSIS COMPANY RESULTS

    Directory of Open Access Journals (Sweden)

    Ștefăniță, ȘUȘU

    2014-11-01

    Full Text Available In many fields of activity the most concrete form under which the competitive fight is carried on is the so-called "price war". In this case, the only form of long-term survival is to reduce the operational costs. Therefore, the accurate knowledge of the costs' level, of their training places and their size in the case of the competitors are vital to the company's management. In the literature, in order to achieve the analysis of the costs' effectiveness, there are used a series of indicators of which the most representative, regardless of the level at which it is determined, is "the average costs" on the basis of which it is realized the analysis from 2012-2013. The theoretical concepts presented in a logical sequence are combined with the practical ones, the source of information representing a profit and loss account of the company Turism Covasna (listed on the Stock Exchange, Bucharest. The results of the analysis are interpreted while trying to formulate some solutions to the economic and financial viability of the entity.

  10. Analysis of the unicompartmental knee arthroplasty results

    Directory of Open Access Journals (Sweden)

    S. A. Firsov

    2015-01-01

    Full Text Available In 2012-2014 total 67 unicompartmental arthroplasty surgeries with use of Oxford knee meniscal bearing were performed. The surgeries were performed by a single surgeon. Minimally invasive approach was used. All patients were evaluated clinically, radiographically and with Oxford Knee score scale, Knee Society score scale and functional scale. Obtained data was processed with nonparametric Mann-Whitney-Wilcoxon test. Results were processed using the statistical analysis application package SPSS, version 10.07. Analysis of of mid-term results showed that the average for Oxford Knee score increased from 16.4 (95% CI 9-23 to 41.3 (95% CI 29-47. Average for Knee Society score scale increased from 42.7 (95% CI 31-55 to 88.6 (95% CI 73-100. No occurrence of early postoperative complications have been reported. Statistically significant improvements of knee function in patients after unicompartmental arthroplasty have been observed. Unicompartmental arthroplasty currently can be considered as an advanced treatment option for medial knee joint pathology. Meniscal bearing cemented prostheses such as Oxford III are preferable.

  11. Long-term carcinologic results of advanced esthesioneuroblastoma: a systematic review.

    Science.gov (United States)

    De Bonnecaze, Guillaume; Lepage, B; Rimmer, J; Al Hawat, A; Vairel, B; Serrano, E; Chaput, B; Vergez, S

    2016-01-01

    Surgical resection followed by radiotherapy can be considered like the optimal treatment modality for limited esthesioneuroblastoma. However, therapeutic management of locally advanced tumors remains a challenge. The aim of our study was to access and compare the oncologic results of the different treatment modalities in advanced esthesioneuroblastoma. We performed a systematic review using the Medline, and Cochrane database in accordance with PRISMA criteria and included all the cases of advanced esthesioneuroblastoma published between 2000 and 2013. We also retrospectively included 15 patients with an advanced esthesioneuroblastoma managed at our tertiary care medical center. Long-term survival rates defined as the time from diagnosis or randomization to the date of death or last follow-up were evaluated for each treatment with Kaplan-Meier survival curve analyses. 283 patients have been included. The mean follow-up was 78 months. Five-year highest survival rates were obtained in patients treated by surgery associated with radiotherapy. Ten-year highest survival rates were obtained in patients treated by the association of surgery, radiotherapy and chemotherapy (p = 0.0008). Within the surgical group, 5-year highest survival rates were obtained in patients treated by endoscopic resection (p = 0.003). Surgical resection combined with radiotherapy offers the gold standard of care. Adjuvant chemotherapy seems to improve the long-term survival in patients with locally advanced esthesioneuroblastoma. Endoscopic resection in advanced tumors should be discussed on a case-by-case basis.

  12. Yttrium-90 radioembolization for the treatment of unresectable liver cancer: Results of a single center

    Directory of Open Access Journals (Sweden)

    Özhan Özgür

    2014-03-01

    Full Text Available Objective: To determine the effects of yttrium-90 (Y-90 resin microsphere radioembolization therapy on patients with unresectable liver cancer who do not benefit from chemotherapy. Methods: Fifty-five patients underwent radioembolization therapy included in the study whose had unresectable primary or metastatic liver cancer originating from the gastrointestinal tract. Three were excluded from the study after pre-evaluation angiography. Thirteen (23.6% of the remaining 52 patients had hepatocellular carcinoma and 39 (76.4% had metastatic liver cancer. Fifty-two patients underwent Y-90 radioembolization treatment. Each patient's response to the administered treatment was evaluated using the Response Evaluation Criteria in Solid Tumors (RECIST and the overall probability of survival was displayed graphically by the Kaplan-Meier method. Results: After Y-90 therapy, 47 patients were follow-up. While 57% of the patients responded to treatment as clinical benefit, the disease progressed in 43%. The median hepatic progression-free survival time of the patients was 3.4 months (95% confidence interval (ci:1.4-5.3 and the overall survival time was 11.3 months (95%, CI:8.7-14.03. Conclusion: This study emphasizes that Y-90 resin microsphere radioembolization treatment is effective in patients with unresectable liver cancer.

  13. Autophagy analysis in oral carcinogenesis.

    Science.gov (United States)

    de Lima, T B; Paz, A H R; Rados, P V; Leonardi, R; Bufo, P; Pedicillo, M C; Santoro, A; Cagiano, S; Aquino, G; Botti, G; Pannone, G; Visioli, F

    2017-09-01

    The aim of this study was to evaluate the levels of autophagy in oral leukoplakia and squamous cell carcinoma and to correlate with clinical pathological features, as well as, the evolution of these lesions. 7 Normal oral mucosa, 51 oral leukoplakias, and 120 oral squamous cell carcinomas (OSCC) were included in the study. Histological sections of the mucosa and leukoplakias were evaluated throughout their length, while the carcinomas were evaluated using Tissue Microarray. After the immunohistochemical technique, LC3-II positive cells were quantified in the different epithelial layers of the mucosa and leukoplakias and in the microarrays of the squamous cell carcinomas. The correlation between positive cells with the different clinical-pathological variables and with the evolution of the lesions was tested using the t test, ANOVA, and Kaplan-Meier survival analysis. We observed increased levels of autophagy in the oral squamous cell carcinomas (p<0.001) in relation to the other groups, but without any association with poorer evolution or survival of these patients. Among the leukoplakias, we observed a higher percentage of positive cells in the intermediate layer of the dysplastic leukoplakias (p=0.0319) and in the basal layer of lesions with poorer evolution (p=0.0133). The levels of autophagy increased during the process of oral carcinogenesis and are correlated with poorer behavior of the leukoplakias. Copyright © 2017 Elsevier GmbH. All rights reserved.

  14. Geothermal industry employment: Survey results & analysis

    Energy Technology Data Exchange (ETDEWEB)

    2005-09-01

    The Geothermal Energy Association (GEA) is ofteh asked about the socioeconomic and employment impact of the industry. Since available literature dealing with employment involved in the geothermal sector appeared relatively outdated, unduly focused on certain activities of the industry (e.g. operation and maintenance of geothermal power plants) or poorly reliable, GEA, in consultation with the DOE, decided to conduct a new employment survey to provide better answers to these questions. The main objective of this survey is to assess and characterize the current workforce involved in geothermal activities in the US. Several initiatives have therefore been undertaken to reach as many organizations involved in geothermal activities as possible and assess their current workforce. The first section of this document describes the methodology used to contact the companies involved in the geothermal sector. The second section presents the survey results and analyzes them. This analysis includes two major parts. The first part analyzes the survey responses, presents employment numbers that were captured and describes the major characteristics of the industry that have been identified. The second part of the analysis estimates the number of workers involved in companies that are active in the geothermal business but did not respond to the survey or could not be reached. Preliminary conclusions and the study limits and restrictions are then presented. The third section addresses the potential employment impact related to manufacturing and construction of new geothermal power facilities. Indirect and induced economic impacts related with such investment are also investigated.

  15. Recent ADI iteration analysis and results

    Energy Technology Data Exchange (ETDEWEB)

    Wachspress, E.L.

    1994-12-31

    Some recent ADI iteration analysis and results are discussed. Discovery that the Lyapunov and Sylvester matrix equations are model ADI problems stimulated much research on ADI iteration with complex spectra. The ADI rational Chebyshev analysis parallels the classical linear Chebyshev theory. Two distinct approaches have been applied to these problems. First, parameters which were optimal for real spectra were shown to be nearly optimal for certain families of complex spectra. In the linear case these were spectra bounded by ellipses in the complex plane. In the ADI rational case these were spectra bounded by {open_quotes}elliptic-function regions{close_quotes}. The logarithms of the latter appear like ellipses, and the logarithms of the optimal ADI parameters for these regions are similar to the optimal parameters for linear Chebyshev approximation over superimposed ellipses. W.B. Jordan`s bilinear transformation of real variables to reduce the two-variable problem to one variable was generalized into the complex plane. This was needed for ADI iterative solution of the Sylvester equation.

  16. Non-Invasive Ventilation in HIV Positive patients with Sepsis and ...

    African Journals Online (AJOL)

    46987.2

    review of 385 folders, every 5thfile was selected as comparator group. .... Depending on patient responses, the oxygen flow rates were adjusted from between ... Kaplan-Meier plots using log rank test for between-group comparison. RESULTS.

  17. 生活方式对胃癌根治术患者预后的多因素研究%Multivariate analysis of lifestyle factors on the prognosis of gastric cancer after radical resection

    Institute of Scientific and Technical Information of China (English)

    李文琦; 黄水平

    2012-01-01

    目的 探讨胃癌根治术后患者的饮食、生活行为方式及心理等多方面因素对患者预后的影响.方法 用回顾性随访方法,调查某市各大医院行胃癌根治性切除术的患者术后的饮食、生活行为方式及心理因素等.采用Kaplan-Meier法计算生存率,Log-Rank时序检验进行单因素分析,比例风险模型(Cox模型)进行多因素分析比较.结果 胃癌根治术患者1、3、5年生存率分别为80.6%、49.5%、35.5%;吸烟习惯、睡眠状况、体育锻炼、爱人对患者病情的了解程度4项因素成为根治术后胃癌患者独立的预后因素.结论 胃癌患者术后戒烟、良好的睡眠状况、规律的体育锻炼习惯及良好的社会支持状况可改善患者的预后,延长其生存时间.%OBJECTIVE To explore the factors that includes dietary, lifestyle and psychological habits related to the prognosis of gastric cancer after radical resection. METHODS 156 patients underwent radical excision were recruited from three large hospitals in a city. The patients' diet, lifestyle and psychological habits were followed from May 2010 to May 2010. Survival rate was calculated by using Kaplan-Meier method. Log-rank test and proportional-hazards regression model (Cox model) were used for univariate and multivariate analysis. RESULTS One-year, three-year and five-year survival rates were 80.6%, 49.5% and 35.5%, respectively. Smoking habits, sleep, psychological habits and support from the patients' spouse were the independent prognostic factors. CONCLUSION Quit smoking, good sleep, regular physical exercise, and social support of gastric cancer after radical resection can improve the prognosis and prolong survival time.

  18. Intermediate to long-term results following the Bernese periacetabular osteotomy and predictors of clinical outcome.

    Science.gov (United States)

    Matheney, Travis; Kim, Young-Jo; Zurakowski, David; Matero, Catherine; Millis, Michael

    2009-09-01

    The Bernese periacetabular osteotomy is a commonly used non-arthroplasty option to treat developmental hip dysplasia in symptomatic younger patients. Predicting which hips will remain preserved and which hips will go on to require arthroplasty following periacetabular osteotomy is a major challenge. In the present study, we assessed the intermediate to long-term results following periacetabular osteotomy to demonstrate the clinical outcomes for patients with varying amounts of dysplasia and arthritis. From these results, a probability-of-failure analysis was conducted to predict the likelihood of hip preservation and to improve surgical decision-making. Of the 189 hips (in 157 patients) that were treated with periacetabular osteotomy by a single surgeon from May 1991 to September 1998, thirty-one had diagnoses other than developmental hip dysplasia and twenty-three were lost to follow-up. The remaining 135 hips (in 109 patients) were retrospectively reviewed at an average of nine years. Hips were evaluated with use of the pain subscale of the Western Ontario and McMaster Universities Osteoarthritis Index postoperatively as well as with radiographs that were made preoperatively and at one and more than five years postoperatively. Osteotomy failure was defined as a pain score of >or=10 or the need for total hip arthroplasty. One hundred and two hips (76%) remained preserved at an average of nine years, with an average Western Ontario and McMaster Universities pain score of 2.4 of 20. Thirty-three hips (24%) met the failure criteria: seventeen underwent arthroplasty at an average of 6.1 years after the osteotomy, and sixteen had a postoperative pain score of >or=10. Kaplan-Meier analysis with arthroplasty as the end point revealed a survival rate of 96% (95% confidence interval, 93% to 99%) at five years and 84% (95% confidence interval, 77% to 90%) at ten years. Complications occurred in twenty hips. Fifteen hips (11%) were treated with a subsequent arthroscopy

  19. Successful Restoration of Severely Mutilated Primary Incisors Using a Novel Method to Retain Zirconia Crowns - Two Year Results.

    Science.gov (United States)

    El Shahawy, Osama Ibrahim; O'Connell, Anne C

    This manuscript describes a simple reliable technique for restoring severely mutilated primary anterior teeth. A rigid glass ionomer post is created over which zirconia crowns can be fitted to achieve a long-term stable esthetic restoration for primary anterior teeth. Children aged 2-5 years with two up to six extensively decayed upper primary incisors were included. Fuji IX was condensed into an intracanal space created to a depth of 3mm, to provide a core which also extended 3mm supragingivally. Crown preparations were completed upon these cores. Zirconia crowns (Nusmile, Houston Texas USA) were fitted and cemented over the prepared cores. All patients were recalled at regular intervals. Twenty-three healthy children with 86 restorations participated in the study. The overall survival of the restorations was 95.3% after 12 months and 80.2% after 24 months. According to Kaplan-Meier survival analysis, the median survival time was not reached while the estimated mean survival time was 22.9 months. This newly described clinical technique is simple and reliable to use for restoration of extensively decayed primary incisors. Use of zirconia crowns retained using this technique offers superior esthetic, durable restorations with remarkable gingival response up to 24 months.

  20. Prognostic significance of the lung scintigraphy scan result and corresponding chest X-ray in patients with suspected pulmonary embolism.

    Science.gov (United States)

    Al-Adhami, A S; Simpson, A J; Reid, J H; MacDougall, M; Murchison, J T

    2010-09-01

    To determine whether the survival of patients with suspected acute pulmonary embolism (PE) relates to radiological probability of acute PE assessed using lung scintigraphy scans (LSS). Lung scintigraphy scan results from a venous thromboembolism database were categorised as high, indeterminate or low probability using the modified PIOPED criteria and corresponding chest X-rays (CXRs) as normal or abnormal. Mortality data on these cases were obtained from the General Register Office for Scotland, and survival was analysed using the Kaplan-Meier method. Of the 1,818 LSS analysed, 941 (51.8%) were normal, 532 (29.3%) indeterminate and 345 (19.0%) high probability. After an adjustment for age and gender, no significant survival difference was found between patients with normal and high probability LSS (p=0.182). However, patients with indeterminate LSS had significantly lower survival than patients in the other groups. This difference persisted after adjustment for CXR result. Indeterminate LSS results are associated with a poor prognosis. Careful follow-up of patients with inderminate LSS would appear to be justified.

  1. Analysis of ONKALO water leakage mapping results

    Energy Technology Data Exchange (ETDEWEB)

    Ahokas, H.; Nummela, J; Turku, J. [Poeyry Finland Oy, Vantaa (Finland)

    2014-04-15

    As part of the programme for the final disposal of spent nuclear fuel, an analysis has been compiled of water leakage mapping performed in ONKALO. Leakage mapping is part of the Olkiluoto Monitoring Programme (OMO) and the field work has been carried out by Posiva Oy. The main objective of the study is to analyse differences detected between mapping campaigns carried out typically twice a year in 2005-2012. Differences were estimated to be caused by the differences in groundwater conditions caused by seasonal effects or by differences between the years. The effect of technical changes like shotcreting, postgrouting, ventilation etc. on the results was also studied. The development of the visualisation of mapping results was also an objective of this work. Leakage mapping results have been reported yearly in the monitoring reports of Hydrology with some brief comments on the detected differences. In this study, the development of the total area and the number of different leakages as well as the correlation of changes with shotcreting and grouting operations were studied. In addition, traces of fractures on tunnel surfaces, and the location of rock bolts and drain pipes were illustrated together with leakage mapping. In water leakage mapping, the tunnel surfaces are visually mapped to five categories: dry, damp, wet, dripping and flowing. Major changes were detected in the total area of damp leakages. It is likely that the increase has been caused by the condensation of warm ventilation air on the tunnel surfaces and the corresponding decrease by the evaporation of moisture into the dry ventilation air. Shotcreting deep in ONKALO may also have decreased the total area of damp leakages. Changes in the total area and number of wet leakages correlate at least near the surface with differences in yearly precipitation. It is possible that strong rains have also caused a temporary increase in wet leakages. Dripping and wet leakages have been observed on average more

  2. Low-dose-rate brachytherapy for patients with transurethral resection before implantation in prostate cancer: long-term results

    Energy Technology Data Exchange (ETDEWEB)

    Prada, Pedro J.; Anchuelo, Javier; Blanco, Ana Garcia; Paya, Gema; Cardenal, Juan; Acuña, Enrique; Ferri, Maria [Department of Radiation Oncology, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria (Spain); Vazquez, Andres; Pacheco, Maite; Sanchez, Jesica [Department of Radiation Physics, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria (Spain)

    2016-01-15

    Objectives: We analyzed the long-term oncologic outcome for patients with prostate cancer and transurethral resection who were treated using low-dose-rate (LDR) prostate brachytherapy. Methods and Materials: From January 2001 to December 2005, 57 consecutive patients were treated with clinically localized prostate cancer. No patients received external beam radiation. All of them underwent LDR prostate brachytherapy. Biochemical failure was defined according to the 'Phoenix consensus'. Patients were stratified as low and intermediate risk based on The Memorial Sloan Kettering group definition. Results: The median follow-up time for these 57 patients was 104 months. The overall survival according to Kaplan-Meier estimates was 88% (±6%) at 5 years and 77% (±6%) at 12 years. The 5 and 10 years for failure in tumour-free survival (TFS) was 96% and respectively (±2%), whereas for biochemical control was 94% and respectively (±3%) at 5 and 10 years, 98% (±1%) of patients being free of local recurrence. A patient reported incontinence after treatment (1.7%). The chronic genitourinary complains grade I were 7% and grade II, 10%. At six months 94% of patients reported no change in bowel function. Conclusions: The excellent long-term results and low morbidity presented, as well as the many advantages of prostate brachytherapy over other treatments, demonstrates that brachytherapy is an effective treatment for patients with transurethral resection and clinical organ-confined prostate cancer. (author)

  3. Long Term Results of Kissing Stents in the Aortic Bifurcation.

    Science.gov (United States)

    Hinnen, J W; Konickx, M A; Meerwaldt, R; Kolkert, J L P; van der Palen, J; Huisman, A B; Geelkerken, R H

    2015-01-01

    To evaluate the long-term outcome after aortoiliac kissing stent placement and to analyze variables, which potentially influence the outcome of endovascular reconstruction of the aortic bifurcation. All patients treated with aortoiliac kissing stents at our institution between April 1995 and August 2011 were retrospectively identified from a prospective single-center database. Data regarding patient characteristics (age, gender, smoking, cardio- and cerebrovascular risk factors, hyperlipidaemia, diabetes mellitus and use of antihypertensive medication), symptoms, pre-interventional examination and imaging, procedural details and follow-up were retrieved. Patency rates were calculated with Kaplan-Meier analysis. Factors affecting the patency were determined with Cox uni- and multivariate analysis. A total of 215 patients (63% men, mean age 61 ± 10 years) were included. The median follow-up period was 31 (IQR 47.1) months. Primary, primary assisted, and secondary patency rates were 97%, 97%, and 99%, respectively, at one month; 92%, 95% and 94% at four months; 75%, 86%, and 91% at two years; 70%, 81%, and 91% at 5 years; and 67%, 81%, and 91% at ten years. Younger age and previous aortoiliac treatment were predictors for reduced primary and primary assisted patency. Smoking, previous aortoiliac intervention, TASC C and D lesions were predictors for reduced secondary patency. Reconstruction of the aortoiliac bifurcation with kissing stents is feasible, safe and effective in all types of lesions with satisfying long term patencies. TASC C and D lesions are associated with a higher occlusion rate. Younger age and previous aortoiliac interventions are predictors for reduced primary and primary assisted patency. © Acta Chirurgica Belgica.

  4. The Joint Physics Analysis Center: Recent results

    CERN Document Server

    Fernandez-Ramirez, Cesar

    2016-01-01

    We review some of the recent achievements of the Joint Physics Analysis Center, a theoretical collaboration with ties to experimental collaborations, that aims to provide amplitudes suitable for the analysis of the current and forthcoming experimental data on hadron physics. Since its foundation in 2013, the group is focused on hadron spectroscopy in preparation for the forthcoming high statistics and high precision experimental data from BELLEII, BESIII, CLAS12, COMPASS, GlueX, LHCb and (hopefully) PANDA collaborations. So far, we have developed amplitudes for $\\pi N$ scattering, $\\bar{K}N$ scattering, pion and $J/\\psi$ photoproduction, two kaon photoproduction and three-body decays of light mesons ($\\eta$, $\\omega$, $\\phi$). The codes for the amplitudes are available to download from the group web page and can be straightforwardly incorporated to the analysis of the experimental data.

  5. The Joint Physics Analysis Center: Recent results

    Science.gov (United States)

    Fernández-Ramírez, César

    2016-10-01

    We review some of the recent achievements of the Joint Physics Analysis Center, a theoretical collaboration with ties to experimental collaborations, that aims to provide amplitudes suitable for the analysis of the current and forthcoming experimental data on hadron physics. Since its foundation in 2013, the group is focused on hadron spectroscopy in preparation for the forthcoming high statistics and high precision experimental data from BELLEII, BESIII, CLAS12, COMPASS, GlueX, LHCb and (hopefully) PANDA collaborations. So far, we have developed amplitudes for πN scattering, KN scattering, pion and J/ψ photoproduction, two kaon photoproduction and three-body decays of light mesons (η, ω, ϕ). The codes for the amplitudes are available to download from the group web page and can be straightforwardly incorporated to the analysis of the experimental data.

  6. Intermediate to long-term results following the bernese periacetabular osteotomy and predictors of clinical outcome: surgical technique.

    Science.gov (United States)

    Matheney, Travis; Kim, Young-Jo; Zurakowski, David; Matero, Catherine; Millis, Michael

    2010-09-01

    The Bernese periacetabular osteotomy is a commonly used non-arthroplasty option to treat developmental hip dysplasia in symptomatic younger patients. Predicting which hips will remain preserved and which hips will go on to require arthroplasty following periacetabular osteotomy is a major challenge. In the present study, we assessed the intermediate to long-term results following periacetabular osteotomy to demonstrate the clinical outcomes for patients with varying amounts of dysplasia and arthritis. From these results, a probability-of-failure analysis was conducted to predict the likelihood of hip preservation and to improve surgical decision-making. Of the 189 hips (in 157 patients) that were treated with periacetabular osteotomy by a single surgeon from May 1991 to September 1998, thirty-one had diagnoses other than developmental hip dysplasia and twenty-three were lost to follow-up. The remaining 135 hips (in 109 patients) were retrospectively reviewed at an average of nine years. Hips were evaluated with use of the pain subscale of the Western Ontario and McMaster Universities Osteoarthritis Index postoperatively as well as with radiographs that were made preoperatively and at one and more than five years postoperatively. Osteotomy failure was defined as a pain score of ≥10 or the need for total hip arthroplasty. One hundred and two hips (76%) remained preserved at an average of nine years, with an average Western Ontario and McMaster Universities pain score of 2.4 of 20. Thirty-three hips (24%) met the failure criteria: seventeen underwent arthroplasty at an average of 6.1 years after the osteotomy, and sixteen had a postoperative pain score of ≥10. Kaplan-Meier analysis with arthroplasty as the end point revealed a survival rate of 96% (95% confidence interval, 93% to 99%) at five years and 84% (95% confidence interval, 77% to 90%) at ten years. Complications occurred in twenty hips. Fifteen hips (11%) were treated with a subsequent arthroscopy because

  7. Prognostic analysis of non - small cell lung cancer with bone metastasis%非小细胞肺癌骨转移的预后因素分析

    Institute of Scientific and Technical Information of China (English)

    李明蔚; 邝先奎; 赵向通; 黄堃; 韩伟; 董文杰; 王丽萍

    2016-01-01

    目的:分析非小细胞肺癌(non - small cell lung cancer,NSCLC)骨转移的预后相关因素和生存情况。方法回顾性分析2013年1月至2013年6月郑州大学第一附属医院收治的78例非小细胞肺癌骨转移患者的临床资料,采用Kaplan - Meier 法估计1年和2年生存率,单因素分析采用 Log - rank 时序分析筛选预后的影响因素,多因素分析采用Cox 比例风险回归模型进一步确认独立影响因素。结果非小细胞肺癌骨转移的中位生存时间为10.5个月,Kaplan -Meier 生存分析结果显示1年和2年生存率分别为48.7%和15.4%。单因素分析显示 ECOG 评分、病理类型、骨以外的其他部位转移、化疗及分子靶向治疗与预后相关(P ﹤0.05);多因素分析显示 ECOG 评分、病理类型、骨以外的其他部位转移、化疗及分子靶向治疗为预后的独立影响因素。结论体能状况好、腺癌、单纯骨转移、接受化疗及分子靶向治疗的非小细胞骨转移患者预后更好。%Objective To investigate the prognosis - related factors of non - small cell lung cancer(NSCLC)with bone me-tastasis. Methods The clinical data of 78 NSCLC patients with bone metastasis treated in the First Affiliated Hospital of Zheng-zhou University from January of 2013 to June of 2013 were retrospectively analyzed. Kaplan - Meier method was used to estima-tethe 1 - and 2 - year survival rates of patients. Log - rank time series analysis for the univariate analysis was used to screen the factors influencing the survival of patients and Cox proportional hazard model for the multivariate analysis was used to further con-NSCLC were 48. 7% and 15. 4% . Single factor analysis showed that ECOG score,pathological type,other parts of metastasis, chemotherapy and molecular targeted therapy(MTT)were associated with the prognosis of patients(P ﹤ 0. 05). Multivariate a-nalysis showed that ECOG score,pathological type,other parts of metastasis

  8. Summary of CPAS EDU Testing Analysis Results

    Science.gov (United States)

    Romero, Leah M.; Bledsoe, Kristin J.; Davidson, John.; Engert, Meagan E.; Fraire, Usbaldo, Jr.; Galaviz, Fernando S.; Galvin, Patrick J.; Ray, Eric S.; Varela, Jose

    2015-01-01

    The Orion program's Capsule Parachute Assembly System (CPAS) project is currently conducting its third generation of testing, the Engineering Development Unit (EDU) series. This series utilizes two test articles, a dart-shaped Parachute Compartment Drop Test Vehicle (PCDTV) and capsule-shaped Parachute Test Vehicle (PTV), both of which include a full size, flight-like parachute system and require a pallet delivery system for aircraft extraction. To date, 15 tests have been completed, including six with PCDTVs and nine with PTVs. Two of the PTV tests included the Forward Bay Cover (FBC) provided by Lockheed Martin. Advancements in modeling techniques applicable to parachute fly-out, vehicle rate of descent, torque, and load train, also occurred during the EDU testing series. An upgrade from a composite to an independent parachute simulation allowed parachute modeling at a higher level of fidelity than during previous generations. The complexity of separating the test vehicles from their pallet delivery systems necessitated the use the Automatic Dynamic Analysis of Mechanical Systems (ADAMS) simulator for modeling mated vehicle aircraft extraction and separation. This paper gives an overview of each EDU test and summarizes the development of CPAS analysis tools and techniques during EDU testing.

  9. Proximal clavicle excision: an analysis of results.

    Science.gov (United States)

    Acus, R W; Bell, R H; Fisher, D L

    1995-01-01

    Medial clavicle excision has been reported by several authors, but few cases are documented, and long-term follow-up information is lacking. The purpose of this study was to examine the long-term results of medial clavicle excision in regard to function, pain, cosmesis, and complications. Fifteen patients ranging in age from 18 to 64 years (average 43 years) were evaluated an average of 4.6 years (range 1 to 14 years) after proximal clavicle excision. The indications for excision were unstable anterior subluxation/dislocation of the sternoclavicular joint (four cases), unstable posterior dislocation (one case), sternoclavicular osteoarthritis (nine cases), and proximal clavicle osteomyelitis (one case). An average of 2.9 cm of the medial clavicle was excised (range 1 to 4 cm). Fourteen of the 15 patients received significant relief of pain. On a strict grading scale four patients had an excellent result, five a good result, four a fair result, and two a poor result. Regeneration of the clavicle appeared to contribute to a poor result. No operative complications occurred. These findings aid our understanding of surgical options and outcome in the treatment of sternoclavicular joint disease.

  10. SNMP Trace Analysis: Results of Extra Traces

    NARCIS (Netherlands)

    Broek, van den Gijs; Hoeve, ten Sietse; Moreira Moura, G.C.; Pras, Aiko; Moreira Moura, G.C.

    2009-01-01

    The Simple Network Management Protocol (SMMP) was introduced in the late 1980s. Since then, several evolutionary protocol changes have taken place, resulting in the SNMP version 3 framework (SNMPv3). Extensive use of SNMP has led to significant practical experience by both network operators and rese

  11. Stability of spinal bone metastases in breast cancer after radiotherapy. A retrospective analysis of 157 cases

    Energy Technology Data Exchange (ETDEWEB)

    Schlampp, Ingmar; Rieken, Stefan; Habermehl, Daniel; Foerster, Robert; Debus, Juergen; Rief, Harald [University Hospital of Heidelberg, Department of Radiation Oncology, Heidelberg (Germany); Bruckner, Thomas [University Hospital of Heidelberg, Department of Medical Biometry, Heidelberg (Germany)

    2014-09-15

    This retrospective analysis was performed to evaluate osteolytic bone lesions of breast cancer in the thoracic and lumbar spine after radiotherapy (RT) in terms of stability using a validated scoring system. The stability of 157 osteolytic metastases, treated from January 2000 to January 2012, in 115 patients with breast cancer was evaluated retrospectively using the Taneichi score. Predictive factors for stability were analyzed and survival rates were calculated. Eighty-five (54 %) lesions were classified as unstable prior to RT. After 3 and 6 months, 109 (70 %) and 124 (79 %) lesions, respectively, were classified as stable. Thirty fractures were detected prior to RT, and after RT seven cases (4.5 %) with pathologic fractures were found within 6 months. None of the examined predictive factors showed significant correlation with stability 6 months after RT. After a median follow-up of 16.7 months, Kaplan-Meier estimates revealed an overall survival of 83 % after 5 years. The majority of patients showed an improved or unchanged stability of the involved vertebral bodies after 6 months. The patients showed only minor cancer-related morbidity during follow-up and reached comparably high survival rates. (orig.) [German] Die retrospektive Analyse untersuchte osteolytische Knochenmetastasen von Patienten mit Mammakarzinom der thorakalen und lumbalen Wirbelsaeule nach Radiotherapie (RT) hinsichtlich Stabilitaet anhand eines validierten Scores. Die Stabilitaet von 157 osteolytischen Metastasen bei 115 Patienten mit Brustkrebs, behandelt von Januar 2000 bis Januar 2012, wurde retrospektiv anhand des Taneichi-Scores evaluiert. Prognostische Faktoren bezueglich Stabilitaet und Ueberlebensraten wurden analysiert. Vor RT wurden 85 Laesionen (54 %) als instabil gewertet. Nach 3 und 6 Monaten wurden 109 (70 %) und 124 (79 %) Laesionen als stabil klassifiziert. Vor RT wurden 30 Frakturen gefunden, nach RT zeigten sich 7 weitere (4,5 %) pathologische Frakturen. Kein prognostischer

  12. Favorable Outcomes after Implantation of Biodegradable Polymer Coated Sirolimus-Eluting Stents in Diabetic Population: Results from INDOLIMUS-G Diabetic Registry

    Directory of Open Access Journals (Sweden)

    Anurag Polavarapu

    2015-01-01

    Full Text Available Objective. The main aim is to evaluate safety, efficacy, and clinical performance of the Indolimus (Sahajanand Medical Technologies Pvt. Ltd., Surat, India sirolimus-eluting stent in high-risk diabetic population with complex lesions. Methods. It was a multicentre, retrospective, non-randomized, single-arm study, which enrolled 372 diabetic patients treated with Indolimus. The primary endpoint of the study was major adverse cardiac events (MACE, which is a composite of cardiac death, target lesion revascularization (TLR, target vessel revascularization (TVR, myocardial infarction (MI, and stent thrombosis (ST. The clinical follow-ups were scheduled at 30 days, 6 months, and 9 months. Results. The mean age of the enrolled patients was 53.4 ± 10.2 years. A total of 437 lesions were intervened successfully with 483 stents (1.1 ± 0.3 per lesion. There were 256 (68.8% male patients. Hypertension and totally occluded lesions were found in 202 (54.3% and 45 (10.3% patients, respectively. The incidence of MACE at 30 days, 6 months and 9 months was 0 (0%, 6 (1.6%, and 8 (2.2%, respectively. The event-free survival at 9-month follow-up by Kaplan Meier method was found to be 97.8%. Conclusion. The use of biodegradable polymer coated sirolimus-eluting stent is associated with favorable outcomes. The results demonstrated in our study depict its safety and efficacy in diabetic population.

  13. Anti-osteoporotic therapy in Denmark-predictors and demographics of poor refill compliance and poor persistence

    DEFF Research Database (Denmark)

    Hansen, Carrinna; Pedersen, Birthe D.; Konradsen, Hanne

    2012-01-01

    -based nationwide cohort study of anti-osteoporotic therapy comprising 100,949 men and women. Statistical analysis including backward stepwise logistic regression analysis was used to explain causes of treatment failure and Kaplan-Meier survival analysis to estimate persistence of treatment. RESULTS: It was noted......, children living at home, living close to a university hospital, anti-osteoporotic therapy other than alendronate, number of drugs especially above three, pulmonary disease, collagen disease. CONCLUSION: The results suggest a need for improved support for patients to facilitate the interpretation...

  14. Statistical analysis of concrete quality testing results

    Directory of Open Access Journals (Sweden)

    Jevtić Dragica

    2014-01-01

    Full Text Available This paper statistically investigates the testing results of compressive strength and density of control concrete specimens tested in the Laboratory for materials, Faculty of Civil Engineering, University of Belgrade, during 2012. The total number of 4420 concrete specimens were tested, which were sampled on different locations - either on concrete production site (concrete plant, or concrete placement location (construction site. To be exact, these samples were made of concrete which was produced on 15 concrete plants, i.e. placed in at 50 different reinforced concrete structures, built during 2012 by 22 different contractors. It is a known fact that the achieved values of concrete compressive strength are very important, both for quality and durability assessment of concrete inside the structural elements, as well as for calculation of their load-bearing capacity limit. Together with the compressive strength testing results, the data concerning requested (designed concrete class, matching between the designed and the achieved concrete quality, concrete density values and frequency of execution of concrete works during 2012 were analyzed.

  15. RTPP Analysis Results: Achievements and Challenges

    Science.gov (United States)

    Agrotis, Loukis; Alfaro Sanz, Pedro; Svehla, Drazen; Dow, John; Zandbergen, Rene

    2010-05-01

    One of the key objectives of the IGS Real Time Pilot Project is the establishment of an experimental IGS Real Time Clock Service comprising individual Analysis Centre (AC) solutions and the investigation of strategies for generating a Real Time combination product. The latter is intended to provide a stable, reliable and high quality GNSS product. Currently there are 4 ACs (BKG, DLR, ESA and NRCan) generating individual real time products, and a fifth (GMV) that is producing a product based on one-hour predictions. This paper will cover the evolution in the accuracies of the individual solutions and will show the impact that the participation in the RTPP has had on the ACs, serving not only as an external benchmark, but also as a discussion forum that has prompted their continued evolution and improvement. In its role as RTPP AC coordinator, ESOC has been computing and disseminating a daily combination clock product since July 2008, based on daily submissions of clock RINEX and SP3 orbit files by the individual ACs. This exercise has helped to develop and validate the combination techniques and the RTPP products are stored at the CDDIS, IGN and KASI data centres with the designation "igt". The current satellite clock quality, of better than 0.2 ns RMS compared to the IGS rapids, comfortably exceeds the initial RTPP goal of 0.5 ns and gives a high confidence on the implemented method. ESOC is currently working on the implementation of a Real Time combination product, from RTCM orbit and clock streams received in real time via BKG's NTRIP system. This service is expected to be ready in the March-April timeframe and be operational by mid 2010. As well as discussing the status and evolution of the Real Time products, this paper will also focus on specific problems and challenges in the Real Time processing. For example, it has been found that GPS Block IIA satellites exhibit occasional glitches, where most receivers loose lock simultaneously. These events cause clock

  16. Five-year results of a prospective randomised controlled clinical trial of posterior computer-aided design-computer-aided manufacturing ZrSiO4 -ceramic crowns.

    Science.gov (United States)

    Passia, N; Stampf, S; Strub, J R

    2013-08-01

    The aim of this prospective randomised controlled clinical trial was to evaluate the clinical outcome of shrinkage-free ZrSiO4 -ceramic full-coverage crowns on premolars and molars in comparison with conventional gold crowns over a 5-year period. Two hundred and twenty-three patients were included and randomly divided into two treatment groups. One hundred and twenty-three patients were restored with 123 ZrSiO4 -ceramic crowns, and 100 patients received 100 gold crowns, which served as the control. All crowns were conventionally cemented with glass-ionomer cement. After an observation period of 6, 12, 24, 36, 48 and 60 months, the survival probability (Kaplan-Meier) for the shrinkage-free ZrSiO4 -ceramic crowns was 98·3%, 92·0%, 84·7%, 79% and 73·2% and for the gold crowns, 99%, 97·9%, 95·7%, 94·6% and 92·3%, respectively. The difference between the test and control group was statistically significant (P = 0·0027). The gold crowns showed a better marginal integrity with less marginal discoloration than the ceramic crowns. The most common failure in the ceramic crown group was fracture of the crown. The 60-month results of this prospective randomised controlled clinical trial suggest that the use of these shrinkage-free ZrSiO4 -ceramic crowns in posterior tooth restorations cannot be recommended.

  17. Burden and outcomes of pressure ulcers in cancer patients receiving the Kerala model of home based palliative care in India: Results from a prospective observational study

    Directory of Open Access Journals (Sweden)

    Biji M Sankaran

    2015-01-01

    Full Text Available Aim: To report the prevalence and outcomes of pressure ulcers (PU seen in a cohort of cancer patients requiring home-based palliative care. Materials and Methods: All patients referred for home care were eligible for this prospective observational study, provided they were living within a distance of 35 km from the institute and gave informed consent. During each visit, caregivers were trained and educated for providing nursing care for the patient. Dressing material for PU care was provided to all patients free of cost and care methods were demonstrated. Factors influencing the occurrence and healing of PUs were analyzed using logistic regression. Duration for healing of PU was calculated using the Kaplan Meier method. P < 0.05 are taken as significant. Results: Twenty-one of 108 (19.4% enrolled patients had PU at the start of homecare services. None of the patients developed new PU during the course of home care. Complete healing of PU was seen in 9 (42.9% patients. The median duration for healing of PU was found to be 56 days. Median expenditure incurred in patients with PU was Rs. 2323.40 with a median daily expenditure of Rs. 77.56. Conclusions: The present model of homecare service delivery was found to be effective in the prevention and management of PUs. The high prevalence of PU in this cohort indicates a need for greater awareness for this complication. Clinical Trial Registry Number: CTRI/2014/03/004477

  18. Deferiprone versus deferoxamine in sickle cell disease: results from a 5-year long-term Italian multi-center randomized clinical trial.

    Science.gov (United States)

    Calvaruso, Giusi; Vitrano, Angela; Di Maggio, Rosario; Ballas, Samir; Steinberg, Martin H; Rigano, Paolo; Sacco, Massimiliano; Telfer, Paul; Renda, Disma; Barone, Rita; Maggio, Aurelio

    2014-12-01

    Blood transfusion and iron chelation currently represent a supportive therapy to manage anemia, vasculopathy and vaso-occlusion crises in Sickle-Cell-Disease. Here we describe the first 5-year long-term randomized clinical trial comparing Deferiprone versus Deferoxamine in patients with Sickle-Cell-Disease. The results of this study show that Deferiprone has the same effectiveness as Deferoxamine in decreasing body iron burden, measured as repeated measurements of serum ferritin concentrations on the same patient over 5-years and analyzed according to the linear mixed-effects model (LMM) (p=0.822). Both chelators are able to decrease, significantly, serum ferritin concentrations, during 5-years, without any effect on safety (p=0.005). Moreover, although the basal serum ferritin levels were higher in transfused compared with non-transfused group (p=0.031), the changes over time in serum ferritin levels were not statistically significantly different between transfused and non-transfused cohort of patients (p=0.389). Kaplan-Meier curve, during 5-years of study, suggests that Deferiprone does not alter survival in comparison with Deferoxamine (p=0.38). In conclusion, long-term iron chelation therapy with Deferiprone was associated with efficacy and safety similar to that of Deferoxamine. Therefore, in patients with Sickle-Cell-Disease, Deferiprone may represent an effective long-term treatment option.

  19. Gastric cancer: texture analysis from multidetector computed tomography as a potential preoperative prognostic biomarker

    Energy Technology Data Exchange (ETDEWEB)

    Giganti, Francesco; Salerno, Annalaura; Marra, Paolo; Esposito, Antonio; Del Maschio, Alessandro; De Cobelli, Francesco [Department of Radiology and Centre for Experimental Imaging San Raffaele Scientific Institute, Milan (Italy); San Raffaele Vita-Salute University, Milan (Italy); Antunes, Sofia [San Raffaele Scientific Institute, Centre for Experimental Imaging, Milan (Italy); Ambrosi, Alessandro [San Raffaele Vita-Salute University, Milan (Italy); Nicoletti, Roberto [Department of Radiology and Centre for Experimental Imaging San Raffaele Scientific Institute, Milan (Italy); Orsenigo, Elena [San Raffaele Scientific Institute, Department of Surgery, Milan (Italy); Chiari, Damiano; Staudacher, Carlo [San Raffaele Vita-Salute University, Milan (Italy); San Raffaele Scientific Institute, Department of Surgery, Milan (Italy); Albarello, Luca [San Raffaele Scientific Institute, Pathology Unit, Milan (Italy)

    2017-05-15

    To investigate the association between preoperative texture analysis from multidetector computed tomography (MDCT) and overall survival in patients with gastric cancer. Institutional review board approval and informed consent were obtained. Fifty-six patients with biopsy-proved gastric cancer were examined by MDCT and treated with surgery. Image features from texture analysis were quantified, with and without filters for fine to coarse textures. The association with survival time was assessed using Kaplan-Meier and Cox analysis. The following parameters were significantly associated with a negative prognosis, according to different thresholds: energy [no filter] - Logarithm of relative risk (Log RR): 3.25; p = 0.046; entropy [no filter] (Log RR: 5.96; p = 0.002); entropy [filter 1.5] (Log RR: 3.54; p = 0.027); maximum Hounsfield unit value [filter 1.5] (Log RR: 3.44; p = 0.027); skewness [filter 2] (Log RR: 5.83; p = 0.004); root mean square [filter 1] (Log RR: - 2.66; p = 0.024) and mean absolute deviation [filter 2] (Log RR: - 4.22; p = 0.007). Texture analysis could increase the performance of a multivariate prognostic model for risk stratification in gastric cancer. Further evaluations are warranted to clarify the clinical role of texture analysis from MDCT. (orig.)

  20. 弥漫大B细胞淋巴瘤125例临床病理分析%Clinical pathology analysis of 125 patients with diffuse large B-cell lymphoma

    Institute of Scientific and Technical Information of China (English)

    李蔚冰; 林英城; 林雯; 王鸿彪; 林文照; 林穗玲

    2011-01-01

    目的:分析弥漫性大B细胞淋巴瘤(DLBCL)临床特点及CHOP方案治疗结果,探讨DLBCL的临床预后因素.方法:回顾性分析125例CHOP类方案初次化疗的DLBCL患者的临床特征,结合随访资料,采用Kaplan-Meier 法对生存率进行评估,进一步采用Cox 回归模型对单因素分析中有统计学意义的参数进行多因素分析.结果:125例DLBCL患者中,男女比例1.3∶1,中位年龄49岁,Ann Arbor Ⅲ~Ⅳ期患者占52.0%,LDH升高占42.1%,IPI中高危组(3~5分)占22.6%.首发为浅表淋巴结肿大60.0%,结外器官受侵72.8%.中位化疗5个周期,CR 38.4%,PR 44.8%.中位随访28.2个月,中位生存期(MST)46.5个月,3和5 年生存率分别为51.9%和48.9%.单因素分析显示,≤60岁、Ann Arbor Ⅰ~Ⅱ、LDH正常、体能评分好(ECOG 0~1)、IPI评分低、未侵及骨髓、肝未受侵、接受放疗、无B症状以及缓解者是DL-BCL的良好预后因素.Cox多因素分析显示,IPI评分高(P=0.000)、未行放疗(P=0.045)和未能缓解者(P=0.049)是DLBCL的独立不良预后因素.结论:DLBCL结外侵犯发生率高,IPI评分高、未行放疗和一线治疗未能缓解者预后不良.%OBJECTIVE: To analyze the clinical features and outcomes of diffuse large B-cell lymphoma(DLBCL) patients treated with CHOP chemotherapy, and study the clinical prognosis factors of DLBCL. METHODS: Clinical features and follow-up data of 125 previously untreated DLBCL patients underwent with CHOP regiments were analyzed. Kaplan-Meier was applied to assess the survival probability. All parameters statistically significant concluded by univariate analysis were then computed as co-variates for multivariate analysis with Cox regression model. RESULTS: Of the 125 patients, the ratio of males to females was approximately 1. 3 ? 1, and the median age of patients was 49 years. The Ann Arbor classification showed that 52. 0% of cases were of stage HI and W , 42. 1 % of cases had elevated serum lactate

  1. Identification of miRNAs associated with recurrence of stage II colorectal cancer

    DEFF Research Database (Denmark)

    Christensen, Lise Lotte; Tobiasen, Heidi; Schepeler, Troels;

    . Kaplan Meier analysis showed significant correlations between low expression of the four miRNAs and poor prognosis. Functional characterization of their impact on cell viability using MTT analysis demonstrated that they all inhibit the viability of HCT116 cells. One miRNAs also inhibited the viability...... selected for detailed analysis. Luciferase miRNA target reporter assays confirmed all three mRNAs to be direct targets. Secondly, siRNA mediated knock-down of the potential targets resulted in growth suppression of HCT116 cells, mimicking the effect of the miRNA. In conclusion, miRNAs are associated...

  2. Prognostic and survival analysis of presbyopia: The healthy twin study

    Science.gov (United States)

    Lira, Adiyani; Sung, Joohon

    2015-12-01

    Presbyopia, a vision condition in which the eye loses its flexibility to focus on near objects, is part of ageing process which mostly perceptible in the early or mid 40s. It is well known that age is its major risk factor, while sex, alcohol, poor nutrition, ocular and systemic diseases are known as common risk factors. However, many other variables might influence the prognosis. Therefore in this paper we developed a prognostic model to estimate survival from presbyopia. 1645 participants which part of the Healthy Twin Study, a prospective cohort study that has recruited Korean adult twins and their family members based on a nation-wide registry at public health agencies since 2005, were collected and analyzed by univariate analysis as well as Cox proportional hazard model to reveal the prognostic factors for presbyopia while survival curves were calculated by Kaplan-Meier method. Besides age, sex, diabetes, and myopia; the proposed model shows that education level (especially engineering program) also contribute to the occurrence of presbyopia as well. Generally, at 47 years old, the chance of getting presbyopia becomes higher with the survival probability is less than 50%. Furthermore, our study shows that by stratifying the survival curve, MZ has shorter survival with average onset time about 45.8 compare to DZ and siblings with 47.5 years old. By providing factors that have more effects and mainly associate with presbyopia, we expect that we could help to design an intervention to control or delay its onset time.

  3. Risk analysis for autonomous underwater vehicle operations in extreme environments.

    Science.gov (United States)

    Brito, Mario Paulo; Griffiths, Gwyn; Challenor, Peter

    2010-12-01

    Autonomous underwater vehicles (AUVs) are used increasingly to explore hazardous marine environments. Risk assessment for such complex systems is based on subjective judgment and expert knowledge as much as on hard statistics. Here, we describe the use of a risk management process tailored to AUV operations, the implementation of which requires the elicitation of expert judgment. We conducted a formal judgment elicitation process where eight world experts in AUV design and operation were asked to assign a probability of AUV loss given the emergence of each fault or incident from the vehicle's life history of 63 faults and incidents. After discussing methods of aggregation and analysis, we show how the aggregated risk estimates obtained from the expert judgments were used to create a risk model. To estimate AUV survival with mission distance, we adopted a statistical survival function based on the nonparametric Kaplan-Meier estimator. We present theoretical formulations for the estimator, its variance, and confidence limits. We also present a numerical example where the approach is applied to estimate the probability that the Autosub3 AUV would survive a set of missions under Pine Island Glacier, Antarctica in January-March 2009.

  4. Survival analysis: a tool in the study of post-harvest diseases in peaches

    Directory of Open Access Journals (Sweden)

    Cristiano Nunes Nesi

    2015-02-01

    Full Text Available Survival analysis is applied when the time until the occurrence of an event is of interest. Such data are routinely collected in plant diseases, although applications of the method are uncommon. The objective of this study was to use two studies on post-harvest diseases of peaches, considering two harvests together and the existence of random effect shared by fruits of a same tree, in order to describe the main techniques in survival analysis. The nonparametric Kaplan-Meier method, the log-rank test and the semi-parametric Cox's proportional hazards model were used to estimate the effect of cultivars and the number of days after full bloom on the survival to the brown rot symptom and the instantaneous risk of expressing it in two consecutive harvests. The joint analysis with baseline effect, varying between harvests, and the confirmation of the tree effect as a grouping factor with random effect were appropriate to interpret the phenomenon (disease evaluated and can be important tools to replace or complement the conventional analysis, respecting the nature of the variable and the phenomenon.

  5. Risk factors and survival analysis of the esophageal cancer in the population of Jammu, India.

    Science.gov (United States)

    Sehgal, S; Kaul, S; Gupta, B B; Dhar, M K

    2012-01-01

    To identify the risk factors of esophageal cancer and study their effect on the survival rates patients of Jammu region, India. Detailed information was collected on socio-demographic, dietary and clinico-pathological parameters for 200 case control pairs. Discrete (categorical) data of 2 independent groups (control and cases) were summarized in frequency (%) and compared by using Chi-square (χ2 ) test. The mean age of two independent groups was compared by independent Student's t-test. To find out potential risk factor (s), the variable (s) found significant in univariate analysis were further subjected to multivariate logistic regression analysis. The association of potential risk factors with patients survival (3-year overall survival) was done by Kaplan-Meier survival curve analysis using Log-rank test. A 2-tailed (a = 2) P food (OR = 1.77, 95% CI = 1.10-2.85) and red chilly (OR = 1.76, 95% CI = 1.07-2.89). Probability of survival lowered significantly (P factor of esophageal cancer in Jammu region, followed by the salt tea, smoking and the sundried food.

  6. 再次肾移植疗效评价及预后多因素分析%Therapeutic outcomes evaluation and multi-factor prognostic analysis of renal retransplantation

    Institute of Scientific and Technical Information of China (English)

    赵于军; 成柯; 明英姿; 刘炼; 刘洪; 佘兴国; 叶启发

    2011-01-01

    BACKGROUND: Renal retransplantation has more benefits of used new immunosuppressive agents and improved perioperative management; however, compared with the primary allografts, regrafts face more risk factors. With the shortage of renal donations,it is necessary to assess long-term outcome of regrafts and to identify risk factors associated with long-term graft survial.OBJECTIVE: To evaluate the therapeutic outcomes of renal retransplantation and analyze the prognostic factors.METHODS: The clinical and follow-up data of 68 patients who underwent renal retransplantation between April 2001 and June 2009 in Xiangya Transplantation Medical Academy of the Third Xiangya Hospital of Central South University were analyzed retrospectively. The patient/graft survival rates were calculated by Kaplan-Meier method and compared to primary ones performed during the same period. A total of 12 clinical indictors were selected, Log-rank test and Cox proportional hazards regression model were performed to analyze prognostic factors of regraft outcome.RESULTS AND CONCLUSION: The follow-up time ranged from 6 to 86 months (median, 38.6 months). The mortality was 14.7%,The regraft loss rate was 26.5% . Survival rates at 1-,3- and 5-year of the patient/graft of retransplantation group were 94.1%/89.7% , 87.3%/80.5% and 80.3%/68.7% respectively, while those at 1 -, 3- and 5- years of the patient/graft of the primary renal transplantation were 96.3%/94.5%, 90.5%/85.4% and 83.8%/75.6%, respectively. No significant difference in the patient/graft survival rates was observed between two groups (P > 0.05). Univariate analysis showed that the duration of primary graft survival, peak panel reactive antibody (PRA) level, HLA mismatch , acute rejection, delayed graft function (DGF) and induction therapy were significantly associated with regraft survival. Multivariate Cox regression analysis showed that the duration of primary graft survival, peak PRA level and HLA

  7. 肝细胞癌患者肝移植术后肿瘤复发的多因素分析%Multivariate analysis of recurrence of hepatocellular carcinoma after liver transplantation

    Institute of Scientific and Technical Information of China (English)

    吴春; 单鸿

    2012-01-01

    of HCC.Methods The preoperative data of 230 consecutive HCC cases undergoing LT were retrospectively collected from our hospital from October 2003 to July 2009.There were 210 males and 20 females with a median age of 50 years.Their survival rates were calculated by Kaplan-Meier method.The disease-free survival curves of different prognostic factors were plotted by Kaplan-Meier method.The prognostic factors were analyzed by Log-rank test and Forward Conditional Cox regression respectively to yield the related risk factors and independent risk factors for the recurrence of HCC after LT.Results The median follow-up period was 29 months ( range:3 - 68 ).The outcomes included recurrence ( n =77 ),no recurrence ( n =153 ) and mortality (n =63 ).Their 1-,3- and 5-year cumulative survival rates and cumulative disease-free survival rates were 84%,75%,69% and 73%,65%,63% respectively.Univariate analysis with Logrank test revealed that the following prognostic factors were significant ( P < 0.05 ):age < 50 years,exceeding Milan-criteria,TNM stages of Ⅱ - Ⅲ,number of tumor ≥ 2,the diameter of the largest viable tumor > 5 cm,the post-intervention diameter of viable tumor ≥ 30% of entire tumor diameter,tumor distribution > 1 lobe,indistinct boundary of tumor,histological differentiation,serum α-fetoprotein level >400 ng/ml,the sum of viable tumor diameters ≥ 7.7 cm and intrahepatic portal venous thrombosis.Multivariate analysis with a forward conditional Cox hazard model revealed that the following prognostic factors were independently statistically significant ( P < 0.05 ):histological differentiation,serum α -fetoprotein level > 400 ng/ml,the sum of viable tumor diameters ≥7.7 cm and intrahepatic portal venous thrombosis.Conclusions Poor histological differentiation,serum α-fetoprotein level > 400 ng/ml,the sum of viable tumor diameters ≥ 7.7 cm and intrahepatic portal venous thrombosis are significant risk factors

  8. Scalable analysis tools for sensitivity analysis and UQ (3160) results.

    Energy Technology Data Exchange (ETDEWEB)

    Karelitz, David B.; Ice, Lisa G.; Thompson, David C.; Bennett, Janine C.; Fabian, Nathan; Scott, W. Alan; Moreland, Kenneth D.

    2009-09-01

    The 9/30/2009 ASC Level 2 Scalable Analysis Tools for Sensitivity Analysis and UQ (Milestone 3160) contains feature recognition capability required by the user community for certain verification and validation tasks focused around sensitivity analysis and uncertainty quantification (UQ). These feature recognition capabilities include crater detection, characterization, and analysis from CTH simulation data; the ability to call fragment and crater identification code from within a CTH simulation; and the ability to output fragments in a geometric format that includes data values over the fragments. The feature recognition capabilities were tested extensively on sample and actual simulations. In addition, a number of stretch criteria were met including the ability to visualize CTH tracer particles and the ability to visualize output from within an S3D simulation.

  9. Analysis of the prognosis of patients with testicular seminoma

    Science.gov (United States)

    DONG, WEI; GANG, WANG; LIU, MIAOMIAO; ZHANG, HONGZHEN

    2016-01-01

    Testicular seminoma is a common malignancy, accounting for 35–50% of testicular tumors. Comprehensive therapies lead to good curative efficacy. However, the factors that affect prognosis remain to be elucidated. The aim of the present study was to analyze the 3-, 5- and 10-year survival rate of patients with testicular seminoma as well as the associated factors of prognosis. The clinical data from 58 patients diagnosed with testicular seminoma were collected betweeen January 1999 and January 2014. The survival rate for this group was evaluated using the Kaplan-Meier method. Associated factors of prognosis were analyzed using the log-rank test. The results showed that approximately 62.1% of the cases were in the 30- to 50-year age group. From this age group, 94.8% of patients survived for 3 years, 86.2% for 5 years and 70.7% for 10 years. A significant difference was identified for the different clinical stages, pathological types and postoperative treatment in the 3-, 5- and 10-year survival rates (Pseminoma. Selection of an appropriate method of treatment including the clinical stages and histological types, is the key element in testicular seminoma therapy. PMID:26893743

  10. 遗传性2型神经纤维瘤病家系基因突变及临床特点分析%Analysis of families with hereditary neurofibromatosis type 2 gene mutation and clinical features

    Institute of Scientific and Technical Information of China (English)

    赵赋; 李朋; 张晶; 杲新晴; 杨智君; 王博; 王兴朝; 王振民; 刘丕楠

    2016-01-01

    Objective To investigate gene mutation and clinical features in families with hereditary neurofibromatosis type 2 (NF2).Methods From January 2011 to December 2014, 37 patients with NF2 from 15 pedigrees treated in Beijing Tiantan Hospital, Capital Medical University were enrolled retrospectively.Thirty-one blood samples and 15 tumor samples (1 case from each pedigree) from patients were obtained;meanwhile, 74 blood samples from healthy controls (24 samples from healthy persons in the pedigrees and 50 samples from healthy persons without kinship) were obtained.Sanger sequencing method was used to sequence the NF2 gene coding region and its adjacent introns.Kaplan-Meier survival curve analysis was used to compare the different types of mutations and the survival period of the patients with different mutations.Results Fifteen and 18 NF2 gene mutation types were detected from blood and tumor samples in patients with NF2, including 2 nonsense mutations, 4 missense mutations, 6 frameshift mutations, 1 in-frame deletion mutation, and 5 splice site mutations, 14 of the mutation types had not been reported.No NF2 gene mutations were detected in all the healthy subjects.Kaplan-Meier survival curves showed that the median survival time of the 18 patients in the NF2 gene nonsense/frameshift mutation group was 120.0 ±20.3 months;that of 11 patients in the missense mutation group was 288.0 ±91.7 months;and that of mutation site located in the NF2 gene 1-7 exon group of the 14 patients was 120.0 ± 15.3 months;and that of mutation site located in the NF2 gene 8-11 exon group of the 15 patients was 276.0 ± 19.6 months.There were significant differences (P =0.01, P =0.005).Conclusions NF2 gene mutation detection is an important method of early diagnosis and screening.The mutation style and sites are the important bases for identifying NF2 disease progression and prognosis.%目的 探讨家系遗传性2型神经纤维瘤病(NF2)基因突变的规律和临床特点.方法 回顾

  11. Survival Analysis of Factors Influencing Cyclic Fatigue of Nickel-Titanium Endodontic Instruments

    Directory of Open Access Journals (Sweden)

    Eva Fišerová

    2015-01-01

    Full Text Available Objective. The aim of this study was to validate a survival analysis assessing the effect of type of rotary system, canal curvature, and instrument size on cyclic resistance. Materials and Methods. Cyclic fatigue testing was carried out in stainless steel artificial canals with radii of curvature of 3 or 5 mm and the angle of curvature of 60 degrees. All the instruments were new and 25 mm in working length, and ISO colour coding indicated the instrument size (yellow for size 20; red for size 25. Wizard Navigator instruments, Mtwo instruments, ProTaper instruments, and Revo-S instruments were passively rotated at 250 rotations per minute, and the time fracture was being recorded. Subsequently, fractographic analysis of broken tips was performed by scanning electron microscope. The data were then analysed by the Kaplan-Meier estimator of the survival function, the Cox proportional hazards model, the Wald test for regression covariates, and the Wald test for significance of regression model. Conclusion. The lifespan registered for the tested instruments was Mtwo > Wizard Navigator > Revo-S > ProTaper; 5 mm radius > 3 mm radius; and yellow > red in ISO colour coding system.

  12. Incidences and Risk Factors of Organ Manifestations in the Early Course of Systemic Sclerosis

    DEFF Research Database (Denmark)

    Jaeger, Veronika K; Wirz, Elina G; Allanore, Yannick

    2016-01-01

    OBJECTIVE: Systemic sclerosis (SSc) is a rare and clinically heterogeneous autoimmune disorder characterised by fibrosis and microvascular obliteration of the skin and internal organs. Organ involvement mostly manifests after a variable period of the onset of Raynaud's phenomenon (RP). We aimed...... and their risk factors were assessed using Kaplan-Meier methods and Cox regression analysis. RESULTS: Of the 695 SSc patients who had a baseline visit within 1 year after RP onset, the incident non-RP manifestations (in order of frequency) were: skin sclerosis (75%) GI symptoms (71%), impaired diffusing capacity...

  13. Clinical Features in a Danish Population-Based Cohort of Probable Multiple System Atrophy Patients

    DEFF Research Database (Denmark)

    Starhof, Charlotte; Korbo, Lise; Lassen, Christina Funch

    2016-01-01

    the criteria for probable MSA. We recorded clinical features, examined differences by MSA subtype and used Kaplan-Meier survival analysis to examine mortality. Results: The mean age at onset of patients with probable MSA was 60.2 years (range 36-75 years) and mean time to wheelchair dependency was 4.7 years...... (range 0-15 years). One-third of patients experienced a transient improvement in motor symptoms with use of levodopa. Median survival from disease onset was 6.9 years (range 1-16 years, 95% CI 6.3-7.5) with no apparent variation according to gender or subtype. Conclusions: Our nationwide approach...

  14. Consistency of Random Survival Forests.

    Science.gov (United States)

    Ishwaran, Hemant; Kogalur, Udaya B

    2010-07-01

    We prove uniform consistency of Random Survival Forests (RSF), a newly introduced forest ensemble learner for analysis of right-censored survival data. Consistency is proven under general splitting rules, bootstrapping, and random selection of variables-that is, under true implementation of the methodology. Under this setting we show that the forest ensemble survival function converges uniformly to the true population survival function. To prove this result we make one key assumption regarding the feature space: we assume that all variables are factors. Doing so ensures that the feature space has finite cardinality and enables us to exploit counting process theory and the uniform consistency of the Kaplan-Meier survival function.

  15. A meta-analysis of gene expression-based biomarkers predicting outcome after tamoxifen treatment in breast cancer.

    Science.gov (United States)

    Mihály, Zsuzsanna; Kormos, Máté; Lánczky, András; Dank, Magdolna; Budczies, Jan; Szász, Marcell A; Győrffy, Balázs

    2013-07-01

    To date, three molecular markers (ER, PR, and CYP2D6) have been used in clinical setting to predict the benefit of the anti-estrogen tamoxifen therapy. Our aim was to validate new biomarker candidates predicting response to tamoxifen treatment in breast cancer by evaluating these in a meta-analysis of available transcriptomic datasets with known treatment and follow-up. Biomarker candidates were identified in Pubmed and in the 2007-2012 ASCO and 2011-2012 SABCS abstracts. Breast cancer microarray datasets of endocrine therapy-treated patients were downloaded from GEO and EGA and RNAseq datasets from TCGA. Of the biomarker candidates, only those identified or already validated in a clinical cohort were included. Relapse-free survival (RFS) up to 5 years was used as endpoint in a ROC analysis in the GEO and RNAseq datasets. In the EGA dataset, Kaplan-Meier analysis was performed for overall survival. Statistical significance was set at p tamoxifen-resistance genes in three independent platforms and identified PGR, MAPT, and SLC7A5 as the most promising prognostic biomarkers in tamoxifen treated patients.

  16. Toward improved statistical methods for analyzing Cotinine-Biomarker health association data

    Directory of Open Access Journals (Sweden)

    Clark John D

    2011-10-01

    Full Text Available Abstract Background Serum cotinine, a metabolite of nicotine, is frequently used in research as a biomarker of recent tobacco smoke exposure. Historically, secondhand smoke (SHS research uses suboptimal statistical methods due to censored serum cotinine values, meaning a measurement below the limit of detection (LOD. Methods We compared commonly used methods for analyzing censored serum cotinine data using parametric and non-parametric techniques employing data from the 1999-2004 National Health and Nutrition Examination Surveys (NHANES. To illustrate the differences in associations obtained by various analytic methods, we compared parameter estimates for the association between cotinine and the inflammatory marker homocysteine using complete case analysis, single and multiple imputation, "reverse" Kaplan-Meier, and logistic regression models. Results Parameter estimates and statistical significance varied according to the statistical method used with censored serum cotinine values. Single imputation of censored values with either 0, LOD or LOD/√2 yielded similar estimates and significance; multiple imputation method yielded smaller estimates than the other methods and without statistical significance. Multiple regression modelling using the "reverse" Kaplan-Meier method yielded statistically significant estimates that were larger than those from parametric methods. Conclusions Analyses of serum cotinine data with values below the LOD require special attention. "Reverse" Kaplan-Meier was the only method inherently able to deal with censored data with multiple LODs, and may be the most accurate since it avoids data manipulation needed for use with other commonly used statistical methods. Additional research is needed into the identification of optimal statistical methods for analysis of SHS biomarkers subject to a LOD.

  17. Sonoclot coagulation analysis: a useful tool to predict mortality in overt disseminated intravascular coagulation.

    Science.gov (United States)

    Wan, Peng; Yu, Min; Qian, Min; Tong, Huasheng; Su, Lei

    2016-01-01

    Disseminated intravascular coagulation (DIC) contributes to high mortality. The study was performed to investigate Sonoclot as a potential predictor of 30-day survival in overt DIC. This cohort included 237 consecutive critically ill patients with overt DIC, admitted to a 15-bed multidisciplinary ICU between July 2010 and July 2013. Hemostasis was analyzed with Sonoclot, including activated clotting time (ACT), clot rate, and platelet function, as well as routine clotting test at admission to the critical care center. Sonoclot variables differed in survivors and nonsurvivors. Mean ACT was prolonged (289.9 ± 200.5 vs. 194.8 ± 126.6 s; P < 0.001) and platelet function (1.2 ± 0.9 vs. 1.6 ± 1.2; P = 0.010) was reduced in nonsurvivors. The clot rate was not different. Cox proportional-hazard model showed that ACT and platelet function correlated independently with survival (P < 0.05). Kaplan-Meier survival curve analysis suggested that patients with one pathological Sonoclot findings have better outcome (P < 0.05). After ACT and platelet function were introduced, the receiver-operating characteristic area under the curve of model achieved 0.876 (P < 0.05), with a specificity of 82.6% and a sensitivity of 80.5% in prediction of 30-day survival by multivariate analyses. Our data suggest that the Sonoclot can predict mortality in critically ill patients with overt DIC.

  18. Survival analysis of mandibular complete dentures with acrylic-based resilient liners.

    Science.gov (United States)

    Kimoto, Suguru; Kimoto, Katsuhiko; Murakami, Hiroshi; Gunji, Atsuko; Ito, Nana; Kawai, Yasuhiko

    2013-09-01

    The purpose of this long-term randomised controlled trial was to compare the longevity of dentures constructed using a conventional acrylic resin (CAR) to that of dentures constructed using an acrylic-based resilient liner (ARL). The follow-up study was essentially carried out by annual telephone calls to each of the 67 participants. The Kaplan-Meier method and life-table analysis were used for univariate analyses. The Cox proportional-hazards test was used as a final model for statistically adjusting predictor variables such as sex, clinician type, mandibular denture type and age at denture delivery. The denture type was likely to affect the survival time of the dentures, while the sex and clinician type were not. The group using acrylic-based resilient denture liners had twice the risk of having shorter denture-survival times than those using conventional acrylic resin dentures. Younger participants were likely to have a reduced risk of having shorter denture-survival times than older participants. We conclude that mandibular complete dentures constructed using ARL are twice as likely as dentures constructed using CAR to have shorter denture survival times, mainly because of material deterioration. © 2012 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

  19. Outcomes and predictive factors of pediatric kidney transplants: an analysis of the Thai Transplant Registry.

    Science.gov (United States)

    Rianthavorn, Pornpimol; Kerr, Stephen J; Lumpaopong, Adisorn; Jiravuttipong, Apichat; Pattaragarn, Anirut; Tangnararatchakit, Kanchana; Avihingsanon, Yingyos; Thirakupt, Prapaipim; Sumethkul, Vasant

    2013-03-01

    As universal coverage for pediatric kidney transplantation (KT) was introduced in Thailand in 2008, the number of recipients has been increasing. We evaluated predictive factors for graft failure to understand how to improve clinical outcomes in these children. Using data obtained from the National Transplant registry, we assessed the risk of graft failure using the Kaplan-Meier method and Cox proportional hazards regression. Altogether, 201 recipients aged <21 yr at the time of KT were studied. Living donors (LD) were significantly older than deceased donor (DD). Mean cold ischemia time of DD was 17 h. The mean donor glomerular filtration rate (GFR) was 84.0 mL/min/1.73 m(2) . Induction immunosuppressive therapy was administered more frequently in DD than in LDKT. Delayed graft function (DGF) occurred in 36 transplants. Over 719 person years of follow-up, 42 graft failures occurred. Graft survival at one, three, and five yr post-transplant were 95%, 88% and 76%, respectively. Two factors independently predicted graft failure in multivariate analysis. The hazard ratios for graft failure in patients with DGF and in patients with donor GFR of ≤30 mL/min/1.73 m(2) were 2.5 and 9.7, respectively. Pediatric recipients should receive the first priority for allografts from young DD with a good GFR, and DGF should be meticulously prevented.

  20. Percutaneous Irreversible Electroporation: Long-term survival analysis of 71 patients with inoperable malignant hepatic tumors

    Science.gov (United States)

    Niessen, C.; Thumann, S.; Beyer, L.; Pregler, B.; Kramer, J.; Lang, S.; Teufel, A.; Jung, E. M.; Stroszczynski, C.; Wiggermann, P.

    2017-01-01

    Aim of this retrospective analysis was to evaluate the survival times after percutaneous irreversible electroporation (IRE) in inoperable liver tumors not amenable to thermal ablation. 71 patients (14 females, 57 males, median age 63.5 ± 10.8 years) with 103 liver tumors were treated in 83 interventions using IRE (NanoKnife® system). The median tumor short-axis diameter was 1.9 cm (minimum 0.4 cm, maximum 4.5 cm). 35 patients had primary liver tumors and 36 patients had liver metastases. The Kaplan-Meier method was employed to calculate the survival rates, and the different groups were compared using multivariate log-rank and Wilcoxon tests. The overall median survival time was 26.3 months; the median survival of patients with primary land secondary liver cancer did not significantly differ (26.8 vs. 19.9 months; p = 0.41). Patients with a tumor diameter >3 cm (p Child-Pugh class B or C cirrhosis died significantly earlier than patients with Child-Pugh class A (p < 0.05). Patients with very early stage HCC survived significantly longer than patients with early stage HCC with a median survival of 22.3 vs. 13.7 months (p < 0.05). PMID:28266600

  1. New fluoride MI Varnish as root canal sealer: An in vitro analysis of bacterial leakage.

    Science.gov (United States)

    Rao, Dhanu G; Trivedi, Malay Vishnuprasad; Havale, Raghavendra; Shrutha, S P

    2016-01-01

    The aim of the present study was to evaluate and compare the sealing ability of root canal obturation after the application of fluoride varnish (MI Varnish) containing 5% sodium fluoride and casein phosphopeptide-amorphous calcium phosphate, fluoride varnish, and AH Plus and AH-Plus as root canal sealer by bacterial penetration test. Root canals of 65 single-rooted and single-canalled teeth were prepared. They were divided into three experimental groups (n = 15) and two control groups (n = 10). The root canal walls in Group I were coated with AH Plus, Group II were coated with AH Plus and fluoride varnish, and Group III were coated with fluoride varnish. All the teeth were obturated with gutta-percha using the lateral condensation technique. Enterococcus faecalis were used as test bacteria to determine the leakage during 100 days. The data were analyzed using log-rank test and Kaplan-Meier survival analysis. Group III showed significantly less bacterial penetration as compared to Group I (P = 0.01) and Group II (P = 0.03). However, there was no statistical significance between Groups I and II (P = 0.672). It can be concluded from the present study that fluoride varnish can be used as a root canal sealer. However, further in vitro and in vivo studies are required.

  2. Survival analysis of patients with high-grade gliomas based on data mining of imaging variables.

    Science.gov (United States)

    Zacharaki, E I; Morita, N; Bhatt, P; O'Rourke, D M; Melhem, E R; Davatzikos, C

    2012-06-01

    The prediction of prognosis in HGGs is poor in the majority of patients. Our aim was to test whether multivariate prediction models constructed by machine-learning methods provide a more accurate predictor of prognosis in HGGs than histopathologic classification. The prediction of survival was based on DTI and rCBV measurements as an adjunct to conventional imaging. The relationship of survival to 55 variables, including clinical parameters (age, sex), categoric or continuous tumor descriptors (eg, tumor location, extent of resection, multifocality, edema), and imaging characteristics in ROIs, was analyzed in a multivariate fashion by using data-mining techniques. A variable selection method was applied to identify the overall most important variables. The analysis was performed on 74 HGGs (18 anaplastic gliomas WHO grades III/IV and 56 GBMs or gliosarcomas WHO grades IV/IV). Five variables were identified as the most significant, including the extent of resection, mass effect, volume of enhancing tumor, maximum B0 intensity, and mean trace intensity in the nonenhancing/edematous region. These variables were used to construct a prediction model based on a J48 classification tree. The average classification accuracy, assessed by cross-validation, was 85.1%. Kaplan-Meier survival curves showed that the constructed prediction model classified malignant gliomas in a manner that better correlates with clinical outcome than standard histopathology. Prediction models based on data-mining algorithms can provide a more accurate predictor of prognosis in malignant gliomas than histopathologic classification alone.

  3. Matched-pair analysis of open versus laparoscopic nephroureterectomy for upper urinary tract urothelial cell carcinoma.

    Science.gov (United States)

    Blackmur, James P; Stewart, Grant D; Egong, Eric A; Cutress, Mark L; Tolley, David A; Riddick, Anthony C P; McNeill, S Alan

    2015-01-01

    Laparoscopic nephroureterectomy (LNU) offers a superior morbidity profile compared with open nephroureterectomy (ONU) in treating upper urinary tract urothelial cell carcinoma. Evidence of oncological equivalence between LNU and ONU is limited. We compare operative and oncological outcomes for LNU and ONU using matched-pair analysis. Of 159 patients who underwent a nephroureterectomy at a single institution between April 1992 and April 2010, 13 pairs of ONU and LNU patients were matched for gender, age, tumour location, tumour grade and stage. Operative details, post-operative characteristics and recurrences were collated and survival rates analysed using the Kaplan-Meier method. There was no significant difference in mean operation time between LNU (191 min) and ONU (194 min, p=0.92). There was no significant difference in the 5-year survival rate between LNU and ONU (overall survival 59.1% vs. 73.5%, p=0.18; progression-free survival 24.0% vs. 56.0%, p=0.14; cancer-specific survival 60.9% vs. 73.5%, p=0.56; bladder cancer recurrence-free survival 8.7% vs. 0.0%, p=0.09). Amidst limited RCT and comparative studies, this study presents further evidence of oncological equivalence between LNU and ONU. There was a trend towards poorer outcomes following LNU though, which merits further study. © 2014 S. Karger AG, Basel.

  4. Integrated analysis of expression profiling data identifies three genes in correlation with poor prognosis of triple-negative breast cancer.

    Science.gov (United States)

    Zhang, Cheng; Han, Yong; Huang, Hao; Min, Li; Qu, Like; Shou, Chengchao

    2014-06-01

    Triple-negative breast cancer (TNBC) shows more aggressive clinical behavior and poorer outcome than non-triple-negative breast cancer (NTNBC), and cannot be treated either via endocrine therapy or by Trastuzumab. For TNBC, chemotherapy is currently the mainstay of systemic medical treatment, the lack of more efficient options of treatment has been a problem in breast cancer prevention. In this study, we aimed to find genes related to prognosis in TNBC by bioinformatic analysis and to provide therapeutic candidates for TNBC treatment. We compared the differences in gene expression levels between cancer patients and healthy individuals across five breast cancer microarray databases to generate a gene cohort specifically upregulated in the NTNBC subtype, whose expression levels are ≥2-fold higher in TNBC compared to NTNBC and healthy individuals. Another two databases with clinical information were applied for following Kaplan-Meier analysis, and high expression of BIRC5, CENPA and FAM64A in this cohort were found to be related to poor survival (OS, DMFS, DFS and RFS). This correlation was also seen in patients at early stages and grades. On the other hand, the outcome of patients with synchronous upregulation of these three genes was the worst, while those with synchronous low gene level was the best. In conclusion, BIRC5, CENPA and FAM64A are specifically upregulated in TNBC, and the high expression of these three genes is associated with poor breast cancer prognosis, suggesting their clinical implication as therapeutic targets in TNBC.

  5. Tumour heterogeneity in non-small cell lung carcinoma assessed by CT texture analysis: a potential marker of survival

    Energy Technology Data Exchange (ETDEWEB)

    Ganeshan, Balaji; Miles, Ken [Brighton and Sussex Medical School, Clinical Imaging Sciences Centre, Division of Clinical and Laboratory Investigation, Brighton, East Sussex (United Kingdom); Panayiotou, Elleny; Burnand, Kate [Brighton and Sussex University Hospitals NHS Trust, Brighton (United Kingdom); Dizdarevic, Sabina [Brighton and Sussex University Hospitals NHS Trust, Department of Nuclear Medicine, Royal Sussex County Hospital, Brighton (United Kingdom)

    2012-04-15

    To establish the potential for tumour heterogeneity in non-small cell lung cancer (NSCLC) as assessed by CT texture analysis (CTTA) to provide an independent marker of survival for patients with NSCLC. Tumour heterogeneity was assessed by CTTA of unenhanced images of primary pulmonary lesions from 54 patients undergoing {sup 18}F-fluorodeoxyglucose (FDG) PET-CT for staging of NSCLC. CTTA comprised image filtration to extract fine, medium and coarse features with quantification of the distribution of pixel values (uniformity) within the filtered images. Receiver operating characteristics identified thresholds for PET and CTTA parameters that were related to patient survival using Kaplan-Meier analysis. The median (range) survival was 29.5 (1-38) months. 24, 10, 14 and 6 patients had tumour stages I, II, III and IV respectively. PET stage and tumour heterogeneity assessed by CTTA were significant independent predictors of survival (PET stage: Odds ratio 3.85, 95% confidence limits 0.9-8.09, P = 0.002; CTTA: Odds ratio 56.4, 95% confidence limits 4.79-666, p = 0.001). SUV was not a significantly associated with survival. Assessment of tumour heterogeneity by CTTA of non-contrast enhanced images has the potential for to provide a novel, independent predictor of survival for patients with NSCLC. (orig.)

  6. Prospective five-year subsidence analysis of a cementless fully hydroxyapatite-coated femoral hip arthroplasty component.

    Science.gov (United States)

    Clauss, Martin; Van Der Straeten, Catherine; Goossens, Marc

    2014-01-01

    Early subsidence >1.5 mm is considered to be a predictive factor for later aseptic loosening of the femoral component following total hip arthroplasty (THA). The aim of this study was to assess five-year subsidence rates of the cementless hydroxyapatite-coated twinSys stem (Mathys Ltd., Bettlach, Switzerland).This prospective single-surgeon series examined consecutive patients receiving a twinSys stem at Maria Middelares Hospital, Belgium. Patients aged >85 years or unable to come to follow-up were excluded. Subsidence was assessed using Ein Bild Roentgen Analyse--Femoral Component Analysis (EBRA-FCA). Additional clinical and radiographic assessments were performed. Follow-ups were prospectively scheduled at two, five, 12, 24, and 60 months.In total, 218 THA (211 patients) were included. At five years, mean subsidence was 0.66 mm (95% CI: 0.43-0.90). Of the 211 patients, 95.2% had an excellent or good Harris Hip Score. There were few radiological changes. Kaplan-Meier analysis indicated five-year stem survival to be 98.4% (95% CI: 97.6-100%).Subsidence levels of the twinSys femoral stem throughout the five years of follow-up were substantially lower than the 1.5 mm level predictive of aseptic loosening. This was reflected in the high five-year survival rate.

  7. Risk stratification of patients with locally aggressive differentiated thyroid cancer. Results of the MSDS trial.

    Science.gov (United States)

    Riemann, Burkhard; Krämer, J A; Schmid, K W; Dralle, H; Dietlein, M; Schicha, H; Sauerland, C; Frankewitsch, T; Schober, O

    2010-01-01

    The Multicentre Study Differentiated Thyroid Cancer (MSDS) collective represents a well defined group of patients with locally aggressive thyroid carcinomas (pT4; AJCC/UICC 1997). The aim of the present study was to compare the survival of patients with minimum and extensive extrathyroidal growth according to the new AJCC/UICC TNM staging system 2009. The follow-up data of 347 patients were analysed. Patients were reclassified according to the current AJCC/UICC 2009 classification. The event-free and overall survival was evaluated using Kaplan-Meier analysis. In addition, postoperative complications and status of disease were documented. 327 patients were assigned to stage pT3 and 20 patients to stage pT4a, respectively. Median follow-up was 6.1 years (range 0.04-9.8 years). 92.5% of patients reached complete remission. There were 7.8 % recurrences in the thyroid bed, in locoregional lymph nodes and/or in distant sites. The overall survival was >98% both in pT3 and pT4a patients (p = n. s.). In contrast, the event-free survival was significantly less favourable in pT4a patients (p MSDS patients with locally aggressive differentiated thyroid cancer showed an excellent overall survival during a median follow-up of 6.1 years. According to the current AJCC/UICC 2009 classification, pT3 patients with minimal extrathyroidal extension revealed a significantly better event-free survival than pT4a patients with extensive extrathyroidal growth.

  8. Clinical results of the Metha short hip stem: a perspective for younger patients?

    Directory of Open Access Journals (Sweden)

    Fritz Thorey

    2013-11-01

    Full Text Available In recent years, various uncemented proximal metaphyseal hip stems were introduced for younger patients as a bone preserving strategy. Initial osteodensitometric analyses of the surrounding bone of short stems indicate an increase of bone mass with secondary bone ingrowth fixation as a predictor of long-term survival of these types of implants. We report the outcome of 151 modular Metha short hip stem implants in 148 patients between March 2005 and October 2007. The mean follow-up was 5.8±0.7 years and the mean age of the patients was 55.7±9.8 years. Along with demographic data and co-morbidities, the Harris Hip Score (HHS, the Hip dysfunction and Osteoarthritis Outcome Score (HOOS, and also the results of a patient-administered questionnaire were recorded pre-operatively and at follow-up. The mean HHS increased from 46±17 pre-operatively to 90±5 the HOOS improved from 55±16 pre-operatively to 89±10 at the final follow-up. A total of three patients have been revised, two for subsidence with femoral revision and one for infection without femoral revision (Kaplan Meier survival estimate 98%. The radiological findings showed no radiolucent lines in any of the patients. The modular Metha short hip stem was implanted in younger patients, who reported an overall high level of satisfaction. The clinical and radiographic results give support to the principle of using short stems with metaphyseal anchorage. However, long-term results are necessary to confirm the success of this concept in the years to come.

  9. Outcome analysis of high-dose chemotherapy and autologous stem cell transplantation in adolescent and young adults with relapsed or refractory Hodgkin lymphoma.

    Science.gov (United States)

    Akhtar, Saad; Rauf, Shahzad M; Elhassan, Tusneem A M; Maghfoor, Irfan

    2016-09-01

    High-dose chemotherapy (HDC) and autologous stem cell transplantation (auto-SCT) can salvage many patients with relapsed or refractory Hodgkin's lymphoma (HL). We are reporting the outcome of HDC auto-SCT and the impact of 21 prognostic factors in relapsed and refractory adolescent (14-21 years) and young adult (>21-30 years) (AYA) HL patients. We used Fine and Gray's competing risk analysis method and regression model for outcome analysis. From 1996 to 2013, 290 consecutive patients with biopsy-proven HL underwent HDC auto-SCT for relapsed/refractory HL; 216 patients (74.5 %) were AYA at the time of auto-SCT. Male/female were equal, median age at auto-SCT was 22.4 years, and there were 94 adolescent (43.5 %) and 122 young adults (56.5 %). There was refractory disease in 121 (56 %) patients, relapsed in 95 (44 %). Median follow-up was 72.6 months. The Kaplan-Meier method estimated that 5-year overall survival is 62.7 % (adolescents (63.5 %), young adults (62 %)) and event-free survival was 51.3 %. Five-year cumulative incidence of disease-specific death (DS-death) is 33 % and that of DS-event is 45 %. For DS-death, the multivariate analysis identified complete remission (CR) duration of young adults.

  10. Molecular genetics analysis of hereditary breast and ovarian cancer patients in India

    Directory of Open Access Journals (Sweden)

    Soumittra Nagasamy

    2009-08-01

    Full Text Available Abstract Background Hereditary cancers account for 5–10% of cancers. In this study BRCA1, BRCA2 and CHEK2*(1100delC were analyzed for mutations in 91 HBOC/HBC/HOC families and early onset breast and early onset ovarian cancer cases. Methods PCR-DHPLC was used for mutation screening followed by DNA sequencing for identification and confirmation of mutations. Kaplan-Meier survival probabilities were computed for five-year survival data on Breast and Ovarian cancer cases separately, and differences were tested using the Log-rank test. Results Fifteen (16% pathogenic mutations (12 in BRCA1 and 3 in BRCA2, of which six were novel BRCA1 mutations were identified. None of the cases showed CHEK2*1100delC mutation. Many reported polymorphisms in the exonic and intronic regions of BRCA1 and BRCA2 were also seen. The mutation status and the polymorphisms were analyzed for association with the clinico-pathological features like age, stage, grade, histology, disease status, survival (overall and disease free and with prognostic molecular markers (ER, PR, c-erbB2 and p53. Conclusion The stage of the disease at diagnosis was the only statistically significant (p

  11. Skeletal Plasmacytoma: Progression of disease and impact of local treatment; an analysis of SEER database

    Directory of Open Access Journals (Sweden)

    Scully Sean P

    2009-09-01

    Full Text Available Abstract Background Previous reports suggest an as yet unidentifiable subset of patients with plasmacytoma will progress to myeloma. The current study sought to establish the risk of developing myeloma and determine the prognostic factors affecting the progression of disease. Methods Patients with plasmacytoma diagnosed between 1973 and 2005 were identified in the SEER database(1164 patients. Patient demographics and clinical characteristics, treatment(s, cause of death, and survival were extracted. Kaplan-Meier, log-rank, and Cox regression were used to analyze prognostic factors. Results The five year survival among patients initially diagnosed with plasmacytoma that later progressed to multiple myeloma and those initially diagnosed with multiple myeloma were almost identical (25% and 23%; respectively. Five year survival for patients with plasmacytoma that did not progress to multiple myeloma was significantly better (72%. Age > 60 years was the only factor that correlated with progression of disease (p = 0.027. Discussion Plasmacytoma consists of two cohorts of patients with different overall survival; those patients that do not progress to systemic disease and those that develop myeloma. Age > 60 years is associated with disease progression. Identifying patients with systemic disease early in the treatment will permit aggressive and novel treatment strategies to be implemented.

  12. Tumor size predicts long-term survival in colon cancer: an analysis of the National Cancer Data Base.

    Science.gov (United States)

    Saha, Sukamal; Shaik, Mohammed; Johnston, Gregory; Saha, Supriya Kumar; Berbiglia, Lindsay; Hicks, Micheal; Gernand, Jill; Grewal, Sandeep; Arora, Madan; Wiese, David

    2015-03-01

    American Joint Committee on Cancer uses tumor size for "T" staging of many solid tumors for its effect on prognosis. However, tumor size has not been incorporated in tumor (T), nodal status (N), metastasis (M) staging for colon cancer. Hence, the National Cancer Data Base was used to determine whether tumor size correlates with TNM staging and survival. For the 300,386 patients, tumor size was divided into S1 (0 to 2 cm), S2 (>2 to 4 cm), S3 (>4 to 6 cm), and S4 (>6 cm). Statistical comparison was done for TNM stage, grade, and nodal status with tumor size. Kaplan-Meier survival analysis was done for each "S" stage. Of the 300,386 patients, 13% were classified as S1, 39% S2, 30% S3 and 18% as S4. Right colon was the most common site (48%). Tumor size positively correlated with grade, T stage, and nodal stage. Tumor size was inversely associated with survival. Tumor size is positively correlated with important prognostic factors and negatively impacted survival. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Practice-based clinical evaluation of metal-ceramic and zirconia molar crowns: 3-year results.

    Science.gov (United States)

    Rinke, S; Schäfer, S; Lange, K; Gersdorff, N; Roediger, M

    2013-03-01

    This practice-based study evaluates the clinical performance of conventionally luted metal-ceramic and zirconia molar crowns fabricated with pronounced anatomical core design and a prolonged cooling period of the veneering porcelain. Fifty-three patients were treated from 07/2008 until 07/2009 with either metal-ceramic crowns (MCC) (high-noble alloy + low-fusing porcelain) or zirconia crowns (Cercon System, DeguDent, Germany). Forty-nine patients (30 women/19 men) with 100 restorations (metal-ceramic: 48/zirconia: 52, mean observational period: 36·5 ± 6 months) participated in a clinical follow-up examination and were included in the study. Time-dependent survival (in situ criteria), success (event-free restorations) and chipping rates (defects of the veneering ceramics) were calculated according to the Kaplan-Meier method and analysed in relation to the crown fabrication technique, using a Cox regression model (P zirconia: 2) were recorded (survival rate after 3 years: metal-ceramic: 97·6%, zirconia: 95·2%). Of the metal-ceramic restorations, 90·9% remained event-free (two ceramic fractures, one endodontic treatment), whereas the success rate for the zirconia was 86·8% (two ceramic fractures, one endodontic treatment, one secondary caries). No significant differences in survival (P = 0·53), success (P = 0·49) and ceramic fracture rates (P = 0·57) were detected. The combination of a pronounced anatomical core design and a modified firing of the veneering porcelain for the fabrication of zirconia molar crowns resulted in a 3-year survival, success and chipping rate comparable to MCC.

  14. The prognostic implications of microvascular density and lymphatic vessel density in esophageal squamous cell carcinoma: Comparative analysis between the traditional whole sections and the tissue microarray.

    Science.gov (United States)

    Chen, Bo; Fang, Wang-Kai; Wu, Zhi-Yong; Xu, Xiu-E; Wu, Jian-Yi; Fu, Jun-Hui; Yao, Xiao-Dong; Huang, Jian-Hao; Chen, Jie-Xin; Shen, Jin-Hui; Zheng, Chun-Peng; Wang, Shao-Hong; Li, En-Min; Xu, Li-Yan

    2014-05-01

    Focal distribution of microvascular and lymphatic vessels is a critical issue in cancer, and is measured by tissue microarray (TMA) construction from paraffin-embedded surgically obtained tissues, a process that may not accurately reflect true focal distribution. The aim of this study was to assess the concordance of microvascular density (MVD) and lymphatic vessel density (LVD) in TMAs with corresponding whole sections, and to correlate the MVD or LVD with clinicopathological parameters in 124 cases of esophageal squamous cell carcinoma (ESCC). MVD, determined by CD105 immunohistochemistry of whole sections, was strongly associated with lymph node metastasis (p=0.000) and pTNM stage (p=0.001). Kaplan-Meier survival analysis showed that increasing CD105 microvessel count correlated with decreasing survival (ptissue microarrays. Analysis of continuous data showed a highly significant correlation between whole sections and TMA data (Pearson r=0.522, p<0.001). Increasing LVD, as determined by D2-40 immunohistochemistry of whole sections, correlated with decreasing survival, but this relationship was undetectable using TMAs. In conclusion, we demonstrate that for the selected endothelial markers, TMAs can provide a realistic and reliable estimate of the extent of MVD, but not LVD in ESCC samples. Copyright © 2013 Elsevier GmbH. All rights reserved.

  15. High Intensity Focused Ultrasound versus Brachytherapy for the Treatment of Localized Prostate Cancer: A Matched-Pair Analysis

    Directory of Open Access Journals (Sweden)

    Fouad Aoun

    2015-01-01

    Full Text Available Purpose. To evaluate postoperative morbidity and long term oncologic and functional outcomes of high intensity focused ultrasound (HIFU compared to brachytherapy for the treatment of localized prostate cancer. Material and Methods. Patients treated by brachytherapy were matched 1 : 1 with patients who underwent HIFU. Differences in postoperative complications across the two groups were assessed using Wilcoxon’s rank-sum or χ2 test. Kaplan-Meier curves, log-rank tests, and Cox regression models were constructed to assess differences in survival rates between the two groups. Results. Brachytherapy was significantly associated with lower voiding LUTS and less frequent acute urinary retention (p<0.05. Median oncologic follow-up was 83 months (13–123 months in the HIFU cohort and 44 months (13–89 months in the brachytherapy cohort. Median time to achieve PSA nadir was statistically shorter in the HIFU. Biochemical recurrence-free survival rate was significantly higher in the brachytherapy cohort compared to HIFU cohort (68.5% versus 53%, p<0.05. No statistically significant difference in metastasis-free, cancer specific, and overall survivals was observed between the two groups. Conclusion. HIFU and brachytherapy are safe with no significant difference in cancer specific survival on long term oncologic follow-up. Nonetheless, a randomized controlled trial is needed to confirm these results.

  16. Survival analysis of hypotensive cats admitted to an intensive care unit with or without hyperlactatemia: 39 cases (2005-2011).

    Science.gov (United States)

    Shea, Emily K; Dombrowski, Stefan C; Silverstein, Deborah C

    2017-04-15

    OBJECTIVE To examine the association between blood lactate concentration and survival to hospital discharge in critically ill hypotensive cats. DESIGN Retrospective case series. ANIMALS 39 cats admitted to an intensive care unit of a university veterinary hospital between January 2005 and December 2011 for which blood lactate concentration was recorded ≤ 1 hour before or after a Doppler-derived arterial blood pressure measurement ≤ 90 mm Hg (ie, hypotension) was obtained. PROCEDURES Medical records of each cat were reviewed to assess survival to hospital discharge, illness severity, duration of hospitalization, age, body weight, and PCV. Results were compared between hypotensive cats with and without hyperlactatemia (blood lactate concentration ≥ 2.5 mmol/L). RESULTS 6 of 39 (15%) hypotensive cats survived to hospital discharge. Twelve (31%) cats were normolactatemic (blood lactate concentration cats with normolactatemia had a higher blood pressure and higher survival rate than hypotensive cats with hyperlactatemia. Five-day Kaplan-Meier survival rates were 57% for normolactatemic cats and 17% for hyperlactatemic cats. Age, body weight, duration of hospitalization, PCV, and illness severity did not differ significantly between hypotensive cats with and without hyperlactatemia. CONCLUSIONS AND CLINICAL RELEVANCE Hypotensive, normolactatemic cats in an intensive care unit had a significantly greater chance of survival to hospital discharge than their hyperlactatemic counterparts. Blood lactate concentration may be a useful prognostic indicator for this patient population when used in conjunction with other clinical and laboratory findings.

  17. Factors Affecting the Recurrence of Giant Cell Tumor of Bone After Surgery: A Clinicopathological Study of 80 Cases from a Single Center

    Directory of Open Access Journals (Sweden)

    Dong-dong Cheng

    2015-07-01

    Full Text Available Background/Aims: This aim of the present study was to identify specific markers determining the recurrence of the giant cell tumor of bone (GCTB. Methods: This study involved the clinicopathological analysis of 80 cases. All of the clinical features, pathological fracture, Campanacci grade, histological features and surgical methods were reviewed. Immunohistochemistry was used to detect the expression of Ki-67, CD147, mutant p53 and p63 in GCTB. Comparisons between different groups were performed using the Chi-square test. The risk factors affecting recurrence were analyzed using a binary logistic model. Kaplan-Meier analysis was employed for the survival analysis between the groups. Cell proliferation assays, migration and invasion assays were used to detect the function of CD147 on GCTB in vitro. Results: The univariate analysis showed that Ki-67 and CD147 expression, pathological fracture, Campanacci grade and surgical method were associated with recurrence. The multivariate analysis revealed that CD147 expression, Campanacci grade and surgical method were the factors affecting GCTB recurrence. In addition, the Kaplan-Meier analysis revealed that these factors affected tumor-free survival time. In vitro study revealed that the CD147 knockdown by small interfering RNA (siRNA technique dramatically reduced the proliferation, migration and invasion of GCTB. Conclusion: Our results suggest that CD147 may serve as an adequate marker for GCTB recurrence. Campanacci grade is a risk factor for GCTB recurrence, which is also affected by the surgical method used.

  18. Exploring Technostress: Results of a Large Sample Factor Analysis

    OpenAIRE

    Steponas Jonušauskas; Agota Giedre Raisiene

    2016-01-01

    With reference to the results of a large sample factor analysis, the article aims to propose the frame examining technostress in a population. The survey and principal component analysis of the sample consisting of 1013 individuals who use ICT in their everyday work was implemented in the research. 13 factors combine 68 questions and explain 59.13 per cent of the answers dispersion. Based on the factor analysis, questionnaire was reframed and prepared to reasonably analyze the respondents’ an...

  19. ANALYSIS RESULTS FOR BUILDING 241 702-AZ A TRAIN

    Energy Technology Data Exchange (ETDEWEB)

    DUNCAN JB; FRYE JM; COOKE CA; LI SW; BROCKMAN FJ

    2006-12-13

    This report presents the analyses results for three samples obtained under RPP-PLAN-28509, Sampling and Analysis Plan for Building 241 702-AZ A Train. The sampling and analysis was done in response to problem evaluation request number PER-2004-6139, 702-AZ Filter Rooms Need Radiological Cleanup Efforts.

  20. The Curriculum in Quantitative Analysis: Results of a Survey.

    Science.gov (United States)

    Locke, David C.; Grossman, William E. L.

    1987-01-01

    Reports on the results of a survey of college level instructors of quantitative analysis courses. Discusses what topics are taught in such courses, how much weight is given to these topics, and which experiments are used in the laboratory. Poses some basic questions about the curriculum in quantitative analysis. (TW)

  1. Novel nitric oxide producing probiotic wound healing patch: preparation and in vivo analysis in a New Zealand white rabbit model of ischaemic and infected wounds.

    Science.gov (United States)

    Jones, Mitchell; Ganopolsky, Jorge G; Labbé, Alain; Gilardino, Mirko; Wahl, Christopher; Martoni, Christopher; Prakash, Satya

    2012-06-01

    The treatment of chronic wounds poses a significant challenge for clinicians and patients alike. Here we report design and preclinical efficacy of a novel nitric oxide gas (gNO)-producing probiotic patch for wound healing. Specifically, a wound healing patch using lactic acid bacteria in an adhesive gas permeable membrane has been designed and investigated for treating ischaemic and infected full-thickness dermal wounds in a New Zealand white rabbit model for ischaemic wound healing. Kaplan-Meier survival curves showed increased wound closure with gNO-producing patch-treated wounds over 21 days of therapy (log-rank P = 0·0225 and Wilcoxon P = 0·0113). Cox proportional hazard regression showed that gNO-producing patch-treated wounds were 2·52 times more likely to close compared with control patches (hazard P = 0·0375, score P = 0·032 and likelihood ratio P = 0·0355), and histological analysis showed improved wound healing in gNO-producing patch-treated animals. This study may provide an effective, safe and less costly alternative for treating chronic wounds. © 2012 The Authors. © 2012 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

  2. Serum creatinine improves body mass index survival prediction in hemodialysis patients: a 1-year prospective cohort analysis from the ARNOS study.

    Science.gov (United States)

    Moreau-Gaudry, Xavier; Guebre-Egziabher, Fitsum; Jean, Guillaume; Genet, Leslie; Lataillade, Dominique; Legrand, Eric; Kuentz, Francois; Trolliet, Pierre; Fouque, Denis

    2011-09-01

    This study sought to better characterize the relationships between body mass index (BMI) and lean body mass (LBM) as assessed by serum creatinine (SCr) and mortality. The data were collected from a prospective prevalent cohort in maintenance hemodialysis patients. The study was carried out in 25 dialysis units in Rhônes Alpes area (France and Switzerland). A total of 1,205 patients were followed up for 1-year, starting July 1, 2005. Mortality as well as clinical and biological routine parameters were recorded. Kaplan-Meier, Cox model, Log rank test were used for the statistical analysis. We found that SCr was a strong predictor of mortality (P 23 (P < .001). BMI should not be used by itself but in conjunction with SCr as a surrogate of LBM to improve its morbid-mortality predictive power. LBM should also be taken into account in further survival studies carried out in hemodialysis patients. Copyright © 2011 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  3. DOE 2009 Geothermal Risk Analysis: Methodology and Results (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Young, K. R.; Augustine, C.; Anderson, A.

    2010-02-01

    This presentation summarizes the methodology and results for a probabilistic risk analysis of research, development, and demonstration work-primarily for enhanced geothermal systems (EGS)-sponsored by the U.S. Department of Energy Geothermal Technologies Program.

  4. Protocol for qRT-PCR analysis from formalin fixed paraffin embedded tissue sections from diffuse large b-cell lymphoma: Validation of the six-gene predictor score

    Science.gov (United States)

    Tekin, Nilgun; Conget, Paulette; Bruna, Flavia; Timar, Botond; Gagyi, Eva; Basak, Ranjan; Naik, Omkar; Auewarakul, Chirayu; Sritana, Narongrit; Levy, Debora; Cerci, Juliano Julio; Bydlowski, Sergio Paulo; Pereira, Juliana; Dimamay, Mark Pierre; Natividad, Filipinas; Chung, June-Key; Belder, Nevin; Kuzu, Isinsu; Paez, Diana; Dondi, Maurizio; Carr, Robert

    2016-01-01

    As a part of an international study on the molecular analysis of Diffuse Large B-cell Lymphoma (DLBCL), a robust protocol for gene expression analysis from RNA extraction to qRT-PCR using Formalin Fixed Paraffin Embedded tissues was developed. Here a study was conducted to define a strategy to validate the previously reported 6-gene (LMO2, BCL6, FN1, CCND2, SCYA3 and BCL2) model as predictor of prognosis in DLBCL. To avoid variation, all samples were tested in a single centre and single platform. This study comprised 8 countries (Brazil, Chile, Hungary, India, Philippines, S. Korea, Thailand and Turkey). Using the Kaplan-Meier and log rank test on patients (n=162) and two mortality risk groups (with those above and below the mean representing high and low risk groups) confirmed that the 6-gene predictor score correlates significantly with overall survival (OS, p<0.01) but not with event free survival (EFS, p=0.18). Adding the International Prognostic Index (IPI) shows that the 6-gene predictor score correlates significantly with high IPI scores for OS (p<0.05), whereas those with low IPI scores show a trend not reaching significance (p=0.08). This study defined an effective and economical qRT-PCR strategy and validated the 6-gene score as a predictor of OS in an international setting. PMID:27825111

  5. Probability Prediction in Multistate Survival Models for Patients with Chronic Myeloid Leukaemia

    Institute of Scientific and Technical Information of China (English)

    FANG Ya; Hein Putter

    2005-01-01

    In order to find an appropriate model suitable for a multistate survival experiment, 634 patients with chronic myeloid leukaemia (CML) were selected to illustrate the method of analysis.After transplantation, there were 4 possible situations for a patient: disease free, relapse but still alive, death before relapse, and death after relapse. The last 3 events were considered as treatment failure. The results showed that the risk of death before relapse was higher than that of the relapse,especially in the first year after transplantation with competing-risk method. The result of patients with relapse time less than 12 months was much poor by the Kaplan-Meier method. And the multistate survival models were developed, which were detailed and informative based on the analysis of competing risks and Kaplan-Meier analysis. With the multistate survival models, a further analysis on conditional probability was made for patients who were disease free and still alive at month 12 after transplantation. It was concluded that it was possible for an individual patient to predict the 4 possible probabilities at any time. Also the prognoses for relapse either death or not and death either before or afterrelapse may be given. Furthermore, the conditional probabilities for patients who were disease free and still alive in a given time after transplantation can be predicted.

  6. Risk Stratification using Human Papillomavirus Testing among Women with Equivocally Abnormal Cytology: Results from a State-wide Surveillance Program

    Science.gov (United States)

    Gage, Julia C; Hunt, William C; Schiffman, Mark; Katki, Hormuzd A; Cheung, Li C; Cuzick, Jack; Myers, Orrin; Castle, Philip E; Wheeler, Cosette M.

    2016-01-01

    Background Clinical guidelines for cervical cancer screening have incorporated comparative risks of cervical intraepithelial neoplasia grade 3 or cancer (CIN3+) for various screening outcomes to determine management. Few cohorts are large enough to distinguish CIN3+ risks among women with minor abnormalities vs. negative cytology because of low incidence. The New Mexico HPV Pap Registry offers a unique opportunity to evaluate cervical cancer screening in a diverse population across a broad-spectrum of health service delivery. Methods Kaplan-Meier and logistic-Weibull survival models were used to estimate cumulative risks of CIN3+ among women aged 21–64 who were screened in New Mexico between 2007–2011 with negative, equivocal or mildly abnormal cytology, i.e., atypical squamous cells of undetermined significance (ASC-US; with or without HPV triage), or low-grade squamous intraepithelial lesions. Results We identified 452,045 women meeting the selection criteria. The 3-year CIN3+ risks for women with negative, ASC-US and LSIL cytology were: 0.30%, 2.6%, and 5.2%, respectively. HPV triage of ASC-US stratified 3-year CIN3+ risks were 0.72% for HPV-negative and 7.7% for HPV-positive. Risks tended to decline after age 30 for all screening results. Conclusions In this state-wide population-based cohort, cytology and HPV triage of ASC-US stratified women’s CIN3+ risk into similar patterns observed previously, suggesting the validity of screening guidelines for diverse populations in the United States (U.S.). Absolute risk estimates should be compared across other large populations. Impact Strategies for HPV triage of ASC-US derived from clinical trials are upheld in large clinical practice settings and across diverse screening populations in the U.S.. PMID:26518316

  7. Plasmacytoid variant of bladder cancer defines patients with poor prognosis if treated with cystectomy and adjuvant cisplatin-based chemotherapy

    Directory of Open Access Journals (Sweden)

    Keck Bastian

    2013-02-01

    Full Text Available Abstract Background Since the definition of different histologic subtypes of urothelial carcinomas by the World Health Organization (WHO 2004 classification, description of molecular features and clinical behavior of these variants has gained more attention. Methods We reviewed 205 tumor samples of patients with locally advanced bladder cancer mainly treated within the randomized AUO-AB05/95 trial with radical cystectomy and adjuvant cisplatin-based chemotherapy for histologic subtypes. 178 UC, 18 plasmacytoid (PUC and 9 micropapillary (MPC carcinomas of the bladder were identified. Kaplan Meier analysis and backward multivariate Cox’s proportional hazards regression analysis were performed to compare overall survival between the three histologic subtypes. Results Patients suffering from PUC have the worst clinical outcome regarding overall survival compared to conventional UC and MPC of the bladder that in turn seem have to best clinical outcome (27.4 months, 62.6 months, and 64.2 months, respectively; p=0.013 by Kaplan Meier analysis. Backward multivariate Cox´s proportional hazards regression analysis (adjusted to relevant clinicopathological parameters showed a hazard ratio of 3.2 (p=0.045 for PUC in contrast to patients suffering from MPC. Conclusions Histopathological diagnosis of rare variants of urothelial carcinoma can identify patients with poor prognosis.

  8. [Short and long-term results of liver resection for hepatocarcinoma in Peru: a Peruvian single center experience on 232 cases].

    Science.gov (United States)

    Ruiz, Eloy; Sanchez, Juvenal; Celis, Juan; Payet, Eduardo; Berrospi, Francisco; Chavez, Ivan; Young, Frank

    2007-01-01

    To evaluate the short and long term outcome of liver resections for hepatocellular carcinoma a retrospective analysis was performed on 232 consecutive patients with hepatocellular carcinoma resected between January 1990 and December 2006 at the Department of Abdomen of the Instituto de Enfermedades Neoplasicas of Lima Peru. Disease-free survival (DFS) and overall survival (OS) were determined by Kaplan-Meier method, Prognostic factors were evaluated using univariate and multivariate analysis The median age was 36 years. 44.2% were associated with hepatitis B, only 16.3% had cirrhosis. The median size of the tumors was 15 cm. The median value of AFP was 5,467 ng/ml. The majority of patients underwent a major hepatectomy (74.2 % had four or more segments resected)Overall morbidity and mortality were 13.7% and 5.3% respectively. After a median follow-up of 40 months, tumour recurrence appeared in 53.3% of the patients. The 1, 3, and 5 year overall survival rates were 66.5%, 38.7% and 26.7%respectively. The 1, 3, and 5 year disease-free survival rates were 53.7%, 27.6%, and 19.9%. On multivariate analysis, presence of multiple nodules (p<0.000), cirrhosis (p=0.001), and macroscopic vascular invasion (p=0.001) were found to be independent prognostic factors related to a worse long-term survival. Surgical resection is the optimal therapy for large HCC and can be safely performed with a reasonable long-term survival.

  9. Radiotherapy and chemotherapy in the treatment of head and neck cancer: results after five years of a randomized study

    Energy Technology Data Exchange (ETDEWEB)

    Santarelli, M.; Raffetto, N.; Torcia, P.; Vitturini, A.; Tombolini, V.; Maurizi Enrici, R. [Istituto di radiologia Universita Roma ' ' La Sapienza' ' , Rome (Italy)

    1999-11-01

    Purpose: this study was undertaken to evaluate the efficacy of two regimens of chemoradiotherapy in the treatment of locally advanced head and neck cancer. Methods: from 1992 to 1997, 127 patients with locally advanced head and neck cancer (stage III-IV) were randomized. Sixty-six patients (group a), 42 male and 24 female, with a median age of 48 years (range 40-72) received during radiotherapy two courses (1.-6. week) of chemotherapy with carbo-platin (300 mg/m{sup 2} day 1) and etoposide (60 mg/m{sup 2} days 1 to 3). Sixty-one patients (group b), 40 male and 21 female, with a median age of 51 years (range 42-69) received two cycles of chemotherapy with 5 FU (750 mg/m{sup 2} days 1 to 5) and MIT C ( 10 mg/m{sup 2} day 1). The median dose of radiotherapy was 60 Gy (range 55-66 Gy) 180 cGy /d 5w. Results: the actuarial five-year survival rate(Kaplan-Meier) was 38 % for group a (CBDCA+etoposide+RT) and 25 % for group b (5FU+MIT C+RT). The difference was statistically significant (p = 0.036). Toxicity group a: mucositis G III in 41 patients and G IV in 16; dysphagia G III in 46 patients and IV in 5; leukopenia in 24 patients; 28 patients required nutritional therapy. Toxicity group b: mucositis G III in 38 patients and G IV in 17; dysphagia G III in 48 patients and G IV in 3; leukopenia in 23 patients; 25 patients needed nutritional therapy. Conclusions: the data of the actuarial survival five-year rate suggest that concomitant chemotherapy in group a (CBDCA+etoposide+RT) is better than the concomitant chemotherapy in group b (5FU+MIT C+RT). (author)

  10. All-ceramic partial coverage restorations--midterm results of a 5-year prospective clinical splitmouth study.

    Science.gov (United States)

    Guess, Petra C; Strub, Joerg R; Steinhart, Niclas; Wolkewitz, Martin; Stappert, Christian F J

    2009-08-01

    Midterm-evaluation of a 5-year prospective clinical splitmouth-investigation on survival rate and long-term behavior of all-ceramic partial coverage restorations (PCRs) on molars. Pressed ceramic and CAD/CAM fabricated PCRs were compared. 80 vital molars of 25 patients were restored with all-ceramic PCRs (40 IPS e.max Press*[IP] and 40 ProCAD*[PC]). IP-PCRs were heat pressed following the lost-wax method. PC-PCRs were fabricated with Cerec 3** and Cerec InLab** CAD/CAM system (**Sirona Dental Systems, Bensheim, Germany). All PCRs were adhesively luted with a light-polymerizing composite (Syntac*/Tetric*) (*Ivoclar Vivadent, Schaan, Liechtenstein). Clinical reevaluations were performed at baseline and 13, 25, and 36 months after insertion of the PCRs according to the modified United States Public Health Services (USPHS) criteria. Absolute failures were demonstrated by Kaplan-Meier survival rate. After an observation time up to 3 years, survival rate of IP-PCRs was 100% and 97% for PC-PCRs due to one severe fracture. The PC-PCR had to be replaced after 9 months. Secondary caries and endodontic complications did not occur. Increased clinical service time resulted in significant decrease of marginal adaptation (p=0.031) and enhanced marginal discoloration (pceramic materials demonstrated significant deteriorations in color match (pceramic and CAD/CAM fabricated partial coverage restorations exhibited a reliable treatment option to restore larger defects in posterior teeth. Marginal degradation of the resin cement and deterioration of the all-ceramic materials during clinical function determine the clinical long-term performance of partial coverage restorations.

  11. Comparison of Surgical Parameters and Results between Curved Varus Osteotomy and Rotational Osteotomy for Osteonecrosis of the Femoral Head.

    Science.gov (United States)

    Lee, Young-Kyun; Park, Chan Ho; Ha, Yong-Chan; Kim, Do-Yeon; Lyu, Sung-Hwa; Koo, Kyung-Hoi

    2017-06-01

    Various osteotomies have been introduced to treat osteonecrosis of the femoral head. The purpose of this study was to compare surgical parameters, postoperative limb length discrepancy, and minimum 5-year clinical and radiological results between transtrochanteric curved varus osteotomy (TCVO) and transtrochanteric rotational osteotomy (TRO) for osteonecrosis of the femoral head. From 2004 to 2009, 103 consecutive TROs (97 patients) followed by 72 consecutive TCVOs (64 patients) were performed for the treatment of osteonecrosis of the femoral head. Of these, 85 patients (91 hips) in the TRO group and 58 patients (65 hips) in the TCVO group completed minimum 5-year clinical and radiological follow-up. The Kaplan-Meier product-limit method was used to estimate survival. The TCVO group had shorter operation time (p TRO group and 7 hips (10.8%) in the TCVO group (p = 0.007). Osteophyte formation was observed in 34 hips (37.4%) in the TRO group and 13 hips (20%) in the TCVO group (p = 0.020). Fifteen hips (16.5%) in the TRO group and 7 hips (10.8%) in the TCVO group underwent conversion total hip arthroplasty (THA). The survival rate at 9 years with radiographic collapse as the endpoint was 68.7% (95% confidence interval [CI], 58.1% to 79.3%) in the TRO group, and 84.7% (95% CI, 71.5% to 97.9%) in the TCVO group. With conversion to THA as the endpoint, the survival rate was 82.2% (95% CI, 73.1% to 91.3%) in the TRO group and 89.2% (95% CI, 81.7% to 96.7%) in the TCVO group. The comparison indicates that TCVO was better than TRO in terms of surgical parameters including operation time and estimated blood loss while the 9-year survival rates were similar.

  12. Identification of C16orf74 as a marker of progression in primary non-muscle invasive bladder cancer.

    Directory of Open Access Journals (Sweden)

    Won Tae Kim

    Full Text Available PURPOSE: Methylation-induced silencing of PRSS3 has been shown to be significantly associated with invasive bladder cancer, and expression of the C16orf74 gene locus has been shown to correlate positively with PRSS3. The aim of the current study was to evaluate the relationship between C16orf74 expression level and progression in non-muscle invasive bladder cancer (NMIBC. MATERIALS AND METHODS: C16orf74 mRNA levels were examined by real-time reverse transcriptase polymerase chain reaction (RT-PCR analysis of 193 tumor specimens from patients with primary NMIBC. Expression data were analyzed in terms of clinical and experimental parameters. Kaplan-Meier curves and multivariate Cox regression models, respectively, were used to determine progression-free survival and to identify independent predictive parameters of progression. RESULTS: Analysis using Kaplan-Meier curves revealed prolonged progression-free survival of high-C16orf74-expressors as compared to low-expressors (p<0.001. Multivariate Cox regression analysis revealed that low C16orf74 mRNA expression levels are a significant risk factor for disease progression in patients with primary NMIBC (HR: 10.042, CI:2.699-37.360, p = 0.001. CONCLUSIONS: Decreased expression of C16orf74 correlates significantly with progression in primary NMIBC. C16orf74 expression level represents a potentially useful marker for predicting progression in primary NMIBC patients.

  13. The value of the 2005 International Society of Urological Pathology (ISUP) modified Gleason grading system as a predictor of biochemical recurrence after radical prostatectomy.

    Science.gov (United States)

    Billis, Athanase; Quintal, Maisa M Q; Meirelles, Luciana; Freitas, Leandro L L; Costa, Larissa B E; Bonfitto, João F L; Diniz, Betina L; Poletto, Paola H; Magna, Luís A; Ferreira, Ubirajara

    2014-05-01

    To compare time and risk to biochemical recurrence (BR) after radical prostatectomy of two chronologically different groups of patients using the standard and the modified Gleason system (MGS). Cohort 1 comprised biopsies of 197 patients graded according to the standard Gleason system (SGS) in the period 1997/2004, and cohort 2, 176 biopsies graded according to the modified system in the period 2005/2011. Time to BR was analyzed with the Kaplan-Meier product-limit analysis and prediction of shorter time to recurrence using univariate and multivariate Cox proportional hazards model. Patients in cohort 2 reflected time-related changes: striking increase in clinical stage T1c, systematic use of extended biopsies, and lower percentage of total length of cancer in millimeter in all cores. The MGS used in cohort 2 showed fewer biopsies with Gleason score ≤ 6 and more biopsies of the intermediate Gleason score 7. Time to BR using the Kaplan-Meier curves showed statistical significance using the MGS in cohort 2, but not the SGS in cohort 1. Only the MGS predicted shorter time to BR on univariate analysis and on multivariate analysis was an independent predictor. The results favor that the 2005 International Society of Urological Pathology modified system is a refinement of the Gleason grading and valuable for contemporary clinical practice.

  14. A randomized controlled trial of various MTA materials for partial pulpotomy in permanent teeth.

    Science.gov (United States)

    Kang, Chung-Min; Sun, Yeji; Song, Je Seon; Pang, Nan-Sim; Roh, Byoung-Duck; Lee, Chan-Young; Shin, Yooseok

    2017-05-01

    The aim of this study was to evaluate and compare the clinical applicability of various MTA materials as partial pulpotomy materials in permanent teeth. Partial pulpotomy was performed on 104 permanent teeth from 82 people (mean 29.3±14.8years old), who met the inclusion criteria in randomized clinical trial. The teeth were divided into three groups: ProRoot MTA (n=33), OrthoMTA (n=36), RetroMTA (n=35). Clinical examination and radiographic comparison were carried out at 1, 3, 6 and 12 months after the treatment. Survival analysis was performed using the Kaplan-Meier survival curves and log rank tests. Partial pulpotomy sustained a high success rate up to 1year with no significant differences in the outcomes treated with three MTA materials: ProRoot MTA, 96.0%; OrthoMTA, 92.8%; RetroMTA, 96.0%. The Kaplan-Meier survival function curves showed no significant differences among three groups concerning clinical and radiographic cumulative survival rates. In addition, no potential prognostic factors related to the success rate of partial pulpotomy among age, sex, tooth type, root apex status, the site and type of pulp exposure, and the type of restoration were observed in log rank analysis. Partial pulpotomy with ProRoot MTA, OrthoMTA and RetroMTA had favorable results and clinical and radiographic results were not significantly different in three groups after 1year. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. 某铜矿矽肺患者生存时间分析%Survival time analysis of the silicosis patients in a copper mine

    Institute of Scientific and Technical Information of China (English)

    夏万夫; 丁建球; 郭仲伟; 张秀军

    2012-01-01

    Objective:To analyze the survival time and main influencing factors on the death from silicosis in a copper mine. Methods; Retrospective analysis was carried out in 48 deaths from silicosis in a copper'mine regarding the clinical history and report of the occupational disease to calculate the age of exposure to dust, duration of exposure, attack age and post-pneumoconiosis life span, and Kaplan-Meier survival analysis was undertaken to compare the survival of different groups. Cox proportional hazards regression model was used to estimate the survival time and important influencing factors. Results: Of the 48 patients, mean age of exposure to dust was (24. 4 ± 6. 0); mean duration of exposure, (22. 5 ± 8.7)years; mean attack age, (62.6 ± 11.1) and mean survival time(95 % CI) ,(14.0 ±2.4) years. No significant difference was found between different stages of disease on death of silicosis, associated pulmonary tuberculosis and lung cancer, smoking history and survival rate ( P > 0. 05 ) . Conclusion; Survival analysis can be useful statistics to deal with the death from silicosis, and survival of silicosis patients is associated with a variety of influencing factors. Besides, the parameters, including duration of exposure, age of exposure to dust and attack age, may be sufficiently to estimate the progression and outcomes of prevention of this disease.%目的:应用生存分析方法研究矽肺死亡病例的生存时间和相关影响因素.方法:收集某铜矿企业48例矽肺病死亡患者的病历资料和职业病报告,建立数据库,计算接尘年龄、接尘工龄、发病年龄、生存时间等,采用Kaplan-Meier法描述不同组别矽肺死亡病例的生存率,运用COX比例风险模型分析矽肺死亡病例生存时间影响因素.结果:48例肺病死亡患者平均接尘年龄为(24.4±6.0)岁,平均接尘工龄(22.5±8.7)年,平均发病年龄(62.6±11.1)岁;生存时间中位数(P25,P75)为14.0(7,22)年;死亡时最高矽肺分期

  16. Exploring Technostress: Results of a Large Sample Factor Analysis

    Directory of Open Access Journals (Sweden)

    Steponas Jonušauskas

    2016-06-01

    Full Text Available With reference to the results of a large sample factor analysis, the article aims to propose the frame examining technostress in a population. The survey and principal component analysis of the sample consisting of 1013 individuals who use ICT in their everyday work was implemented in the research. 13 factors combine 68 questions and explain 59.13 per cent of the answers dispersion. Based on the factor analysis, questionnaire was reframed and prepared to reasonably analyze the respondents’ answers, revealing technostress causes and consequences as well as technostress prevalence in the population in a statistically validated pattern. A key elements of technostress based on factor analysis can serve for the construction of technostress measurement scales in further research.

  17. Factor V Leiden mutation increases the risk for venous thromboembolism in cancer patients - results from the Vienna Cancer And Thrombosis Study (CATS).

    Science.gov (United States)

    Pabinger, I; Ay, C; Dunkler, D; Thaler, J; Reitter, E-M; Marosi, C; Zielinski, C; Mannhalter, C

    2015-01-01

    Patients with cancer are at an increased risk for venous thromboembolism (VTE). The risk varies markedly in different patient populations. Factor V (FV) Leiden is the most common genetic risk factor for VTE, and the impact of FV Leiden on cancer-associated thrombosis is not yet fully elucidated. To study the impact of FV Leiden on the risk of thrombosis in cancer patients. In the prospective observational Vienna Cancer And Thrombosis Study (CATS), 982 patients were included and were followed until occurrence of VTE or death, for a maximum period of 2 years. FV Leiden was determined by genotyping at inclusion. Main outcome measures were symptomatic or lethal objectively confirmed VTE. Of the 982 patients, FV Leiden was diagnosed in 72 (7.3%, 70 were heterozygous and 2 were homozygous). Ten of 72 (13.9%) patients with FV Leiden developed VTE, whereas this was the case in 69 of 910 (7.6%) patients without FV Leiden. In multivariate analysis that included age, sex, different tumor types, tumor stage, newly diagnosed vs. recurrence of disease, and the treatment modalities, the hazard ratio was 2.0 (95% confidence interval 1.0-4.0). In Kaplan-Meier analysis, the probability for development of VTE was 13% in those with and 5.7% in those without FV Leiden after 6 months; after 1 year, the corresponding risks were 15% and 7.3%. FV Leiden is a genetically determined and thus disease-independent parameter, which is associated with VTE in cancer patients and could therefore be used for individual risk assignment. © 2014 International Society on Thrombosis and Haemostasis.

  18. African Primary Care Research: quantitative analysis and presentation of results.

    Science.gov (United States)

    Mash, Bob; Ogunbanjo, Gboyega A

    2014-06-06

    This article is part of a series on Primary Care Research Methods. The article describes types of continuous and categorical data, how to capture data in a spreadsheet, how to use descriptive and inferential statistics and, finally, gives advice on how to present the results in text, figures and tables. The article intends to help Master's level students with writing the data analysis section of their research proposal and presenting their results in their final research report.

  19. African Primary Care Research: Quantitative analysis and presentation of results

    Directory of Open Access Journals (Sweden)

    Bob Mash

    2014-01-01

    Full Text Available This article is part of a series on Primary Care Research Methods. The article describes types of continuous and categorical data, how to capture data in a spreadsheet, how to use descriptive and inferential statistics and, finally, gives advice on how to present the results in text, figures and tables. The article intends to help Master’s level students with writing the data analysis section of their research proposal and presenting their results in their final research report.

  20. On the importance of accounting for competing risks in pediatric cancer trials designed to delay or avoid radiotherapy: I. Basic concepts and first analyses.

    Science.gov (United States)

    Tai, Bee-Choo; Grundy, Richard G; Machin, David

    2010-04-01

    In trials designed to delay or avoid irradiation among children with malignant brain tumor, although irradiation after disease progression is an important event, patients who have disease progression may decline radiotherapy (RT), or those without disease progression may opt for elective RT. To accurately describe the cumulative need for RT in such instances, it is crucial to account for these distinct events and to evaluate how each contributes to the delay or advancement of irradiation via a competing risks analysis. We describe the summary of competing events in such trials using competing risks methods based on cumulative incidence functions and Gray's test. The results obtained are contrasted with standard survival methods based on Kaplan-Meier curves, cause-specific hazard functions and log-rank test. The Kaplan-Meier method overestimates all event-specific rates. The cause-specific hazard analysis showed reduction in hazards for all events (A: RT after progression; B: no RT after progression; C: elective RT) among children with ependymoma. For event A, a higher cumulative incidence was reported for ependymoma. Although Gray's test failed to detect any difference (p = 0.331) between histologic subtypes, the log-rank test suggested marginal evidence (p = 0.057). Similarly, for event C, the log-rank test found stronger evidence of reduction in hazard among those with ependymoma (p = 0.005) as compared with Gray's test (p = 0.086). To evaluate treatment differences, failing to account for competing risks using appropriate methodology may lead to incorrect interpretations.

  1. Duration of clopidogrel treatment and risk of mortality and recurrent myocardial infarction among 11 680 patients with myocardial infarction treated with percutaneous coronary intervention: a cohort study

    Directory of Open Access Journals (Sweden)

    Køber Lars

    2010-01-01

    Full Text Available Abstract Background The optimal duration of clopidogrel treatment after percutaneous coronary intervention (PCI is unclear. We studied the risk of death or recurrent myocardial infarction (MI in relation to 6- and 12-months clopidogrel treatment among MI patients treated with PCI. Methods Using nationwide registers of hospitalizations and drug dispensing from pharmacies we identified 11 680 patients admitted with MI, treated with PCI and clopidogrel. Clopidogrel treatment was categorized in a 6-months and a 12-months regimen. Rates of death, recurrent MI or a combination of both were analyzed by the Kaplan Meier method and Cox proportional hazards models. Bleedings were compared between treatment regimens. Results The Kaplan Meier analysis indicated no benefit of the 12-months regimen compared with the 6-months in all endpoints. The Cox proportional hazards analysis confirmed these findings with hazard ratios for the 12-months regimen (the 6-months regimen used as reference for the composite endpoint of 1.01 (confidence intervals 0.81-1.26 and 1.24 (confidence intervals 0.95-1.62 for Day 0-179 and Day 180-540 after discharge. Bleedings occurred in 3.5% and 4.1% of the patients in the 6-months and 12-months regimen (p = 0.06. Conclusions We found comparable rates of death and recurrent MI in patients treated with 6- and 12-months' clopidogrel. The potential benefit of prolonged clopidogrel treatment in a real-life setting remains uncertain.

  2. Estimating the Duration of Public Concern After the Fukushima Dai-ichi Nuclear Power Station Accident From the Occurrence of Radiation Exposure-Related Terms on Twitter: A Retrospective Data Analysis

    Science.gov (United States)

    2016-01-01

    Background After the Fukushima Dai-ichi Nuclear Power Station accident in Japan on March 11, 2011, a large number of comments, both positive and negative, were posted on social media. Objective The objective of this study was to clarify the characteristics of the trend in the number of tweets posted on Twitter, and to estimate how long public concern regarding the accident continued. We surveyed the attenuation period of the first term occurrence related to radiation exposure as a surrogate endpoint for the duration of concern. Methods We retrieved 18,891,284 tweets from Twitter data between March 11, 2011 and March 10, 2012, containing 143 variables in Japanese. We selected radiation, radioactive, Sievert (Sv), Becquerel (Bq), and gray (Gy) as keywords to estimate the attenuation period of public concern regarding radiation exposure. These data, formatted as comma-separated values, were transferred into a Statistical Analysis System (SAS) dataset for analysis, and survival analysis methodology was followed using the SAS LIFETEST procedure. This study was approved by the institutional review board of Hokkaido University and informed consent was waived. Results A Kaplan-Meier curve was used to show the rate of Twitter users posting a message after the accident that included one or more of the keywords. The term Sv occurred in tweets up to one year after the first tweet. Among the Twitter users studied, 75.32% (880,108/1,168,542) tweeted the word radioactive and 9.20% (107,522/1,168,542) tweeted the term Sv. The first reduction was observed within the first 7 days after March 11, 2011. The means and standard errors (SEs) of the duration from the first tweet on March 11, 2011 were 31.9 days (SE 0.096) for radioactive and 300.6 days (SE 0.181) for Sv. These keywords were still being used at the end of the study period. The mean attenuation period for radioactive was one month, and approximately one year for radiation and radiation units. The difference in mean duration

  3. POMO--Plotting Omics analysis results for Multiple Organisms.

    Science.gov (United States)

    Lin, Jake; Kreisberg, Richard; Kallio, Aleksi; Dudley, Aimée M; Nykter, Matti; Shmulevich, Ilya; May, Patrick; Autio, Reija

    2013-12-24

    Systems biology experiments studying different topics and organisms produce thousands of data values across different types of genomic data. Further, data mining analyses are yielding ranked and heterogeneous results and association networks distributed over the entire genome. The visualization of these results is often difficult and standalone web tools allowing for custom inputs and dynamic filtering are limited. We have developed POMO (http://pomo.cs.tut.fi), an interactive web-based application to visually explore omics data analysis results and associations in circular, network and grid views. The circular graph represents the chromosome lengths as perimeter segments, as a reference outer ring, such as cytoband for human. The inner arcs between nodes represent the uploaded network. Further, multiple annotation rings, for example depiction of gene copy number changes, can be uploaded as text files and represented as bar, histogram or heatmap rings. POMO has built-in references for human, mouse, nematode, fly, yeast, zebrafish, rice, tomato, Arabidopsis, and Escherichia coli. In addition, POMO provides custom options that allow integrated plotting of unsupported strains or closely related species associations, such as human and mouse orthologs or two yeast wild types, studied together within a single analysis. The web application also supports interactive label and weight filtering. Every iterative filtered result in POMO can be exported as image file and text file for sharing or direct future input. The POMO web application is a unique tool for omics data analysis, which can be used to visualize and filter the genome-wide networks in the context of chromosomal locations as well as multiple network layouts. With the several illustration and filtering options the tool supports the analysis and visualization of any heterogeneous omics data analysis association results for many organisms. POMO is freely available and does not require any installation or

  4. Modular titanium alloy neck adapter failures in hip replacement - failure mode analysis and influence of implant material

    Directory of Open Access Journals (Sweden)

    Bloemer Wilhelm

    2010-01-01

    Full Text Available Abstract Background Modular neck adapters for hip arthroplasty stems allow the surgeon to modify CCD angle, offset and femoral anteversion intraoperatively. Fretting or crevice corrosion may lead to failure of such a modular device due to high loads or surface contamination inside the modular coupling. Unfortunately we have experienced such a failure of implants and now report our clinical experience with the failures in order to advance orthopaedic material research and joint replacement surgery. The failed neck adapters were implanted between August 2004 and November 2006 a total of about 5000 devices. After this period, the titanium neck adapters were replaced by adapters out of cobalt-chromium. Until the end of 2008 in total 1.4% (n = 68 of the implanted titanium alloy neck adapters failed with an average time of 2.0 years (0.7 to 4.0 years postoperatively. All, but one, patients were male, their average age being 57.4 years (36 to 75 years and the average weight 102.3 kg (75 to 130 kg. The failures of neck adapters were divided into 66% with small CCD of 130° and 60% with head lengths of L or larger. Assuming an average time to failure of 2.8 years, the cumulative failure rate was calculated with 2.4%. Methods A series of adapter failures of titanium alloy modular neck adapters in combination with a titanium alloy modular short hip stem was investigated. For patients having received this particular implant combination risk factors were identified which were associated with the occurence of implant failure. A Kaplan-Meier survival-failure-analysis was conducted. The retrieved implants were analysed using microscopic and chemical methods. Modes of failure were simulated in biomechanical tests. Comparative tests included modular neck adapters made of titanium alloy and cobalt chrome alloy material. Results Retrieval examinations and biomechanical simulation revealed that primary micromotions initiated fretting within the modular tapered neck

  5. Bioinformatics analysis to screen the key prognostic genes in ovarian cancer.

    Science.gov (United States)

    Li, Li; Cai, Shengyun; Liu, Shengnan; Feng, Hao; Zhang, Junjie

    2017-04-13

    Ovarian cancer (OC) is a gynecological oncology that has a poor prognosis and high mortality. This study is conducted to identify the key genes implicated in the prognosis of OC by bioinformatic analysis. Gene expression data (including 568 primary OC tissues, 17 recurrent OC tissues, and 8 adjacent normal tissues) and the relevant clinical information of OC patients were downloaded from The Cancer Genome Atlas database. After data preprocessing, cluster analysis was conducted using the ConsensusClusterPlus package in R. Using the limma package in R, differential analysis was performed to identify feature genes. Based on Kaplan-Meier (KM) survival analysis, prognostic seed genes were selected from the feature genes. After key prognostic genes were further screened by cluster analysis and KM survival analysis, they were performed functional enrichment analysis and multivariate survival analysis. Using the survival package in R, cox regression analysis was conducted for the microarray data of GSE17260 to validate the key prognostic genes. A total of 3668 feature genes were obtained, among which 75 genes were identified as prognostic seed genes. Then, 25 key prognostic genes were screened, including AXL, FOS, KLF6, WDR77, DUSP1, GADD45B, and SLIT3. Especially, AXL and SLIT3 were enriched in ovulation cycle. Multivariate survival analysis showed that the key prognostic genes could effectively differentiate the samples and were significantly associated with prognosis. Additionally, GSE17260 confirmed that the key prognostic genes were associated with the prognosis of OC. AXL, FOS, KLF6, WDR77, DUSP1, GADD45B, and SLIT3 might affect the prognosis of OC.

  6. NATURAL CONVECTION IN PASSIVE SOLAR BUILDINGS: EXPERIMENTS, ANALYSIS AND RESULTS

    Energy Technology Data Exchange (ETDEWEB)

    Gadgil, A.; Bauman, F.; Kammerud, R.

    1981-04-01

    Computer programs have been developed to numerically simulate natural convection in two- and three-dimensional room geometries. The programs have been validated using published data from the literature, results from a full-scale experiment performed at the Massachusetts Institute of Technology, and results from a small-scale experiment performed at LBL. One of the computer programs has been used to study the influence of natural convection on the thermal performance of a single zone in a direct-gain passive solar building. It is found that the convective heat transfer coefficients between the air and the enclosure surfaces can be substantially different from the values assumed in the standard building energy analysis methods, and can exhibit significant variations across a given surface. This study implies that the building heating loads calculated by standard building energy analysis methods may have substantial errors as a result of their use of common assumptions regarding the convection processes which occur in an enclosure.

  7. Representation of analysis results involving aleatory and epistemic uncertainty.

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Jay Dean (ProStat, Mesa, AZ); Helton, Jon Craig (Arizona State University, Tempe, AZ); Oberkampf, William Louis; Sallaberry, Cedric J.

    2008-08-01

    Procedures are described for the representation of results in analyses that involve both aleatory uncertainty and epistemic uncertainty, with aleatory uncertainty deriving from an inherent randomness in the behavior of the system under study and epistemic uncertainty deriving from a lack of knowledge about the appropriate values to use for quantities that are assumed to have fixed but poorly known values in the context of a specific study. Aleatory uncertainty is usually represented with probability and leads to cumulative distribution functions (CDFs) or complementary cumulative distribution functions (CCDFs) for analysis results of interest. Several mathematical structures are available for the representation of epistemic uncertainty, including interval analysis, possibility theory, evidence theory and probability theory. In the presence of epistemic uncertainty, there is not a single CDF or CCDF for a given analysis result. Rather, there is a family of CDFs and a corresponding family of CCDFs that derive from epistemic uncertainty and have an uncertainty structure that derives from the particular uncertainty structure (i.e., interval analysis, possibility theory, evidence theory, probability theory) used to represent epistemic uncertainty. Graphical formats for the representation of epistemic uncertainty in families of CDFs and CCDFs are investigated and presented for the indicated characterizations of epistemic uncertainty.

  8. Practical results from a mathematical analysis of guard patrols

    Energy Technology Data Exchange (ETDEWEB)

    Indusi, Joseph P.

    1978-12-01

    Using guard patrols as a primary detection mechanism is not generally viewed as a highly efficient detection method when compared to electronic means. Many factors such as visibility, alertness, and the space-time coincidence of guard and adversary presence all have an effect on the probability of detection. Mathematical analysis of the guard patrol detection problem is related to that of classical search theory originally developed for naval search operations. The results of this analysis tend to support the current practice of using guard forces to assess and respond to previously detected intrusions and not as the primary detection mechanism. 6 refs.

  9. An electronic health record-enabled obesity database

    Directory of Open Access Journals (Sweden)

    Wood G

    2012-05-01

    Full Text Available Abstract Background The effectiveness of weight loss therapies is commonly measured using body mass index and other obesity-related variables. Although these data are often stored in electronic health records (EHRs and potentially very accessible, few studies on obesity and weight loss have used data derived from EHRs. We developed processes for obtaining data from the EHR in order to construct a database on patients undergoing Roux-en-Y gastric bypass (RYGB surgery. Methods Clinical data obtained as part of standard of care in a bariatric surgery program at an integrated health delivery system were extracted from the EHR and deposited into a data warehouse. Data files were extracted, cleaned, and stored in research datasets. To illustrate the utility of the data, Kaplan-Meier analysis was used to estimate length of post-operative follow-up. Results Demographic, laboratory, medication, co-morbidity, and survey data were obtained from 2028 patients who had undergone RYGB at the same institution since 2004. Pre-and post-operative diagnostic and prescribing information were available on all patients, while survey laboratory data were available on a majority of patients. The number of patients with post-operative laboratory test results varied by test. Based on Kaplan-Meier estimates, over 74% of patients had post-operative weight data available at 4 years. Conclusion A variety of EHR-derived data related to obesity can be efficiently obtained and used to study important outcomes following RYGB.

  10. Therapy and Prognosis Analysis of 47 Patients with Extranodal NK/T-Cell Lymphoma%47例结外NK/T细胞淋巴瘤治疗和预后分析

    Institute of Scientific and Technical Information of China (English)

    张松松; 于力; 魏敏; 李红华; 靖彧; 李菲; 黄文荣; 陆晓林; 刘占祥; 周颖

    2011-01-01

    本研究探讨结外NK/T细胞淋巴瘤的临床特征、治疗和预后情况.对中国人民解放军总医院血液科自1995年10月到2008年12月收治的47例结外NK/T细胞淋巴瘤患者进行回顾性分析.运用Kaplan-Meier方法行生存分析,COX回归分析模型对预后进行多变量分析.采用的临床参数分别为CD56、Ann Arbor分期、国际预后指标和B组症状.结果表明,全组2年、5年总生存(OS)率分别为91%和71%.单纯放疗患者的累积生存率较单纯化疗患者明显提高,二者相比有统计学差异;而放疗与放化疗结合治疗之间无统计学差异.COX回归分析模型多变量分析显示,CD56、Ann Arbor分期是独立的预后因素;单纯化疗中使用CHOP方案治疗的患者以分期为单因素分析显示,分期≥ⅢE期为预后的因素之一;以B症状为单因素分析3种疗法的生存曲线显示,B症状亦为预后因素之一.结论:单纯放疗的近期疗效明显优于单纯化疗.放化疗结合对近期生存率没有显著提高;CD56阴性和Ann Arbor分期较早是患者预后良好的指标,改善病人的一般状况可以使患者的预后更佳.%This study was purposed to explore the clinical characteristics, therapy and prognosis of patients with extranodal NK/T cell lymphoma (ENKL). 47 patients with ENKL from October 1995 to December 2008 in our hospital were analyzed retrospectively. The survival of patients was analyzed by using Kaplan-Meier methods, the prognosis of patients was evaluated by multivariate analysis using COX regression model. The clinical parameters used included CD56, Ann Arbor stage, international prognostic index (IPI) and B symptom. The results showed that the 2- year and 5-year overall survival (OS) rates were 91% ,71% respectively. Multivariant analysis by COX regression showed the CD56 and Ann Arbor stage were independent prognostic factors. Single factor analysis with staging in CHOP chemotherapy group indicated that more than stage

  11. Effects of Smoking on Menopausal Age: Results From the Korea National Health and Nutrition Examination Survey, 2007 to 2012

    OpenAIRE

    Yang, Hee Jung; Suh, Pae Sun; Kim, Soo Jeong; Lee, Soon Young

    2015-01-01

    Objectives: Decreased fertility and impaired health owing to early menopause are significant health issues. Smoking is a modifiable health-related behavior that influences menopausal age. We investigated the effects of smoking-associated characteristics on menopausal age in Korean women. Methods: This study used data from the Korea National Health and Nutrition Examination Survey from 2007 to 2012. Menopausal age in relation to smoking was analyzed as a Kaplan-Meier survival curve for 11 510 ...

  12. 绝经前卵巢上皮性癌预后因素分析%Clinical analysis about prognostic factors of the ovarian epithelial cell in cancer premenstrual woman

    Institute of Scientific and Technical Information of China (English)

    林丽红; 郭玉

    2012-01-01

    Objective To investigate prognostic factors of the premenstrual woman with ovarian epithelial cell cancer. Methods From January 2000 to January 2007, the data on 163 cases of patients were collected,and the factors which affected prognosis were retrospectively analyzed. Based on five years of follow-up, the survival rate was compared between layer factors with chi-square test, life method was used in calculation of survival, Kaplan-meier, Log-rank and COX multi-factor mode analytic method was respectively adopted to analyze variables, survival differences and multi-factors analysis. Results The 2-year survival rate was 79.07%, with a 46.01% 5-year survival rate; the cytology grade, residual tumor size and the method of surgery were prognostic factors (P < 0.01) according to the Cox-model multifactor results; based on the COX model multi-factor analysis, cytology classification, residual focal size, the operation method were the independent factors affecting the prognosis (P < 0.01); A statistical significance was found about the 5-year survival rate between every group under a different layer factors by a single factor Logistic regression analysis (P < 0.01). Conclusion The research data shows earlier staging, higher cell differentiation, fewer residual focal size, more optimistic prognosis for the premenstrual epithelial ovarian carcinoma.%目的 探讨影响绝经前卵巢上皮性癌患者生存预后的相关因素.方法 回顾性分析2000年1月~2007年1月共163例绝经前卵巢上皮性癌患者临床资料,评估预后因素.随访时间为5年,各分层因素间生存率比较采用χ2检验,寿命法计算生存率,Kaplan-meier法分析变量,Log-rank法检验生存差异,COX多因素模型进行多因素分析.结果绝经前卵巢上皮性癌患者2年生存率为79.75%,5年生存率为46.01%.单因素逐步COX模型分析与分层因素间生存率比较结果显示:临床分期、病理类型、细胞学分级、残留灶大小、手术方式是

  13. 139例晚期食管鳞状细胞癌的一线化疗及生存分析%First-line chemotherapy of patients with advanced esophageal squamous cell carcinoma:A survival analysis of 139 cases

    Institute of Scientific and Technical Information of China (English)

    闫晓杰; 夏学明; 刘钦兰; 白莉

    2015-01-01

    目的:研究晚期食管鳞状细胞癌(esophageal squamous cell carcinoma,ESCC)一线化疗情况及影响预后的相关因素。方法回顾性分析2009年1月-2014年8月在我院初治Ⅳ期行一线化疗的139例ESCC患者的临床资料,其中男性124例,女性15例,年龄39~78岁,中位年龄为58岁。采用Kaplan-Meier法分析总生存时间(overall survival,OS),单因素和Cox回归多因素分析影响生存及预后的相关因素。结果139例患者化疗总有效率为46.8%,1年、3年、5年生存率分别为55.4%、15.8%、4.5%。一线化疗的中位OS为13.9个月,单因素及多因素分析显示,肝转移(P=0.028)、一线化疗疗效(P=0.001)、是否胸部放疗(P=0.000)与OS有关。结论有无肝转移、化疗是否有效、是否接受放疗对患者预后有重要影响,无肝转移患者的预后好,化疗评价有效、接受放疗有益于生存。%Objective To study the survival of patients with advanced esophageal squamous cell carcinoma (ESCC) in first-line chemotherapy and the factors related to the prognosis. Methods Clinical data about 139 advanced ESCC patients with 124 males and 15 females who received first-line chemotherapy in our hospital from January 2009 to August 2014 were retrospectively analyzed. The distribution of age range was 39 to 78 years old with median age of 58 years old. Kaplan-Meier method was used to calculate the overall survival (OS). Univariate analysis and Cox regression analysis were used to detect the influence factors of survival and prognosis. Results The response rate of 139 patients with chemotherapy was 46.8%with 1-year, 3-year, 5-year survival rates of 55.4%, 15.8%, 4.5%, respectively. The median OS of patients with advanced ESCC in first-line chemotherapy was 13.9 months. According to the results of univariate and COX multivariate analysis, OS of patients with advanced ESCC was closely associated with liver metastasis (P=0.028), curative effect of first

  14. Impaction grafting in the femur in cementless modular revision total hip arthroplasty: a descriptive outcome analysis of 243 cases with the MRP-TITAN revision implant

    Directory of Open Access Journals (Sweden)

    Wimmer Matthias D

    2013-01-01

    Full Text Available Abstract Background We present a descriptive and retrospective analysis of revision total hip arthroplasties (THA using the MRP-TITAN stem (Peter Brehm, Weisendorf, GER with distal diaphyseal fixation and metaphyseal defect augmentation. Our hypothesis was that the metaphyseal defect augmentation (Impaction Bone Grafting improves the stem survival. Methods We retrospectively analyzed the aggregated and anonymized data of 243 femoral stem revisions. 68 patients with 70 implants (28.8% received an allograft augmentation for metaphyseal defects; 165 patients with 173 implants (71.2% did not, and served as controls. The mean follow-up was 4.4 ± 1.8 years (range, 2.1–9.6 years. There were no significant differences (p > 0.05 between the study and control group regarding age, body mass index (BMI, femoral defects (types I-III as described by Paprosky, and preoperative Harris Hip Score (HHS. Postoperative clinical function was evaluated using the HHS. Postoperative radiologic examination evaluated implant stability, axial implant migration, signs of implant loosening, periprosthetic radiolucencies, as well as bone regeneration and resorption. Results There were comparable rates of intraoperative and postoperative complications in the study and control groups (p > 0.05. Clinical function, expressed as the increase in the postoperative HHS over the preoperative score, showed significantly greater improvement in the group with Impaction Bone Grafting (35.6 ± 14.3 vs. 30.8 ± 15.8; p ≤ 0.05. The study group showed better outcome especially for larger defects (types II C and III as described by Paprosky and stem diameters ≥ 17 mm. The two groups did not show significant differences in the rate of aseptic loosening (1.4% vs. 2.9% and the rate of revisions (8.6% vs. 11%. The Kaplan-Meier survival for the MRP-TITAN stem in both groups together was 93.8% after 8.8 years. [Study group 95.7% after 8.54 years ; control group 93

  15. Analysis of clinical characteristics of twice-weekly hemodialysis patients%每周两次血液透析患者临床特征分析

    Institute of Scientific and Technical Information of China (English)

    林星辉; 严玉澄; 朱铭力; 顾乐怡; 倪兆慧; 张伟明; 钱家麒

    2012-01-01

    Objective To investigate the clinical characteristics of twice-weekly hemodialysis patients.Methods Data were collected from Shanghai Renal Registry.A total of 1288 patients undergoing regular hemodialysis (HD) with dialysis adequacy index and other biochemical parameters in Shanghai in January 2007 were enrolled into the cohort study with 2 years follow-up.Clinical characteristics and outcome of twice-weekly HD patients were analyzed as compared with thrice-weekly HD patients.Results Compared with patients on thrice-weekly HD,the twice-weekly HD patients were significantly younger and had significantly shorter HD vintage,smaller body surface area,longer HD session time,higher single-pool Kt/V (spKt/V) and serum albumin but lower weekly Kt/V (P<0.05).There was no statistical difference in ultrafiltration volume between two groups.Kaplan-Meier survival analysis indicated that both groups had similar two-year survival.Multivariate Cox regression analysis showed that age,body mass index,serum albumin and weekly Kt/V were predictors of patient mortality.Conclusion It is acceptable for some hemodialys patients with twice-weekly HD,and close monitor of dialysis adequacy and volume status is necessary for this therapy model.%目的 研究每周两次血液透析(血透)患者的临床特征.方法 资料来自上海市透析登记网络,1288例于2007年1月登记有透析充分性指标及其他常规生化指标患者纳入本研究.采用回顾性队列研究方法,随访2年.比较每周两次血透与每周3次血透患者的临床特征及其预后情况.结果 与每周3次相比,每周两次血透患者年龄更小,透析龄更短,体表面积更小,单次透析时间更长,单池Kt/V( spKt/V)及血清白蛋白更高,但每周Kt/V显著更低,差异均有统计学意义(P<0.05).单次透析超滤量两组患者差异无统计学意义.Kaplan Meier生存分析显示两组患者两年生存率相似.多因素Cox回归分析显示年龄、体质量指数、血

  16. Bioelectrical impedance analysis for bovine milk: Preliminary results

    Science.gov (United States)

    Bertemes-Filho, P.; Valicheski, R.; Pereira, R. M.; Paterno, A. S.

    2010-04-01

    This work reports the investigation and analysis of bovine milk quality by using biological impedance measurements using electrical impedance spectroscopy (EIS). The samples were distinguished by a first chemical analysis using Fourier transform midinfrared spectroscopy (FTIR) and flow citometry. A set of milk samples (100ml each) obtained from 17 different cows in lactation with and without mastitis were analyzed with the proposed technique using EIS. The samples were adulterated by adding distilled water and hydrogen peroxide in a controlled manner. FTIR spectroscopy and flow cytometry were performed, and impedance measurements were made in a frequency range from 500Hz up to 1MHz with an implemented EIS system. The system's phase shift was compensated by measuring saline solutions. It was possible to show that the results obtained with the Bioelectrical Impedance Analysis (BIA) technique may detect changes in the milk caused by mastitis and the presence of water and hydrogen peroxide in the bovine milk.

  17. Hypertension Control in Adults With Diabetes Mellitus and Recurrent Cardiovascular Events: Global Results From the Trial Evaluating Cardiovascular Outcomes With Sitagliptin.

    Science.gov (United States)

    Navar, Ann Marie; Gallup, Dianne S; Lokhnygina, Yuliya; Green, Jennifer B; McGuire, Darren K; Armstrong, Paul W; Buse, John B; Engel, Samuel S; Lachin, John M; Standl, Eberhard; Van de Werf, Frans; Holman, Rury R; Peterson, Eric D

    2017-08-28

    Systolic blood pressure (SBP) treatment targets for adults with diabetes mellitus remain unclear. SBP levels among 12 275 adults with diabetes mellitus, prior cardiovascular disease, and treated hypertension were evaluated in the TECOS (Trial Evaluating Cardiovascular Outcomes with Sitagliptin) randomized trial of sitagliptin versus placebo. The association between baseline SBP and recurrent cardiovascular disease was evaluated using multivariable Cox proportional hazards modeling with restricted cubic splines, adjusting for clinical characteristics. Kaplan-Meier curves by baseline SBP were created to assess time to cardiovascular disease and 2 potential hypotension-related adverse events: worsening kidney function and fractures. The association between time-updated SBP and outcomes was examined using multivariable Cox proportional hazards models. Overall, 42.2% of adults with diabetes mellitus, cardiovascular disease, and hypertension had an SBP ≥140 mm Hg. The association between SBP and cardiovascular disease risk was U shaped, with a nadir ≈130 mm Hg. When the analysis was restricted to those with baseline SBP of 110 to 150 mm Hg, the adjusted association between SBP and cardiovascular disease risk was flat (hazard ratio per 10-mm Hg increase, 0.96; 95% confidence interval, 0.91-1.02). There was no association between SBP and risk of fracture. Above 150 mm Hg, higher SBP was associated with increasing risk of worsening kidney function (hazard ratio per 10-mm Hg increase, 1.10; 95% confidence interval, 1.02-1.18). Many patients with diabetes mellitus have uncontrolled hypertension. The U-shaped association between SBP and cardiovascular disease events was largely driven by those with very high or low SBP, with no difference in cardiovascular disease risk between 110 and 150 mm Hg. Lower SBP was not associated with higher risks of fractures or worsening kidney function. © 2017 American Heart Association, Inc.

  18. Outcome of Triple Antiplatelet Therapy Including Cilostazol in Elderly Patients with ST-Elevation Myocardial Infarction who Underwent Primary Percutaneous Coronary Intervention: Results from the INTERSTELLAR Registry.

    Science.gov (United States)

    Jang, Ho-Jun; Park, Sang-Don; Park, Hyun Woo; Suh, Jon; Oh, Pyung Chun; Moon, Jeonggeun; Lee, Kyounghoon; Kang, Woong Chol; Kwon, Sung Woo; Kim, Tae-Hoon

    2017-06-01

    Compared with dual antiplatelet therapy including aspirin and clopidogrel, triple antiplatelet therapy including cilostazol has a mortality benefit in patients with ST-segment elevation myocardial infarction. However, whether the mortality benefit persists in elderly patients is not clear. From 2007 to 2014, 1278 patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention were retrospectively analyzed. The patients were divided into four groups by age (antiplatelet strategy (triple or dual antiplatelet therapy). We compared the mortality rates between the triple and dual antiplatelet therapy groups. There were 1052 (male, 85%; mean age, 56.3 ± 10.4 years) patients in the young group and 241 (male, 52.7%; mean age, 80.3 ± 4.5 years) patients in the elderly group. In the young and elderly groups, 220 (20.9%) and 28 (12.3%) patients were treated with triple antiplatelet therapy. During a 1-year follow-up period, 80 patients died (4.2% in the young group vs. 15.5% in the elderly group). Kaplan-Meier survival analysis revealed that triple antiplatelet therapy was associated with a lower mortality rate in the young group (log-rank, p = 0.005). Although there were more angiographic high-risk patients in the elderly group, similar mortality rates were reported (log-rank, p = 0.803) without increased bleeding rates (1 vs. 3.6% in the elderly group, p = 0.217). Triple antiplatelet therapy might be a better antiplatelet regimen than dual antiplatelet therapy for patients with ST-segment elevation myocardial infarction. Although this benefit was strong in patients aged <75 years, no definite increase in major bleeding was seen for elderly patients (aged ≥75 years).

  19. Downregulation and pro-apoptotic effect of hypoxia-inducible factor 2 alpha in hepatocellular carcinoma

    Science.gov (United States)

    Niu, Leilei; Sun, Yun-fan; Yang, Xing-rong; Fan, Jia; Ren, Jian-wei; Chen, George G.; Lai, Paul B.S.

    2016-01-01

    The role of HIF-2α in hepatocellular carcinoma (HCC) is unclear. The aim of the present study was to investigate the expression pattern and role of HIF-2α in HCC patients. Immunohistochemical staining and western blotting analyses were applied to detect the protein level of HIF-2α in 206 paired HCC and peritumoral tissues. Kaplan-Meier survival and Cox proportional hazard regression analyses were performed to identify risk factors for overall survival and recurrence-free survival in these patients. The function of HIF-2α was studied in HCC cells and in vivo models. We found that the protein levels of HIF-2α in HCC tissues were lower than in peritumoral tissues, and were negatively correlated with tumor size (P < 0.05). Kaplan-Meier survival and univariate analysis revealed that HCC patients with high HIF-2α protein levels had longer overall survival (P < 0.05). Over-expression of HIF-2α induced apoptosis in HCC cells and increased the levels of pro-apoptotic proteins, Bak, ZBP-89 and PDCD4, whereas the inhibition of HIF-2α expression achieved opposite results. The findings were confirmed in a mouse HCC xenograft model. In conclusion, our study revealed that HIF-2α was decreased and played an anti-tumorigenic role in HCC. PMID:27119229

  20. Radiologic Placement of Tunneled Central Venous Catheters in Pediatric Patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Ji; Song, Soon Young; Cho, On Koo; Koh, Byung Hee; Kim, Yong Soo; Jeong, Woo Kyoung; Lee, Yong Ho [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2010-08-15

    We evaluated the technical success and complication rates associated with the radiological placement of tunneled central venous catheters in pediatric patients. Between May 1, 2005 and March 31, 2008, a total of 46 tunneled central venous catheters were placed in 34 children (M:F = 22:12; mean age, 9.9 years [9 months to 16.8 years]). All procedures were performed under ultrasonographic and fluoroscopic guidance. Follow-up data were obtained through the retrospective review of the medical records. We used the Kaplan-Meier survival method for the evaluation of survival rate of the catheters. All procedures were technically successful. The observed periprocedural complications included hematoma formation in three patients. The mean catheter life was 189.3 days (total, 8710 days; range, 7-810). Catheters were removed due to death (n=9), the end of treatment (n=8), catheter sepsis (n=4), malfunction (n=8), and accidental removal (n=4). The rate of catheter sepsis and malfunction was 0.459 and 0.919 for every 1000 catheter days, respectively. The expected mean catheter life was 479.6 days as per the Kaplan- Meier analysis. The results suggest that the radiologic placement of a tunneled central venous catheter is an effective technique with a high technical success rate and low complication rate.

  1. Decreased graft survival in liver transplant recipients of donors with positive blood cultures: a review of the United Network for Organ Sharing dataset.

    Science.gov (United States)

    Huaman, Moises A; Vilchez, Valery; Mei, Xiaonan; Shah, Malay B; Daily, Michael F; Berger, Jonathan; Gedaly, Roberto

    2016-11-29

    Liver transplantation using blood culture positive donors (BCPD) has allowed a significant expansion of the donor pool. We aimed to characterize BCPD and assess the outcomes of BCPD liver transplant recipients. We retrieved data from the United Network for Organ Sharing (UNOS) registry on all adults who underwent primary, single-organ deceased-donor liver transplantation in the USA between 2008 and 2013. Patients were classified into two cohorts: the BCPD cohort and the non-BCPD cohort. One-year graft and patient survival were compared between cohorts using Kaplan-Meier estimates and Cox models. A total of 28 961 patients were included. There were 2316 (8.0%) recipients of BCPD. BCPD were more likely to be older, female, black, diabetic, hypertensive, and obese compared to non-BCPD. Graft survival was significantly lower in BCPD recipients compared to non-BCPD recipients (Kaplan-Meier, 0.85 vs. 0.87; P = 0.009). Results remained significant in propensity-matched analysis (P = 0.038). BCPD was independently associated with decreased graft survival (adjusted HR; 1.10, 95% CI 1.01-1.20; P = 0.04). There were no significant differences in patient survival between study groups. BCPD was associated with decreased graft survival in liver transplant recipients. Studies are needed to identify subgroups of BCPD with the highest risk of graft failure and characterize the underlying pathogenic mechanisms.

  2. Inbreeding and genetic diversity in dogs: results from DNA analysis.

    Science.gov (United States)

    Wade, Claire M

    2011-08-01

    This review assesses evidence from DNA analysis to determine whether there is sufficient genetic diversity within breeds to ensure that populations are sustainable in the absence of cross breeding and to determine whether genetic diversity is declining. On average, dog breeds currently retain approximately 87% of the available domestic canine genetic diversity. Requirements that breeding stock must be 'clear' for all genetic disorders may firstly place undue genetic pressure on animals tested as being 'clear' of known genetic disorders, secondly may contribute to loss of diversity and thirdly may result in the dissemination of new recessive disorders for which no genetic tests are available. Global exchange of genetic material may hasten the loss of alleles and this practice should be discussed in relation to the current effective population size of a breed and its expected future popularity. Genomic data do not always support the results from pedigree analysis and possible reasons for this are discussed.

  3. Metastatic axillary lymph node ratio (LNR) is prognostically superior to pN staging in patients with breast cancer--results for 804 Chinese patients from a single institution.

    Science.gov (United States)

    Xiao, Xiang-Sheng; Tang, Hai-Lin; Xie, Xin-Hua; Li, Lai-Sheng; Kong, Ya-Nan; Wu, Min-Qing; Yang, Lu; Gao, Jie; Wei, Wei-Dong; Xie, Xiaoming

    2013-01-01

    The number of axillary lymph nodes involved and retrieved are important prognostic factors in breast cancer. The purpose of our study was to investigate whether the lymph node ratio (LNR) is a better prognostic factor in predicting disease-free survival (DFS) for breast cancer patients as compared with pN staging. The analysis was based on 804 breast cancer patients who had underwent axillary lymph node dissection between 1999 and 2008 in Sun Yat-Sen University Cancer Center. Optimal cutoff points of LNR were calculated using X-tile software and validated by bootstrapping. Patients were then divided into three groups (low-, intermediate-, and high-risk) according to the cutoff points. Predicting risk factors for relapse were performed according to Cox proportional hazards analysis. DFS was estimated using the Kaplan-Meier method and compared by the log-rank test. The 5-year DFS rate decreased significantly with increasing LNRs and pN. Univariate analysis found that the pT , pN, LNR, molecule type, HER2, pTNM stage and radiotherapy well classified patients with significantly different prognosis. By multivariate analysis, only LNR classification was retained as an independent prognostic factor. Furthermore, there was a significant prognostic difference among different LNR categories for pN2 category, but no apparent prognostic difference was seen between different pN categories in any LNR category. Therefore, LNR rather than pN staging is preferable in predicting DFS in node positive breast cancer patients, and routine clinical decision-making should take the LNR into consideration.

  4. Is Intermediate Radiation Dose Escalation With Concurrent Chemotherapy for Stage III Non–Small-Cell Lung Cancer Beneficial? A Multi-Institutional Propensity Score Matched Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Rodrigues, George, E-mail: george.rodrigues@lhsc.on.ca [London Health Sciences Centre, London, Ontario (Canada); Oberije, Cary [MAASTRO Clinic, Maastricht (Netherlands); Senan, Suresh [VU University Medical Center, Amsterdam (Netherlands); Tsujino, Kayoko [Hyogo Cancer Center, Akashi (Japan); Wiersma, Terry [MAASTRO Clinic, Maastricht (Netherlands); Moreno-Jimenez, Marta [Universidad de Navarra, Pamplona (Spain); Kim, Tae Hyun [National Cancer Center, Goyang-si, Gy eonggi (Korea, Republic of); Marks, Lawrence B. [University of North Carolina, Chapel Hill, North Carolina (United States); Rengan, Ramesh [University of Washington, Seattle, Washington (United States); De Petris, Luigi [Karolinska University Hospital, Stockholm (Sweden); Ramella, Sara [Campus Bio-Medico University, Rome (Italy); DeRuyck, Kim [Ghent University, Ghent (Belgium); De Dios, Núria Rodriguez [Universidad Pompeu Fabra, Barcelona (Spain); Warner, Andrew [London Health Sciences Centre, London, Ontario (Canada); Bradley, Jeffrey D. [Washington University School of Medicine, St. Louis, Missouri (United States); Palma, David A. [London Health Sciences Centre, London, Ontario (Canada)

    2015-01-01

    Purpose: The clinical benefits and risks of dose escalation (DE) for stage III non–small-cell lung cancer (NSCLC) remain uncertain despite the results from Radiation Therapy Oncology Group (RTOG) protocol 0617. There is significant heterogeneity of practice, with many clinicians prescribing intermediate dose levels between the 0617 study arms of 60 and 74 Gy. This study investigated whether this strategy is associated with any survival benefits/risks by analyzing a large multi-institutional database. Methods and Materials: An individual patient database of stage III NSCLC patients treated with radical intent concurrent chemoradiation therapy was created (13 institutions, n=1274 patients). Patients were divided into 2 groups based on tumor Biological Effective Dose at 10 Gy (BED 10): those receiving standard dose (SD; n=552), consisting of 72Gy ≤ BED 10 ≤ 76.8 Gy (eg 60-64 Gy/30-32 fractions [fr]), and those receiving intermediate dose (ID; n=497), consisting of 76.8Gy < BED 10 < 100.8 Gy (eg >64 Gy/32 fr and <74 Gy/37 fr), with lower-dose patients (n=225) excluded from consideration. Patients were then matched using propensity scores, leading to 2 matched groups of 196 patients. Outcomes were compared using various statistics including interquartile range (IQR), Kaplan-Meier curves, and adjusted Cox regression analysis. Results: Matched groups were found to be balanced except for N stage (more N3 disease in SD), median treatment year (SD in 2003; ID in 2007), platinum and taxane chemotherapy (SD in 28%; ID in 39%), and median follow-up (SD were 89 months; ID were 40 months). Median dose fractionation was 60 Gy/30 fr in SD (BED 10 IQR: 72.0-75.5 Gy) and 66 Gy/33 fr (BED 10 IQR: 78.6-79.2 Gy) in ID. Survival curves for SD and ID matched cohorts were statistically similar (P=.27); however, a nonstatistically significant trend toward better survival for ID was observed after 15 months (median survival SD: 19.3 months; ID: 21.0

  5. The GLOBE Contrail Protocol: Initial Analysis of Results

    Science.gov (United States)

    Chambers, Lin; Duda, David

    2004-01-01

    The GLOBE contrail protocol was launched in March 2003 to obtain surface observer reports of contrail occurrence to complement satellite and model studies underway at NASA Langley, among others. During the first year, more than 30,000 ground observations of contrails were submitted to GLOBE. An initial analysis comparing the GLOBE observations to weather prediction model results for relative humidity at flight altitudes is in progress. This paper reports on the findings to date from this effort.

  6. STATISTICAL ANALYSIS OF TANK 19F FLOOR SAMPLE RESULTS

    Energy Technology Data Exchange (ETDEWEB)

    Harris, S.

    2010-09-02

    Representative sampling has been completed for characterization of the residual material on the floor of Tank 19F as per the statistical sampling plan developed by Harris and Shine. Samples from eight locations have been obtained from the tank floor and two of the samples were archived as a contingency. Six samples, referred to in this report as the current scrape samples, have been submitted to and analyzed by SRNL. This report contains the statistical analysis of the floor sample analytical results to determine if further data are needed to reduce uncertainty. Included are comparisons with the prior Mantis samples results to determine if they can be pooled with the current scrape samples to estimate the upper 95% confidence limits (UCL95%) for concentration. Statistical analysis revealed that the Mantis and current scrape sample results are not compatible. Therefore, the Mantis sample results were not used to support the quantification of analytes in the residual material. Significant spatial variability among the current scrape sample results was not found. Constituent concentrations were similar between the North and South hemispheres as well as between the inner and outer regions of the tank floor. The current scrape sample results from all six samples fall within their 3-sigma limits. In view of the results from numerous statistical tests, the data were pooled from all six current scrape samples. As such, an adequate sample size was provided for quantification of the residual material on the floor of Tank 19F. The uncertainty is quantified in this report by an UCL95% on each analyte concentration. The uncertainty in analyte concentration was calculated as a function of the number of samples, the average, and the standard deviation of the analytical results. The UCL95% was based entirely on the six current scrape sample results (each averaged across three analytical determinations).

  7. 原发睾丸淋巴瘤的临床特点及预后因素分析%Clinical characteristics and prognostic analysis of primary testicular lymphoma

    Institute of Scientific and Technical Information of China (English)

    赵翠翠; 王华庆; 付凯; 钱正子; 刘贤明; 张会来; 郝希山

    2010-01-01

    目的 探讨原发睾丸淋巴瘤(PTL)的临床特点及其与预后的相关性. 方法回顾性分析1977年6月至2009年5月收治的33例PTL患者的临床资料,以Kaplan-Meier法绘制生存曲线,Log-rank检验进行单因素分析,采用COX回归模型多因素分析评估独立的预后因素. 结果 33例患者中位发病年龄为62(33~81)岁,24例就诊时处于早期,首发症状主要表现为睾丸无痛性肿大,最常见的病理类型是B细胞淋巴瘤,占76%(25/33),其中弥漫大B细胞淋巴瘤占48%(16/33).经术后化疗和(或)放疗,23例完全缓解,7例部分缓解.中位随访时间23(4~231)个月.5、10年总生存率分别为39.1%和19.5%.化疗≥4个周期及B细胞淋巴瘤加利妥昔单抗患者疗效好.多因素分析显示:Ann Arbor分期、B症状、年龄和结外受侵数是PTL的独立预后因素. 结论 PTL应采取综合治疗,术后给予蒽环类药物为主的全身化疗,B细胞淋巴瘤首选利妥昔单抗联合化疗,预防性鞘内注射和对侧睾丸预防性放疗有助于减少复发.Ann Arbor分期、B症状、年龄和结外受侵数为PTL预后的独立影响因素.%Objective To discuss the clinical features and prognostic factors of primary testicular lymphoma (PTL). Methods A retrospective review was performed based on the clinical records of 33 PTL cases treated at Tianjin Medical University Cancer Hospital from June 1977 to May 2009.Drawing survival curves by Kaplan-Meier method, using Log-rank test to the univariate analysis, and multivariate analysis by COX regression model to evaluate independent prognostic factors. Results The median age of patients was 62 years at presentation(range 33-81 years). Painless testicular swelling was the initial symptom. The majority of histological subtype was B cell lymphoma, 48% of which was diffuse large B-cell non-Hodgkin's lymphoma. By postoperative chemotherapy and/or radiotherapy, 23 patients achieved complete remission and 7 achieved partial remission

  8. ICU患者死亡的危险因子及其交互作用分析%Analysis of risk factors for death in patients with ICU and their interaction

    Institute of Scientific and Technical Information of China (English)

    于战备; 张巧敏; 高丽

    2016-01-01

    Objective To explore the risk factors for death in patients with ICU and their interaction .Methods Col-lected 25 items of routine factors of 191 ICU inpatients in the hospital ,did binary logistic regression ,ROC curve,Kaplan-Meier survival curve analysis.Results After logistic analysis,large platelet ratio(P<0.03),microalbuminuria(P<0.022) were an important factor that affects ICU mortality .The distribution of red blood cell ,serum albumin concentration ,serum creatinine ,se-rum sodium ion,hemoglobin concentration,large platelet ratio,microalbuminuria and the product of seven factors were analyzed by ROC curve(P<0.04).Analysis of serum sodiumion and ROC curve of the product of the trace protein in urine (P<0.008).Conclusion Platelet large cell ratio,trace proteinuria,serum sodium and urine trace protein product is the major risk factors for ICU mortality,creatinine,serum sodium ion,platelet large cell ratio,hemoglobin,serum albumin,red blood cell dis-tribution width seven product factor is independent risk factors of ICU mortality .%目的 分析影响ICU病死率的常见因素. 方法 采集该院ICU住院患者191例常用临床指标25项数据,进行二元logistics回归、ROC曲线、Kaplan-Meier生存曲线分析. 结果 经logistic回归分析,大血小板比率( P<0.03)、微量白蛋白尿(P<0.022),是影响ICU病死率的重要因素. 红细胞分布宽度、血清白蛋白浓度、血肌酐、血清钠离子、血红蛋白浓度、大血小板比率、微量蛋白尿7项因子乘积对病死率做ROC曲线分析( P<0.04). 血清钠离子及微量蛋白尿乘积ROC曲线分析(P<0.008). 结论 大血小板比率、微量蛋白尿、血清钠离子及微量蛋白尿乘积是影响ICU病死率的重要危险因素;肌酐、血清钠离子、大血小板比率、血红蛋白、血清白蛋白、红细胞分布宽度7项因子乘积是影响ICU病死率的独立危险因素.

  9. Prognosis analysis of esophageal carcinoma patients with tumor loco-regional recurrence after curative surgery%93例食管癌根治术后局部复发预后因素分析

    Institute of Scientific and Technical Information of China (English)

    孙晓江; 许亚萍; 季永领; 刘金石; 蒋友华; 马胜林; 毛伟敏

    2010-01-01

    Objective To evaluate the outcome of radiotherapy for recurrent esophageal cancer after surgery and to determine the prognostic factors. Methods From Jan 2004 to Dec 2009, 93 patients of esophageal carcinoma with loco-regional recurrence as the first site of failure after surgery were retrospectively reviewed. Kaplan-Meier method was used to analyze the survival. Logrank test was used to evaluate the difference between the groups. Multivariate survival analysis was conducted using a Cox proportional hazard regression model with a backward stepwise procedure. Results The overall survival rates at 1, 2 and 3 years were 40. 9% , 10. 1% and 6. 7% ,respectively,but with a median survival time of 11.0 months(95% CI 9. 4-12. 6) . In univariate analysis, age,PS, radiation dose and retreatment methods were independent prognostic factors. In multivariate analysis, only radiation dose and retreatment methods were independent prognostic factors for overall survival. Conclusions The prognosis of patients with postoperative loco-regional recurrence of esophageal cancer is poor. However, a long-term survival maybe expected by definitive chemoradiotherapy.%目的 探讨食管癌根治术后局部复发患者的放射治疗疗效和预后影响因素.方法 回顾性分析食管癌根治术后局部区域复发行放射治疗93例患者的临床特点,结合随访资料进行预后因素分析,用Kaplan-Meier法和Logrank法分析比较生存率,用Cox模型进行多因素回归分析.结果 全组患者中位生存时间11.0个月(95%CI 9.4~12.6个月),1、2、3年累积生存率分别为40.9%、10.1%和6.7%.单因素分析显示:患者年龄、PS评分、是否放化疗联合治疗、放射治疗剂量与预后相关;原发灶部位、术后复发间隔时间、以及转移灶数目均不影响预后.Cox模型多因素回归分析显示仅是否放化疗联合治疗、放射治疗剂量为独立预后因素.结论 食管癌根治术后复发放射治疗可以使部分患者生

  10. SCD1 thermal design and test result analysis

    Science.gov (United States)

    Cardoso, Humberto Pontes; Muraoka, Issamu; Mantelli, Marcia Barbosa Henriques; Leite, Rosangela M. G.

    1990-01-01

    The SCD 01 (Satelite de Coleta de Dados 01) is a spin stabilized low Earth orbit satellite dedicated to the collection and distribution of environmental data. It was completely developed at the Brazilian Institute for Space Research (INPE) and is scheduled to be launched in 1992. The SCD 01 passive thermal control design configuration is presented and the thermal analysis results are compared with the temperatures obtained from a Thermal Balance Test. The correlation between the analytical and experimental results is considered very good. Numerical flight simulations show that the thermal control design can keep all the subsystem temperatures within their specified temperature range.

  11. Recent Vh, h→bb̄ Analysis Results

    CERN Document Server

    Hetherly, Jeffrey Wayne; The ATLAS collaboration

    2016-01-01

    New analysis results are presented for vector-boson associated production of the Higgs boson using leptonic decay channels of the vector boson and where the Higgs decays to a $b\\bar{b}$ pair. Results are interpreted in the context of the Standard Model setting $m_{\\mathrm{Higgs}}=125\\,\\mathrm{GeV}$ and using $13.2 \\mathrm{fb}^{-1}$ of data collected during 2015-16 using the ATLAS detector. The data are consistent with the Standard Model with an observed significance of $0.42\\sigma$ versus an expected significance of $1.94\\sigma$.

  12. Simulation results of the grasping analysis of an underactuated finger

    Directory of Open Access Journals (Sweden)

    Niola Vincenzo

    2016-01-01

    Full Text Available The results of a number of simulations concerning the grasping analysis is presented. The grasping device consist in an under-actuated finger driven by un-extendible tendon that is one of the fingers of a mechanical prosthesis that was principally conceived as human prosthesis. The results, however, are useful for any similar finger to be used in grasping devices for industrial and agricultural applications, Aanalysis maps of the grasping were obtained which show the “robustness” of the socket. The method seems to be a suitable tool for the optimum design of such under-actuated fingers for grasping devices.

  13. A Comparative Study of Treatment-Emergent Adverse Events Following Use of Common Bowel Preparations Among a Colonoscopy Screening Population: Results from a Post-Marketing Observational Study.

    Science.gov (United States)

    Anastassopoulos, Kathryn; Farraye, Francis A; Knight, Tyler; Colman, Sam; Cleveland, Mark vB; Pelham, Russell W

    2016-10-01

    Colonoscopy may be one of the most frequent elective procedures in older adults and is associated with a low occurrence of complications. However, reduction of risks attributable to the bowel preparation may be achieved with the use of effective and safer products. The aim of this study was to examine the incidence of treatment-emergent adverse events (TEAEs) associated with SUPREP(®) [oral sulfate solution (OSS)] and other common prescription bowel preparations (non-OSS). This real-world, observational study used de-identified health insurance claims and laboratory results to identify TEAEs in the 3 months following screening colonoscopy in adults with a prescription for a bowel preparation in the prior 60 days. The unadjusted and adjusted (controlling for patient risk factors) cumulative incidences of TEAEs were estimated using Kaplan-Meier and Poisson regression, respectively. Among patients ≥45 years, the overall cumulative incidence was significantly lower (p < 0.001) in the OSS cohort than in the non-OSS cohort (unadjusted: 2.31 vs. 2.89 %; adjusted: 1.61 vs. 1.95 %), with significantly lower acute cardiac conditions (1.56 vs. 1.90 %; p < 0.001), renal failure/other serious renal diseases (OSS: 0.21 %, non-OSS: 0.32 %; p < 0.001), and serum electrolyte abnormalities (OSS: 0.39 %, non-OSS: 0.49 %; p = 0.017). There were no significant differences between cohorts in death, seizure disorders, aggravation of gout, and ischemic colitis. Results were similar in the adjusted cumulative incidences. In actual use, the overall cumulative incidence of TEAEs was significantly lower in the OSS cohort, demonstrating that OSS is as safe as, or possibly safer than, non-OSS prescription bowel preparations.

  14. Analysis of survival risk on post-operative patients with rectal cancer excised%直肠癌患者术后生存风险分析

    Institute of Scientific and Technical Information of China (English)

    柳文蔚

    2013-01-01

    Objective To analyze survival risk factors on patients with rectal cancer excised, and to provide reference for clinical therapies of rectal cancer. Methods 72 clinical data of rectal cancer excised in Gangdao Hospital in Hainan Province from January 1998 to January 2007 were selected and analyzed retrospectively, survivorship curve and survival risk curve were drawn, survival time and survival rate were analyzed by Kaplan-Meier analysis; survival related factors and survival risk factors were screened and analyzed by chi-square test and Cox survival risk scale model. Results Operation modality, excision extent, tumor localization, TNM stage, tumor differentiation, and whether radiation and chemotherapy or not were found had relationship with survival time of patients by chi-square test (P < 0.05); xcision extent, tumor localization, TNM stage, and whether radiation and chemotherapy or not were the independent risk factors with the survival time by the Cox survival risk scale model. Conclusions It is useful to take sufficient evaluation and select reasonable treatment according to the main risk factors of survival time after colorectal cancer surgery, it also can enhance the treatment effect%目的 分析影响直肠癌患者术后生存的风险因素,为直肠癌的临床治疗提供参考.方法 选择海南省港岛医院1998年1月~2007年1月手术切除的直肠癌患者临床资料72例,绘制生存曲线及生存风险曲线,采用Kaplan-Meier分析患者生存时间及生存率,采用χ2检验及Cox生存风险比例模型筛选及分析患者生存相关因素及生存危险因素采用.结果手术治疗的直肠癌患者中位生存时间10~132个月,中位生存时间为51个月,伴随患者生存时间延长生存风险增加,χ2检验结果显示切除范围、肿瘤位置、肿瘤分期、肿瘤分化程度及是否放化疗与患者生存时间有关(P < 0.05);Cox生存风险比例模型分析显示,切除范围、肿瘤位置、肿瘤分期

  15. Open Latarjet versus arthroscopic Latarjet: clinical results and cost analysis.

    Science.gov (United States)

    Randelli, P; Fossati, C; Stoppani, C; Evola, F R; De Girolamo, L

    2016-02-01

    The aim of this study was to compare the clinical results between open and arthroscopic Latarjet and perform a cost analysis of the two techniques. A systematic review of articles present in PubMed and MEDLINE was performed in accordance with PRISMA guidelines. Studies concerning post-operative outcomes following Latarjet procedures for chronic anterior shoulder instability were selected for analysis. The clinical and radiographic results as well as the costs of the open and arthroscopic techniques were evaluated. Twenty-three articles, describing a total of 1317 shoulders, met the inclusion criteria: 17 studies were related to open Latarjet, and 6 to the arthroscopic technique. Despite the heterogeneity of the evaluation scales, the clinical results seemed very satisfactory for both techniques. We detected a statistically significant difference in the percentage of bone graft healing in favour of the open technique (88.6 vs 77.6 %). Recurrent dislocation was more frequent following open surgery (3.3 % after open surgery vs 0.3 % after arthroscopy), but this finding was biased by the large difference in follow-up duration between the two techniques. The direct costs of the arthroscopic procedure were double in comparison to open surgery (€2335 vs €1040). A lack of data prevented evaluation of indirect costs and, therefore, a cost-effectiveness analysis. The open and arthroscopic Latarjet techniques showed excellent and comparable clinical results. However, the much higher direct costs of the arthroscopic procedure do not seem, at present, to be justified by a benefit to the patient. III.

  16. Nonlinear independent component analysis: Existence and uniqueness results.

    Science.gov (United States)

    Hyvärinen, Aapo; Pajunen, Petteri

    1999-04-01

    The question of existence and uniqueness of solutions for nonlinear independent component analysis is addressed. It is shown that if the space of mixing functions is not limited there exists always an infinity of solutions. In particular, it is shown how to construct parameterized families of solutions. The indeterminacies involved are not trivial, as in the linear case. Next, it is shown how to utilize some results of complex analysis to obtain uniqueness of solutions. We show that for two dimensions, the solution is unique up to a rotation, if the mixing function is constrained to be a conformal mapping together with some other assumptions. We also conjecture that the solution is strictly unique except in some degenerate cases, as the indeterminacy implied by the rotation is essentially similar to estimating the model of linear ICA.

  17. Computer analysis of shells of revolution using asymptotic results

    Science.gov (United States)

    Steele, C. R.; Ranjan, G. V.; Goto, C.; Pulliam, T. H.

    1979-01-01

    It is suggested that asymptotic results for the behavior of thin shells can be incorporated in a general computer code for the analysis of a complex shell structure. The advantage when compared to existing finite difference or finite element codes is a substantial reduction in computational labor with the capability of working to a specified level of accuracy. A reduction in user preparation time and dependance on user judgment is also gained, since mesh spacing can be internally generated. The general theory is described in this paper, as well as the implementation in the computer code FAST 1 (Functional Algorithm for Shell Theory) for the analysis of the general axisymmetric shell structure with axisymmetric loading.

  18. Surprising hair analysis results following acute carbofuran intoxication.

    Science.gov (United States)

    Dulaurent, S; Gaulier, J M; Zouaoui, K; Moesch, C; François, B; Lachâtre, G

    2011-10-10

    We present two non fatal cases of intoxication with carbofuran (CBF) documented by hair analysis. Carbofuran and 3-hydroxycarbofuran (OHCBF, its main metabolite) hair concentrations were determined using a liquid chromatography-tandem mass spectrometry method. The obtained results were surprising if we consider several hair analyses previously published and based on a theory of the presence of xenobiotic in the only segment that comprised its intake. Among the two intoxication cases, we noticed the presence of CBF and OHCBF in hair segments corresponding to 45 days before, and more than 100 days after, the day of intoxication. Additionally, repeated hair samplings and subsequent analysis revealed a decrease of the carbofuran's concentration during the hair life.

  19. Results of the probabilistic volcanic hazard analysis project

    Energy Technology Data Exchange (ETDEWEB)

    Youngs, R.; Coppersmith, K.J.; Perman, R.C. [Geomatrix Consultants, Inc., San Francisco, CA (United States)

    1996-12-01

    The Probabilistic Volcanic Hazard Analysis (PVHA) project, sponsored by the U.S. Department of Energy (DOE), has been conducted to assess the probability of a future volcanic event disrupting the potential repository at Yucca Mountain. The methodology for the PVHA project is summarized in Coppersmith and others (this volume). The judgments of ten earth scientists who were members of an expert panel were elicited to ensure that a wide range of approaches were considered. Each expert identified one or more approaches for assessing the hazard and they quantified their uncertainties in models and parameter values. Aggregated results are expressed as a probability distribution on the annual frequency of intersecting the proposed repository block. This paper presents some of the key results of the PVHA assessments. These results are preliminary; the final report for the study is planned to be submitted to DOE in April 1996.

  20. Risk Analysis on Uric Acid Resulting in Carotid Atherosclerosis

    Institute of Scientific and Technical Information of China (English)

    肖敏; 李河; 郭兰; 石美铃; 麦劲壮

    2004-01-01

    Objectives To explore the risk of uric acid (UA) resulting in carotid atherosclerosis. Methods With a cross sectional study, 643 subjects (aged 41-83 yrs, male 552 and female 91)were surveyed in 1999 in Guangdong Province, China.The main research variables were uric acid (UA), occurrence and the size of carotid artery plaque. Results There was no statistical significance between the UA means of plaque occurrence and no-occurrence groups (t=0.60, df=242, P=0.5495). It seemed UA was not a possible risk factor of carotid atherosclerosis (OR=1.060, P=-0.8448>0.05, n=244) based on the logistic regression analysis. Conclusions Our results are not consistent with serum UA being an independent risk factor for atherosclerosis and coronary heart disease (CHD). It is necessary to do more research to learn the risk degree of UA during the progress of atherosclerosis/CHD.

  1. Clinical prospective evaluation of zirconia-based three-unit posterior fixed dental prostheses: Up-to ten-year results.

    Science.gov (United States)

    Ioannidis, Alexis; Bindl, Andreas

    2016-04-01

    Only a few studies exist, which assess the clinical long-term behavior of all-ceramic FDPs in the posterior region. The aim of the present prospective clinical study was to evaluate the clinical performance of posterior three-unit FDPs manufactured from Y-TZP after a service period up to 10 years. 55 patients received 59 three-unit FDPs in the posterior region of the maxilla or mandible. Abutment teeth were prepared and full-arch impressions were taken. Definitive casts were fabricated and optically scanned. Frameworks were fabricated with computer-aided design (CAD) and manufacturing (CAM) technology. Y-TZP frameworks were veneered and adhesively luted to the abutment teeth. Baseline and follow-up examinations (service time: ≥ 48 months) were recorded by applying modified United States Public Health Services (USPHS) rating criteria. Cumulative survival rate was analyzed with Kaplan-Meier. Percentage of biological and technical complication was calculated. Fifty-three patients with 57 FDPs attended the last follow-up visit and a mean observation period of the remaining was 6.3 ± 1.9 years was calculated. Biological complications occurred in 17.5%, technical complications in 28% of the FDPs. The 10-year cumulative survival rate amounted 85.0%. Three FDPs failed to survive, two due to a root fracture of the abutment tooth and one due to secondary caries. Three-unit FDPs made from Y-TZP, veneered with ceramic offer a treatment option with a high rate of chipping. However, the manufacturing processes nowadays are modified in order to avoid this complication. The results of the present investigation suggest that three-unit Y-TZP posterior FDPs may are a possible treatment option. However, a high rate of chipping can be expected. Copyright © 2016. Published by Elsevier Ltd.

  2. Serum vitamin D in patients with chronic obstructive lung disease does not correlate with mortality--results from a 10-year prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Dennis Back Holmgaard

    Full Text Available BACKGROUND: Recent studies have found vitamin D (25-OHD deficiency and insufficiency to be common among patients with COPD. Serum level of 25-OHD seems to correlate to pulmonary function, COPD disease staging, and increased susceptibility to respiratory infections. We wanted to investigate whether vitamin D deficiency or insufficiency was associated with mortality rate in patients suffering from advanced COPD. METHODS: 25-OHD serum levels were measured in 462 patients suffering from moderate to very severe COPD. Patients were stratified into three groups according to serum levels of 25-OHD. Outcome measure was mortality in a 10 year follow-up period. Kaplan-Meier curves (KM were plotted and mortality hazard ratios (HR were calculated using Cox Proportional Hazard regression (Cox PH. RESULTS: Serum 25-OHD deficiency and insufficiency were prevalent. We were unable to demonstrate any association between baseline serum levels of 25-OHD and mortality rate. We found an association between mortality and age [HR 1.05 (CI 95%: 1.03-1.06], Charlson score [HR 1.49 (CI 95%: 1.06-2.09], increasing neutrophil count [HR 1.05 (CI 95%: 1.02-1.09], severe [HR 1.41 (CI 95%: 1.06-1.86]/very severe COPD [HR 2.19 (CI 95%: 1.58-3.02] and a smoking history of more than 40 pack years [HR 1.27 (CI 95%: 1.02-1.70]. CONCLUSIONS: Serum level of 25-OHD does not seem to be associated with mortality rate, suggesting no or only a minor role of 25-OHD in disease progression in patients with moderate to very severe COPD.

  3. Predictors of nursing home admission of individuals without a dementia diagnosis before admission - results from the Leipzig Longitudinal Study of the Aged (LEILA 75+

    Directory of Open Access Journals (Sweden)

    Matschinger Herbert

    2010-06-01

    Full Text Available Abstract Background In previous decades a substantial number of community-based studies mostly including dementia cases examined predictors of nursing home admission (NHA among elderly people. However, no one study has analysed predictors of NHA for individuals without developing dementia before NHA. Methods Data were derived from the Leipzig Longitudinal Study of the Aged, a population-based study of individuals aged 75 years and older. 1,024 dementia-free older adults were interviewed six times on average every 1.4 years. Socio-demographic, clinical, and psychometric variables were obtained. Kaplan-Meier estimates were used to determine mean time to NHA. Cox proportional hazards regression was used to examine predictors of long-term NHA. Results Of the overall sample, 7.8 percent of the non-demented elderly (n = 59 were admitted to nursing home (NH during the study period. The mean time to NHA in the dementia-free sample was 7.6 years. Characteristics associated with a shorter time to NHA were increased age, living alone, functional and cognitive impairment, major depression, stroke, myocardial infarction, a low number of specialist visits and paid home helper use. Conclusions Severe physical or psychiatric diseases and living alone have a significant effect on NHA for dementia-free individuals. The findings offer potentialities of secondary prevention to avoid or delay NHA for these elderly individuals. Further investigation of predictors of institutionalization is warranted to advance understanding of the process leading to NHA for this important group.

  4. Percutaneous transluminal angioplasty for Brescia-Cimino hemodialysis fistula dysfunction: technical success rate, patency rate and factors that influence the results

    Energy Technology Data Exchange (ETDEWEB)

    Maeda, Kiyosumi [Department of Radiology, Shiga University of Medical Science, Seta-Tsukinowa-cho, Otsu-city, Shiga 520-2192 (Japan)]. E-mail: kiyosumi@belle.shiga-med.ac.jp; Furukawa, Akira [Department of Radiology, Shiga University of Medical Science, Seta-Tsukinowa-cho, Otsu-city, Shiga 520-2192 (Japan); Yamasaki, Michio [Department of Radiology, Shiga University of Medical Science, Seta-Tsukinowa-cho, Otsu-city, Shiga 520-2192 (Japan); Murata, Kiyoshi [Department of Radiology, Shiga University of Medical Science, Seta-Tsukinowa-cho, Otsu-city, Shiga 520-2192 (Japan)

    2005-06-01

    Objective: To evaluate the initial clinical success and long-term patency rates of percutaneous transluminal angioplasty (PTA) using a venous approach for dysfunctional Brescia-Cimino fistula and to identify factors that may affect initial success and long-term patency. Materials and methods: A total of 99 PTA procedures were performed in retrograde fassion for 60 mature Brescia-Cimino shunts with dysfunction caused by anastomotic or peripheral outflow vein stenosis or occlusion. The initial clinical success rates were compared between stenosis and occlusion using Fisher's exact test. The Kaplan-Meier method was used to calculate the primary and secondary cumulative patency rates, and the log-rank test was used for comparison. Relative risks of patency loss according to clinical characteristics were determined with multivariate Cox models. Results: The initial clinical success rate of all interventions was 92%, and the rates for stenosis and occlusion were 99 and 65%, respectively (P < 0.0001). The primary and secondary cumulative patency rates for fistulas (excluding initial failure) at 12 months were 53 and 84%, respectively. The relative risks were 5.2 (P 0.004) for longer lesions and 4.5 (P = 0.007) for younger fistulas. The primary cumulative patency rate of four patients with a younger fistula and a longer stenosis at 4 months was 0%. Conclusion: Favorable primary and secondary cumulative patency rates are obtained in most patients. Long lesion length and younger age of fistulas were the two factors that reduced the patency rate after PTA.

  5. Clinical Characteristics and Prognostic Analysis of Primary Malignant Bone Lymphoma%37例原发骨恶性淋巴瘤的临床特点及预后因素分析

    Institute of Scientific and Technical Information of China (English)

    赵静; 王华庆; 钱正子; 张会来; 邱立华; 周世勇; 李兰芳; 付凯

    2011-01-01

    目的:探讨原发骨恶性淋巴瘤 (primary bone lymphoma,PBL) 的临床特点及其与预后的相关性.方法:回顾性分析1995年6月至2009年5月本院收治的37例PTL患者的临床资料,以Kaplan-Meier法绘制生存曲线,用Log-rank检验进行单因素分析,多因素分析采用Cox回归模型以评估独立的预后因素.结果:37例患者的中位发病年龄为61 (18~85) 岁,首发症状主要表现为骨痛,局部软组织肿胀、肿块形成和病理性骨折.78%患者的病理类型为弥漫大B细胞淋巴瘤.经化疗和/或放疗,18例完全缓解 (complete response,CR),13例部分缓解 (partial response,PR),3例稳定 (stable disease,SD),2例进展 (progressive disease,PD).中位随访时间32 (7~171) 个月,5年和10年总生存率分别为59.5%和43.2%.患者接受4周期以上化疗,B细胞淋巴瘤加用利妥昔单抗者疗效较好.多因素分析显示:Ann Arbor分期、B症状、年龄和结外受侵数是PBL的独立预后因素.结论:PBL应采取综合治疗,同时给予蒽环类药物为主的全身化疗,B细胞淋巴瘤首选利妥昔单抗联合化疗,给予帕米膦酸盐治疗骨病变.AnnArbor分期、B症状、年龄和结外受侵数为PBL预后的独立影响因素.%Objective: To investigate the clinical features and prognostic factors of primary bone lymphoma ( PBL ). Methods: A retrospective analysis was performed based on the clinical records of 37 PBL cases treated at the Tianjin Medical University Cancer Hospital between June 1995 and May 2009. Survival curves were plotted using the Kaplan-Meier method, with the Log-rank COX regression model to evaluate the independent prognostic factors. Results: The median age of patients was 61 years ( range 18-85 years). Ostealgia was the initial symptom. The majority of cases presented with diffuse large B-cell non-Hodgkin's lymphoma. Through chemotherapy and/or radiotherapy, 18 patients achieved complete remission (CR) and 13 achieved partial remission (PR), with a

  6. Efficient analysis and extraction of MS/MS result data from Mascot™ result files

    Directory of Open Access Journals (Sweden)

    Sickmann Albert

    2005-12-01

    Full Text Available Abstract Background Mascot™ is a commonly used protein identification program for MS as well as for tandem MS data. When analyzing huge shotgun proteomics datasets with Mascot™'s native tools, limits of computing resources are easily reached. Up to now no application has been available as open source that is capable of converting the full content of Mascot™ result files from the original MIME format into a database-compatible tabular format, allowing direct import into database management systems and efficient handling of huge datasets analyzed by Mascot™. Results A program called mres2x is presented, which reads Mascot™ result files, analyzes them and extracts either selected or all information in order to store it in a single file or multiple files in formats which are easier to handle downstream of Mascot™. It generates different output formats. The output of mres2x in tab format is especially designed for direct high-performance import into relational database management systems using native tools of these systems. Having the data available in database management systems allows complex queries and extensive analysis. In addition, the original peak lists can be extracted in DTA format suitable for protein identification using the Sequest™ program, and the Mascot™ files can be split, preserving the original data format. During conversion, several consistency checks are performed. mres2x is designed to provide high throughput processing combined with the possibility to be driven by other computer programs. The source code including supplement material and precompiled binaries is available via http://www.protein-ms.de and http://sourceforge.net/projects/protms/. Conclusion The database upload allows regrouping of the MS/MS results using a database management system and complex analyzing queries using SQL without the need to run new Mascot™ searches when changing grouping parameters.

  7. ETRAN--R Extension Package for Eye Tracking Results Analysis.

    Science.gov (United States)

    Zhegallo, Alexander V; Marmalyuk, Pavel A

    2015-01-01

    Novel open source R extension package for general-purpose eye tracking results analysis proposed. Now supported features are data loading from SMI eye trackers, different methods of fixations detection, various imaging techniques for raw data, and detected fixations (time sequence, scanpath, heatmap, and dynamic visualization). The modular structure of the package and a detailed description of each function provide a convenient way to further extend the functionality. Effective use of package requires knowledge of R programming language and environment. © The Author(s) 2015.

  8. New results on performance analysis of opportunistic regenerative relaying

    KAUST Repository

    Tourki, Kamel

    2013-12-01

    In this paper, we investigate an opportunistic relaying scheme where the selected relay assists the source-destination (direct) communication. In our study, we consider a regenerative opportunistic relaying scheme in which the direct path may be unusable, and takes into account the effect of the possible erroneously detected and transmitted data at the selected relay. We first derive the signal-to-noise (SNR) statistics for each hop, which are used to determine accurate closed form expressions for end-to-end bit-error rate (BER) of binary phase-shift keying (BPSK) modulation and end-to-end outage probability for a transmission rate R over Rayleigh fading channels. Furthermore, we evaluate the asymptotical performance and deduce the diversity order. Finally, we validate our analysis by showing that performance simulation results coincide with our analytical results over linear network architecture. © 2013 Elsevier B.V.

  9. The Coronal Loop Inventory Project: Expanded Analysis and Results

    Science.gov (United States)

    Schmelz, J. T.; Christian, G. M.; Chastain, R. A.

    2016-11-01

    We have expanded upon earlier work that investigates the relative importance of coronal loops with isothermal versus multithermal cross-field temperature distributions. These results are important for determining if loops have substructure in the form of unresolved magnetic strands. We have increased the number of loops targeted for temperature analysis from 19 to 207 with the addition of 188 new loops from multiple regions. We selected all loop segments visible in the 171 Å images of the Atmospheric Imaging Assembly (AIA) that had a clean background. Eighty-six of the new loops were rejected because they could not be reliably separated from the background in other AIA filters. Sixty-one loops required multithermal models to reproduce the observations. Twenty-eight loops were effectively isothermal, that is, the plasma emission to which AIA is sensitive could not be distinguished from isothermal emission, within uncertainties. Ten loops were isothermal. Also, part of our inventory was one small flaring loop, one very cool loop whose temperature distribution could not be constrained by the AIA data, and one loop with inconclusive results. Our survey can confirm an unexpected result from the pilot study: we found no isothermal loop segments where we could properly use the 171-to-193 ratio method, which would be similar to the analysis done for many loops observed with TRACE and EIT. We recommend caution to observers who assume the loop plasma is isothermal, and hope that these results will influence the direction of coronal heating models and the effort modelers spend on various heating scenarios.

  10. Design of financial results on the basis of factor analysis

    Directory of Open Access Journals (Sweden)

    V. M. Sidorov

    2016-01-01

    Full Text Available Approaches are presented in the article, qualificatory the design of financial results on the basis of factor analysis. Connection marks between development of enterprises and scientific and technical progress. It is shown that potential of enterprises can be based on the design of financial results. Actuality of this direction of research marks on a background the entered approvals against Russia. A control role is indicated at the effective use of resources. It is well-proven that a key moment in forming of profit of enterprise is a design of financial results. A factor analysis is reasonable at the estimation of activity of organization, which exposed an application of this determined model domain. is sent to capital augmentation. The role of the financial system and separate elements is shown in to financially-economic activity. Connection is set between a design and structure of the investigated object. A design cannot come true without determination of structure of the investigated object, because a structure characterizes steady connections between elements. The components of elements are able in totality to counteract to external influences. For expansion of the system to distinguish the most meaningful factors. To distinguish integrating connections from appropriate. Distinguished, that factors due to co-operating with each other can create a synergistically or extinguishing effect or neutralize each other. Factors will organize or will disorganize work of organization. The design of objects is built on the certain terms, and separate parties of object are examined at abandonment from the less meaningful elements of the system. The role of empiric and theoretical level of research in the design of activity of organization is shown. An author suggested to use the determined model for determination of functional connections between a resulting index and factor signs. Exposed an application of this determined model domain.

  11. Relationships proximate analysis results and higher heating values of lignites

    Energy Technology Data Exchange (ETDEWEB)

    Demirbas, A. [Sila Science, Trabzon (Turkey)

    2008-07-01

    In this study, the higher heating values (HHVs) of 26 lignite samples were calculated by using the proximate and elemental analyses data. The proximate analysis results such as volatile materials (VM), fixed carbon (FC) and HHV and the elemental analysis results such as carbon, hydrogen (H), oxygen (O), nitrogen (N) and sulfur (S) were determined for 26 lignite samples from different areas of Turkey. The lignite samples have been tested with particle size of 0-0.05 mm. The HHVs of 26 lignite samples obtained from different Turkish sources were determined experimentally and calculated from both ultimate and proximate analyses. HHVs of 26 the lignite samples can be calculated from the equation based modeling. The HHVs (MJ/kg) of the lignite samples as a function of fixed carbon (FC, wt%) or volatile materials (VM, %) was calculated from the following equations: HHV = 0.300FC + 11.117 (1) HHV = -0.323VM + 42.223 (2) where the correlation coefficients for Eqs. (1) and (2) were 0.9907 and 0.9862, respectively. The combustion heats calculated from Eqs. (1) and (2) showed mean differences of +3.9% and +0.3%, respectively. The HHVs (MJ/kg) of the lignite samples as a function of C, H, O, N, and S were calculated from a given equation where the correlation coefficients for the equation was 0.9891. HHVs calculated from this equation showed a mean deviation of +0.1.

  12. Sensitivity analysis of FDS 6 results for nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Alvear, Daniel; Puente, Eduardo; Abreu, Orlando [Cantabria Univ., Santander (Spain). Group GIDAI - Fire Safety-Research and Technology; Peco, Julian [Consejo de Seguridad Nuclear, Madrid (Spain)

    2015-12-15

    The Spanish standard ''Instruction IS-30, Rev. 1'' (February 21, 2013) allows the new approaches of risk informed performance based design (PBD) The Spanish standard ''Instruction IS-30, rev. 1'' (February 21, 2013) for demonstrating the safe shutdown capability in case of fire in nuclear power plants. In this sense, fire computer models have become an interesting tool to study real fire scenarios. Such models use a set of input parameters that define the features of the physical domain, material, radiation, turbulence, etc. This paper analyses the impact of the grid size and different sub-models of the fire simulation code FDS, version 6 with the objective to evaluate and define their relative weight in the final simulation results. For the grid size analysis, two different scale scenarios were selected, the bench scale test PENLIGHT and a large-scale test similar to Appendix B of NUREG - 1934 (17 m x 10 m x 4.6 m, with an ignition source of 2 MW and 16 cable trays). For the sub-model analysis, the PRS-INT4 real scale configuration of the INTEGRAL experimental campaign of the international OECD PRISME Project has been used. The results offer relevant data for users and show the critical parameters that must be selected properly to guarantee the quality of the simulations.

  13. Racial disparities in anaplastic oligodendroglioma: An analysis on 1643 patients.

    Science.gov (United States)

    Shin, Jacob Y; Yoon, Ja Kyoung; Diaz, Aidnag Z

    2017-03-01

    The objective of our study is to determine the influence of race on overall survival (OS) for anaplastic oligodendroglioma (AO). Data were extracted from the National Cancer Data Base (NCDB). Chi-square test, Kaplan-Meier method, and Cox regression models were employed in SPSS 22.0 (Armonk, NY: IBM Corp.) for data analyses. 1643 patients with AO were identified. 1386 (84.3%) were White, 83 (5.0%) Black, 133 (8.1%) Hispanic, and 41 (2.5%) were Asian. White and Black patients were significantly older than Hispanic and Asian patients (49.3% vs. 49.4% vs. 33.1% vs. 39.0%, p=0.003). Black patients were significantly less likely to be insured than White patients (12.8 vs. 7.2%, p<0.001) and significantly more likely to have lower income than other races (p<0.001). A trend towards higher comorbidity burden and lower rate of gross total resection was seen in Black patients. Black patients had significantly worse five-year OS compared to White, Hispanic, and Asian patients (40.3% vs. 52.3% vs. 67.8% vs. 67.7%, p=0.028). Of those who received adjuvant chemoRT, Black patients still had significantly worse OS compared to White patients (p=0.021). On multivariate analysis, Black race, older age at diagnosis, and not receiving adjuvant chemoradiotherapy were independent prognostic factors for worse OS in anaplastic oligodendroglioma. Future studies are warranted to help determine predictors for unfavorable molecular status, ways to optimize management of comorbidities, and interventions to help ensure adequate access to medical care for all patients to better care for those who may be at more risk for poorer outcome.

  14. Statistical Analysis of Tank 5 Floor Sample Results

    Energy Technology Data Exchange (ETDEWEB)

    Shine, E. P.

    2013-01-31

    Sampling has been completed for the characterization of the residual material on the floor of Tank 5 in the F-Area Tank Farm at the Savannah River Site (SRS), near Aiken, SC. The sampling was performed by Savannah River Remediation (SRR) LLC using a stratified random sampling plan with volume-proportional compositing. The plan consisted of partitioning the residual material on the floor of Tank 5 into three non-overlapping strata: two strata enclosed accumulations, and a third stratum consisted of a thin layer of material outside the regions of the two accumulations. Each of three composite samples was constructed from five primary sample locations of residual material on the floor of Tank 5. Three of the primary samples were obtained from the stratum containing the thin layer of material, and one primary sample was obtained from each of the two strata containing an accumulation. This report documents the statistical analyses of the analytical results for the composite samples. The objective of the analysis is to determine the mean concentrations and upper 95% confidence (UCL95) bounds for the mean concentrations for a set of analytes in the tank residuals. The statistical procedures employed in the analyses were consistent with the Environmental Protection Agency (EPA) technical guidance by Singh and others [2010]. Savannah River National Laboratory (SRNL) measured the sample bulk density, nonvolatile beta, gross alpha, and the radionuclide1, elemental, and chemical concentrations three times for each of the composite samples. The analyte concentration data were partitioned into three separate groups for further analysis: analytes with every measurement above their minimum detectable concentrations (MDCs), analytes with no measurements above their MDCs, and analytes with a mixture of some measurement results above and below their MDCs. The means, standard deviations, and UCL95s were computed for the analytes in the two groups that had at least some measurements

  15. STATISTICAL ANALYSIS OF TANK 5 FLOOR SAMPLE RESULTS

    Energy Technology Data Exchange (ETDEWEB)

    Shine, E.

    2012-03-14

    Sampling has been completed for the characterization of the residual material on the floor of Tank 5 in the F-Area Tank Farm at the Savannah River Site (SRS), near Aiken, SC. The sampling was performed by Savannah River Remediation (SRR) LLC using a stratified random sampling plan with volume-proportional compositing. The plan consisted of partitioning the residual material on the floor of Tank 5 into three non-overlapping strata: two strata enclosed accumulations, and a third stratum consisted of a thin layer of material outside the regions of the two accumulations. Each of three composite samples was constructed from five primary sample locations of residual material on the floor of Tank 5. Three of the primary samples were obtained from the stratum containing the thin layer of material, and one primary sample was obtained from each of the two strata containing an accumulation. This report documents the statistical analyses of the analytical results for the composite samples. The objective of the analysis is to determine the mean concentrations and upper 95% confidence (UCL95) bounds for the mean concentrations for a set of analytes in the tank residuals. The statistical procedures employed in the analyses were consistent with the Environmental Protection Agency (EPA) technical guidance by Singh and others [2010]. Savannah River National Laboratory (SRNL) measured the sample bulk density, nonvolatile beta, gross alpha, radionuclide, inorganic, and anion concentrations three times for each of the composite samples. The analyte concentration data were partitioned into three separate groups for further analysis: analytes with every measurement above their minimum detectable concentrations (MDCs), analytes with no measurements above their MDCs, and analytes with a mixture of some measurement results above and below their MDCs. The means, standard deviations, and UCL95s were computed for the analytes in the two groups that had at least some measurements above their

  16. Statistical Analysis Of Tank 5 Floor Sample Results

    Energy Technology Data Exchange (ETDEWEB)

    Shine, E. P.

    2012-08-01

    Sampling has been completed for the characterization of the residual material on the floor of Tank 5 in the F-Area Tank Farm at the Savannah River Site (SRS), near Aiken, SC. The sampling was performed by Savannah River Remediation (SRR) LLC using a stratified random sampling plan with volume-proportional compositing. The plan consisted of partitioning the residual material on the floor of Tank 5 into three non-overlapping strata: two strata enclosed accumulations, and a third stratum consisted of a thin layer of material outside the regions of the two accumulations. Each of three composite samples was constructed from five primary sample locations of residual material on the floor of Tank 5. Three of the primary samples were obtained from the stratum containing the thin layer of material, and one primary sample was obtained from each of the two strata containing an accumulation. This report documents the statistical analyses of the analytical results for the composite samples. The objective of the analysis is to determine the mean concentrations and upper 95% confidence (UCL95) bounds for the mean concentrations for a set of analytes in the tank residuals. The statistical procedures employed in the analyses were consistent with the Environmental Protection Agency (EPA) technical guidance by Singh and others [2010]. Savannah River National Laboratory (SRNL) measured the sample bulk density, nonvolatile beta, gross alpha, and the radionuclide, elemental, and chemical concentrations three times for each of the composite samples. The analyte concentration data were partitioned into three separate groups for further analysis: analytes with every measurement above their minimum detectable concentrations (MDCs), analytes with no measurements above their MDCs, and analytes with a mixture of some measurement results above and below their MDCs. The means, standard deviations, and UCL95s were computed for the analytes in the two groups that had at least some measurements

  17. Polygraph Test Results Assessment by Regression Analysis Methods

    Directory of Open Access Journals (Sweden)

    K. A. Leontiev

    2014-01-01

    Full Text Available The paper considers a problem of defining the importance of asked questions for the examinee under judicial and psychophysiological polygraph examination by methods of mathematical statistics. It offers the classification algorithm based on the logistic regression as an optimum Bayesian classifier, considering weight coefficients of information for the polygraph-recorded physiological parameters with no condition for independence of the measured signs.Actually, binary classification is executed by results of polygraph examination with preliminary normalization and standardization of primary results, with check of a hypothesis that distribution of obtained data is normal, as well as with calculation of coefficients of linear regression between input values and responses by method of maximum likelihood. Further, the logistic curve divided signs into two classes of the "significant" and "insignificant" type.Efficiency of model is estimated by means of the ROC analysis (Receiver Operator Characteristics. It is shown that necessary minimum sample has to contain results of 45 measurements at least. This approach ensures a reliable result provided that an expert-polygraphologist possesses sufficient qualification and follows testing techniques.

  18. Analysis of Numerical Simulation Results of LIPS-200 Lifetime Experiments

    Science.gov (United States)

    Chen, Juanjuan; Zhang, Tianping; Geng, Hai; Jia, Yanhui; Meng, Wei; Wu, Xianming; Sun, Anbang

    2016-06-01

    Accelerator grid structural and electron backstreaming failures are the most important factors affecting the ion thruster's lifetime. During the thruster's operation, Charge Exchange Xenon (CEX) ions are generated from collisions between plasma and neutral atoms. Those CEX ions grid's barrel and wall frequently, which cause the failures of the grid system. In order to validate whether the 20 cm Lanzhou Ion Propulsion System (LIPS-200) satisfies China's communication satellite platform's application requirement for North-South Station Keeping (NSSK), this study analyzed the measured depth of the pit/groove on the accelerator grid's wall and aperture diameter's variation and estimated the operating lifetime of the ion thruster. Different from the previous method, in this paper, the experimental results after the 5500 h of accumulated operation of the LIPS-200 ion thruster are presented firstly. Then, based on these results, theoretical analysis and numerical calculations were firstly performed to predict the on-orbit lifetime of LIPS-200. The results obtained were more accurate to calculate the reliability and analyze the failure modes of the ion thruster. The results indicated that the predicted lifetime of LIPS-200's was about 13218.1 h which could satisfy the required lifetime requirement of 11000 h very well.

  19. Assessing the effect of quantitative and qualitative predictors on gastric cancer individuals survival using hierarchical artificial neural network models.

    Science.gov (United States)

    Amiri, Zohreh; Mohammad, Kazem; Mahmoudi, Mahmood; Parsaeian, Mahbubeh; Zeraati, Hojjat

    2013-01-01

    There are numerous unanswered questions in the application of artificial neural network models for analysis of survival data. In most studies, independent variables have been studied as qualitative dichotomous variables, and results of using discrete and continuous quantitative, ordinal, or multinomial categorical predictive variables in these models are not well understood in comparison to conventional models. This study was designed and conducted to examine the application of these models in order to determine the survival of gastric cancer patients, in comparison to the Cox proportional hazards model. We studied the postoperative survival of 330 gastric cancer patients who suffered surgery at a surgical unit of the Iran Cancer Institute over a five-year period. Covariates of age, gender, history of substance abuse, cancer site, type of pathology, presence of metastasis, stage, and number of complementary treatments were entered in the models, and survival probabilities were calculated at 6, 12, 18, 24, 36, 48, and 60 months using the Cox proportional hazards and neural network models. We estimated coefficients of the Cox model and the weights in the neural network (with 3, 5, and 7 nodes in the hidden layer) in the training group, and used them to derive predictions in the study group. Predictions with these two methods were compared with those of the Kaplan-Meier product limit estimator as the gold standard. Comparisons were performed with the Friedman and Kruskal-Wallis tests. Survival probabilities at different times were determined using the Cox proportional hazards and a neural network with three nodes in the hidden layer; the ratios of standard errors with these two methods to the Kaplan-Meier method were 1.1593 and 1.0071, respectively, revealed a significant difference between Cox and Kaplan-Meier (P neural network, and the neural network and the standard (Kaplan-Meier), as well as better accuracy for the neural network (with 3 nodes in the hidden layer

  20. 老年维持性血液透析患者生存分析%Survival analysis of elderly patients on maintenance hemodialysis

    Institute of Scientific and Technical Information of China (English)

    吕文律; 滕杰; 邹建洲; 钟一红; 丁小强

    2012-01-01

    2009 and followed up through 31 December 2010 were enrolled in this retrospective cohort study. Survival analysis was performed using Kaplan-Meier method and Cox regression model. Results A total of 131 patients were included in this study. The median follow-up period was 25 months (14-41 months) from initiation of dialysis, and 52 patients died in the follow-up period. The median survival time was 48 months (37.72-58.28 months). The main causes of death were congestive heart failure, infection and cerebrovascular disease. In the death cases, the age when dialysis began was older. More patients were found to have congestive heart failure and cerebrovascular disease history before dialysis, Charlson co-morbidity index (CCI) ≥ 5, catheters for hemodialysis vascular access, and dialysis due to heart failure. The estimated glomerular filtration rate (eGFR) at the initiation of dialysis increased significantly. The proportion of patients with CCI=3-4 was lower. In addition, urine volume, serum creatinine and serum albumin at initiation of dialysis were significantly lower than the survival cases. Kaplan-Meier survival curve revealed that the 1 year, 2year, 3year, 4year and 5year survival rate of elderly MHD patients was 80.9%, 74.6%, 63.2%, 48.0% and 33.9%, respectively. Cox regression model indicated that older age (HR=1.070, 95% CI 1.015-1.127, P<0.05), history of cerebrovascular accident before dialysis (HR=2.052, 95% CI 1.035-4.068, P<0.05), history of congestive heart failure before dialysis (HR=1.888, 95% CI 1.029 -3.463, P<0.05), CCI =5 before dialysis (HR=2.675, 95% CI 1.323-5.411, P<0.05) and lower serum albumin at initiation of dialysis (HR=0.949, 95% CI 0.901 -0.999, P<0.05) were the main risk factors for survival of elderly MHD patients. Conclusions The main causes of death in elderly MHD patients were cardiovascular disease, infection and cerebrovascular disease. Older age, malnutrition status, and co-morbidities at initiation of dialysis may be the main risk

  1. Analysis of the diagnosis and treatment of myoepithelial carcinoma of the parotid gland:report of 17 cases%17例腮腺肌上皮癌的诊治分析

    Institute of Scientific and Technical Information of China (English)

    刘绍严; 倪松; 朱一鸣; 王健

    2015-01-01

    Objective Myoepithelial carcinoma ( MC) is a rare malignant neoplasm of the salivary gland.The aim of this study was to analyze the diagnosis, treatment and prognosis of MC of the parotid gland. Methods The clinicopathological data of 17 cases of MC of the parotid gland treated in our hospital from 1999 to 2013 were analyzed retrospectively.Of all the 17 patients, 9 cases received radical surgery only, 5 cases received postoperative radiotherapy, 2 cases received preoperative radiotherapy, and one case received chemotherapy.The survival rate was calculated by Kaplan-Meier analysis.Results Among the 17 patients, 11 patients had post-operative recurrence ( 11/17, 64.7%) , Of these 11 cases,5 cases ( 45.5%) had recurrence within one year after the first operation.During the follow-up for 12-180 months ( median 50 months) , six cases died ( two patients died of distant metastases and 4 cases died of local recurrence) .The overall 1-year, 2-year and 5-year survival rates were 94.1%, 74.2%and 64.9%, and the overall 1-year, 2-year and 5-year recurrence-free survival rates were 70.6%, 48.1%and 40.1%, respectively.Conclusions Radical surgery is the main treatment modality for myoepithelial carcinoma of the parotid gland.For the patients with extensive lesions or after palliative surgery, adjuvant radiotherapy or chemotherapy might be helpful. However, its therapeutic efficacy remains to be proved.%目的:分析17例腮腺肌上皮癌的的临床特点、诊治情况及预后。方法对1999年至2013年收治的17例腮腺肌上皮癌患者进行回顾性分析。17例患者中,9例行单纯手术治疗,5例行术后放疗,2例行术前放疗,1例行化疗。应用Kaplan-Meier法计算患者的生存率。结果17例患者中,术后复发11例,复发率为647.%。在复发的11例患者中,有5例(45.5%)患者在初次手术1年内复发。随访期间,死亡6例,其中2例死于远处转移,4例死于局部复发。17例患者的1、2和5

  2. The Multiple Faces of Non-Cystic Fibrosis Bronchiectasis. A Cluster Analysis Approach.

    Science.gov (United States)

    Martínez-García, Miguel Á; Vendrell, Montserrat; Girón, Rosa; Máiz-Carro, Luis; de la Rosa Carrillo, David; de Gracia, Javier; Olveira, Casilda

    2016-09-01

    The clinical presentation and prognosis of non-cystic fibrosis bronchiectasis are both very heterogeneous. To identify different clinical phenotypes for non-cystic fibrosis bronchiectasis and their impact on prognosis. Using a standardized protocol, we conducted a multicenter observational cohort study at six Spanish centers with patients diagnosed with non-cystic fibrosis bronchiectasis before December 31, 2005, with a 5-year follow-up from the bronchiectasis diagnosis. A cluster analysis was used to classify the patients into homogeneous groups by means of significant variables corresponding to different aspects of bronchiectasis (clinical phenotypes): age, sex, body mass index, smoking habit, dyspnea, macroscopic appearance of sputum, number of exacerbations, chronic colonization with Pseudomonas aeruginosa, FEV1, number of pulmonary lobes affected, idiopathic bronchiectasis, and associated chronic obstructive pulmonary disease. Survival analysis (Kaplan-Meier method and log-rank test) was used to evaluate the comparative survival of the different subgroups. A total of 468 patients with a mean age of 63 (15.9) years were analyzed. Of these, 58% were females, 39.7% had idiopathic bronchiectasis, and 29.3% presented with chronic Pseudomonas aeruginosa colonization. Cluster analysis showed four clinical phenotypes: (1) younger women with mild disease, (2) older women with mild disease, (3) older patients with severe disease who had frequent exacerbations, and (4) older patients with severe disease who did not have frequent exacerbations. The follow-up period was 54 months, during which there were 95 deaths. Mortality was low in the first and second groups (3.9% and 7.6%, respectively) and high for the third (37%) and fourth (40.8%) groups. The third cluster had a higher proportion of respiratory deaths than the fourth (77.8% vs. 34.4%; P cluster analysis, it is possible to separate patients with bronchiectasis into distinct clinical phenotypes with different

  3. Comparative Analysis of Results of Online and Offline Customer Satisfaction

    Directory of Open Access Journals (Sweden)

    Jovović Milorad

    2017-05-01

    Full Text Available The logic that customer satisfaction is the starting point of marketing and business activities is based on the assumption that customer satisfaction leads to customer loyalty, keeping in mind all of the positive effects that customer loyalty has on business success of an organization. Because of this, marketing and management theory and practice dedicate particular attention to the concepts of customer satisfaction and loyalty. In this paper we will use the surveys of customers of banking services not only to show the levels of their satisfaction and loyalty, but also to make a comparative analysis of data obtained through online and offline research. This approach was made possible because the research was carried out on a sample which was divided in two groups. All of the participants answered the questions from a unique questionnaire, however, one group took the survey via the Internet (online while data from the other group of participants was collected in the field by using printed questionnaires (offline. The findings of the comparative analysis of online and offline survey results are presented in the final part of the paper.

  4. Acoustic analysis in Mudejar-Gothic churches: Experimental results

    Science.gov (United States)

    Galindo, Miguel; Zamarreño, Teófilo; Girón, Sara

    2005-05-01

    This paper describes the preliminary results of research work in acoustics, conducted in a set of 12 Mudejar-Gothic churches in the city of Seville in the south of Spain. Despite common architectural style, the churches feature individual characteristics and have volumes ranging from 3947 to 10 708 m3. Acoustic parameters were measured in unoccupied churches according to the ISO-3382 standard. An extensive experimental study was carried out using impulse response analysis through a maximum length sequence measurement system in each church. It covered aspects such as reverberation (reverberation times, early decay times), distribution of sound levels (sound strength); early to late sound energy parameters derived from the impulse responses (center time, clarity for speech, clarity, definition, lateral energy fraction), and speech intelligibility (rapid speech transmission index), which all take both spectral and spatial distribution into account. Background noise was also measured to obtain the NR indices. The study describes the acoustic field inside each temple and establishes a discussion for each one of the acoustic descriptors mentioned by using the theoretical models available and the principles of architectural acoustics. Analysis of the quality of the spaces for music and speech is carried out according to the most widespread criteria for auditoria. .

  5. Acoustic analysis in Mudejar-Gothic churches: experimental results.

    Science.gov (United States)

    Galindo, Miguel; Zamarreño, Teófilo; Girón, Sara

    2005-05-01

    This paper describes the preliminary results of research work in acoustics, conducted in a set of 12 Mudejar-Gothic churches in the city of Seville in the south of Spain. Despite common architectural style, the churches feature individual characteristics and have volumes ranging from 3947 to 10 708 m3. Acoustic parameters were measured in unoccupied churches according to the ISO-3382 standard. An extensive experimental study was carried out using impulse response analysis through a maximum length sequence measurement system in each church. It covered aspects such as reverberation (reverberation times, early decay times), distribution of sound levels (sound strength); early to late sound energy parameters derived from the impulse responses (center time, clarity for speech, clarity, definition, lateral energy fraction), and speech intelligibility (rapid speech transmission index), which all take both spectral and spatial distribution into account. Background noise was also measured to obtain the NR indices. The study describes the acoustic field inside each temple and establishes a discussion for each one of the acoustic descriptors mentioned by using the theoretical models available and the principles of architectural acoustics. Analysis of the quality of the spaces for music and speech is carried out according to the most widespread criteria for auditoria.

  6. Disc Motor: Conventional and Superconductor Simulated Results Analysis

    Science.gov (United States)

    Inácio, David; Martins, João; Neves, Mário Ventim; Álvarez, Alfredo; Rodrigues, Amadeu Leão

    Taking into consideration the development and integration of electrical machines with lower dimensions and higher performance, this paper presents the design and development of a three-phase axial flux disc motor, with 50 Hz frequency supply. It is made with two conventional semi-stators and a rotor, which can be implemented with a conventional aluminum disc or a high temperature-superconducting disc. The analysis of the motor characteristics is done with a 2D commercial finite elements package, being the modeling performed as a linear motor. The obtained results allow concluding that the superconductor motor provides a higher force than the conventional one. The conventional disc motor presents an asynchronous behavior, like a conventional induction motor, while the superconductor motor presents both synchronous and asynchronous behaviors.

  7. Initial Data Analysis Results for ATD-2 ISAS HITL Simulation

    Science.gov (United States)

    Lee, Hanbong

    2017-01-01

    To evaluate the operational procedures and information requirements for the core functional capabilities of the ATD-2 project, such as tactical surface metering tool, APREQ-CFR procedure, and data element exchanges between ramp and tower, human-in-the-loop (HITL) simulations were performed in March, 2017. This presentation shows the initial data analysis results from the HITL simulations. With respect to the different runway configurations and metering values in tactical surface scheduler, various airport performance metrics were analyzed and compared. These metrics include gate holding time, taxi-out in time, runway throughput, queue size and wait time in queue, and TMI flight compliance. In addition to the metering value, other factors affecting the airport performance in the HITL simulation, including run duration, runway changes, and TMI constraints, are also discussed.

  8. Prognostic factors influencing the result of postoperative radiotherapy in endometrial carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Ki, Yong Kan; Kwon, Byung Hyun; Kim, Won Taek; Nam, Ji Ho; Yun, Man Su; Kim, Dong Won [Pusan National University School of Medicine, Busan (Korea, Republic of); Lee, Hyung Sik [Dong-A University School of Medicine, Busan (Korea, Republic of)

    2006-06-15

    This study was performed to determine the prognostic factors influencing relapse pattern, overall and disease-free survival in patients treated with postoperative radiotherapy for endometrial carcinoma. The records of 54 patients with endometrial adenocarcinoma treated postoperative radiotherapy at Pusan National University Hospital between April 1992 and May 2003 were reviewed retrospectively. Median age of the patients was 55 (range 35 {approx} 76). The distribution by surgical FIGO stages were 63.0% for 0 Stage I, 14.8% for Stage II, 22.2% for Stage III. All patients received postoperative external radiotherapy up to 41.4 {approx} 54 Gy (median: 50.4 Gy). Additional intravaginal brachytherapy was applied to 20 patients (37.0% of all). Median follow-up time was 35 months (5 {approx} 115 months). Significant factors of this study: histologic grade, lymphovascular space invasion and myometrial invasion depth were scored (GLM sore) and analyzed. Survival analysis was performed using Kaplan-Meier method. The log-rank test was used for univariate analysis and the Cox regression model for multivariate analysis. 5-year overall and disease-free survival rates were 87.7% and 87.1%, respectively. Prognostic factors related with overall and disease-free survival were histologic grade, lymphovascular space invasion and myometrial invasion according to the univariate analysis. According to the multivariate analysis, lymphovascular space invasion was associated with decreased disease-free survival. GLM score was a meaningful factor affecting overall and disease-free survival ({rho} = 0.0090, {rho} = 0.0073, respectively) and distant recurrence ({rho} = 0.0132), which was the sum of points of histologic grade, lymphovascular space invasion and myometrial invasion. Total failure rate was 11% with 6 patients. Relapse sites were 2 para-aortic lymph nodes, 2 lungs, a supraclavicular lymph node and a vagina. The prognosis in patients with endometrial carcinoma treated by

  9. Prognostic significance of the interval between the initiation of antiretroviral therapy and the initiation of anti-tuberculosis treatment in HIV/tuberculosis-coinfected patients: results from the TREAT Asia HIV Observational Database.

    Science.gov (United States)

    Han, S H; Zhou, J; Lee, M P; Zhao, H; Chen, Y-M A; Kumarasamy, N; Pujari, S; Lee, C; Omar, S F S; Ditangco, R; Phanuphak, N; Kiertiburanakul, S; Chaiwarith, R; Merati, T P; Yunihastuti, E; Tanuma, J; Saphonn, V; Sohn, A H; Choi, J Y

    2014-02-01

    We evaluated the effect of the time interval between the initiation of antiretroviral therapy (ART) and the initiation of tuberculosis (TB) treatment on clinical outcomes in HIV/TB-coinfected patients in an Asian regional cohort. Adult HIV/TB-coinfected patients in an observational HIV-infected cohort database who had a known date of ART initiation and a history of TB treatment were eligible for study inclusion. The time interval between the initiation of ART and the initiation of TB treatment was categorized as follows: TB diagnosed while on ART, ART initiated ≤ 90 days after initiation of TB treatment ('early ART'), ART initiated > 90 days after initiation of TB treatment ('delayed ART'), and ART not started. Outcomes were assessed using survival analyses. A total of 768 HIV/TB-coinfected patients were included in this study. The median CD4 T-cell count at TB diagnosis was 100 [interquartile range (IQR) 40-208] cells/μL. Treatment outcomes were not significantly different between the groups with early ART and delayed ART initiation. Kaplan-Meier analysis indicated that mortality was highest for those diagnosed with TB while on ART (3.77 deaths per 100 person-years), and the prognoses of other groups were not different (in deaths per 100 person-years: 2.12 for early ART, 1.46 for delayed ART, and 2.94 for ART not started). In a multivariate model, the interval between ART initiation and TB therapy initiation did not significantly impact all-cause mortality. A negative impact of delayed ART in patients coinfected with TB was not observed in this observational cohort of moderately to severely immunosuppressed patients. The broader impact of earlier ART initiation in actual clinical practice should be monitored more closely. © 2013 British HIV Association.

  10. Comparison of MCCI Analysis Results using the Newest MAAP5

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Ro; Kim, Hyeong Taek [KHNP-CRI, Daejeon (Korea, Republic of)

    2013-10-15

    In this study, we try to find the improvement in the newest MAAP5 MCCI model by comparing the results using the same sequence and the same condition those used in the previous paper. In this study, we can find that the problem which overestimated the concrete ablation for Basaltic concrete is somewhat resolved. And, in case that the cavity is flooded, it is confirmed that the debris coolability for Limestone and Limestone Common Sand concrete is maintained. But, in case of Basaltic concrete, though the interaction is somewhat inactive, but the debris Coolability is not maintained. We are planning to report these results to EPRI in order to confirm whether this phenomenon is appropriate. After the Fukushima accident, EPRI has developed the MAAP5 that is expected to make up the limitation of MAAP4. The newest version of MAAP5 is known as the Ver.5.0.2 (Build 5.01.2182, simply called 502D) which is published in July this year for final beta testing. In this, it is expected that so many models should be upgraded such as the Lower head plenum model, Debris Coolability model, Molten Core Concrete Interaction, Spent Fuel Pool model and Containment Heat Sink model, etc. During the severe accident progression, the molten corium ejected into the cavity reacted with the concrete in the cavity floor and the phenomenon is called MCCI (Molten Core Concrete Interaction). In the last KNS Spring Meeting, KHNP presented the MCCI analysis results according to the concrete composition using MAAP Ver. 5.0.2 (Build 5.01.1100, simply called 502B) published in April, 2012. In that report, we pointed out that the results of MCCI for Basaltic concrete was too much conservative, so we raised the issues related the MCCI model in the MUG meeting.

  11. Utilizing video animation to present FEA (Finite Element Analysis) results

    Energy Technology Data Exchange (ETDEWEB)

    Hayer, L.K.; Vossler, J.J. III.

    1990-01-01

    Finite element Analysis (FEA) technique are used to analyze forming, rolling, extrusion, and other continuous manufacturing processes to produce solutions at discrete points in time. These solutions are then displayed using a graphical post-processor. The post-processor displays one plot at a time making it difficult to follow events over the entire process. A means of linking these images that occur at discrete points in time and displaying them in a continuous fashion would aid in comprehending the significance of dynamic or time dependent events that evolve during the processes. Video recording of the graphics provides a means to link the graphical ouput at each discrete point in time and project the results in a continuous fashion upon playback. This presentation outlines the video hardware, the modifications to the pre- and post-processing software, and the process used to make video animation recording of FEA results. Several examples will be shown: Hydroforming of a Spherical Aluminum Shell'' and Three-Stage Forging.'' 5 refs., 7 figs.

  12. Compilation of PRF Canyon Floor Pan Sample Analysis Results

    Energy Technology Data Exchange (ETDEWEB)

    Pool, Karl N. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Minette, Michael J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Wahl, Jon H. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Greenwood, Lawrence R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Coffey, Deborah S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); McNamara, Bruce K. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Bryan, Samuel A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Scheele, Randall D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Delegard, Calvin H. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Sinkov, Sergey I. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Soderquist, Chuck Z. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Fiskum, Sandra K. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Brown, Garrett N. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Clark, Richard A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-06-30

    On September 28, 2015, debris collected from the PRF (236-Z) canyon floor, Pan J, was observed to exhibit chemical reaction. The material had been transferred from the floor pan to a collection tray inside the canyon the previous Friday. Work in the canyon was stopped to allow Industrial Hygiene to perform monitoring of the material reaction. Canyon floor debris that had been sealed out was sequestered at the facility, a recovery plan was developed, and drum inspections were initiated to verify no additional reactions had occurred. On October 13, in-process drums containing other Pan J material were inspected and showed some indication of chemical reaction, limited to discoloration and degradation of inner plastic bags. All Pan J material was sealed back into the canyon and returned to collection trays. Based on the high airborne levels in the canyon during physical debris removal, ETGS (Encapsulation Technology Glycerin Solution) was used as a fogging/lock-down agent. On October 15, subject matter experts confirmed a reaction had occurred between nitrates (both Plutonium Nitrate and Aluminum Nitrate Nonahydrate (ANN) are present) in the Pan J material and the ETGS fixative used to lower airborne radioactivity levels during debris removal. Management stopped the use of fogging/lock-down agents containing glycerin on bulk materials, declared a Management Concern, and initiated the Potential Inadequacy in the Safety Analysis determination process. Additional drum inspections and laboratory analysis of both reacted and unreacted material are planned. This report compiles the results of many different sample analyses conducted by the Pacific Northwest National Laboratory on samples collected from the Plutonium Reclamation Facility (PRF) floor pans by the CH2MHill’s Plateau Remediation Company (CHPRC). Revision 1 added Appendix G that reports the results of the Gas Generation Rate and methodology. The scope of analyses requested by CHPRC includes the determination of

  13. Cluster analysis of autoantibodies in 852 patients with systemic lupus erythematosus from a single center.

    Science.gov (United States)

    Artim-Esen, Bahar; Çene, Erhan; Şahinkaya, Yasemin; Ertan, Semra; Pehlivan, Özlem; Kamali, Sevil; Gül, Ahmet; Öcal, Lale; Aral, Orhan; Inanç, Murat

    2014-07-01

    Associations between autoantibodies and clinical features have been described in systemic lupus erythematosus (SLE). Herein, we aimed to define autoantibody clusters and their clinical correlations in a large cohort of patients with SLE. We analyzed 852 patients with SLE who attended our clinic. Seven autoantibodies were selected for cluster analysis: anti-DNA, anti-Sm, anti-RNP, anticardiolipin (aCL) immunoglobulin (Ig)G or IgM, lupus anticoagulant (LAC), anti-Ro, and anti-La. Two-step clustering and Kaplan-Meier survival analyses were used. Five clusters were identified. A cluster consisted of patients with only anti-dsDNA antibodies, a cluster of anti-Sm and anti-RNP, a cluster of aCL IgG/M and LAC, and a cluster of anti-Ro and anti-La antibodies. Analysis revealed 1 more cluster that consisted of patients who did not belong to any of the clusters formed by antibodies chosen for cluster analysis. Sm/RNP cluster had significantly higher incidence of pulmonary hypertension and Raynaud phenomenon. DsDNA cluster had the highest incidence of renal involvement. In the aCL/LAC cluster, there were significantly more patients with neuropsychiatric involvement, antiphospholipid syndrome, autoimmune hemolytic anemia, and thrombocytopenia. According to the Systemic Lupus International Collaborating Clinics damage index, the highest frequency of damage was in the aCL/LAC cluster. Comparison of 10 and 20 years survival showed reduced survival in the aCL/LAC cluster. This study supports the existence of autoantibody clusters with distinct clinical features in SLE and shows that forming clinical subsets according to autoantibody clusters may be useful in predicting the outcome of the disease. Autoantibody clusters in SLE may exhibit differences according to the clinical setting or population.

  14. Identification and validation of asthma phenotypes in Chinese population using cluster analysis.

    Science.gov (United States)

    Wang, Lei; Liang, Rui; Zhou, Ting; Zheng, Jing; Liang, Bing Miao; Zhang, Hong Ping; Luo, Feng Ming; Gibson, Peter G; Wang, Gang

    2017-08-30

    Asthma is a heterogeneous airway disease, so it is crucial to clearly identify clinical phenotypes to achieve better asthma management. To identify and prospectively validate asthma clusters in a Chinese population. Two hundred eighty-four patients were consecutively recruited and 18 sociodemographic and clinical variables were collected. Hierarchical cluster analysis was performed by the Ward method followed by k-means cluster analysis. Then, a prospective 12-month cohort study was used to validate the identified clusters. Five clusters were successfully identified. Clusters 1 (n = 71) and 3 (n = 81) were mild asthma phenotypes with slight airway obstruction and low exacerbation risk, but with a sex differential. Cluster 2 (n = 65) described an "allergic" phenotype, cluster 4 (n = 33) featured a "fixed airflow limitation" phenotype with smoking, and cluster 5 (n = 34) was a "low socioeconomic status" phenotype. Patients in clusters 2, 4, and 5 had distinctly lower socioeconomic status and more psychological symptoms. Cluster 2 had a significantly increased risk of exacerbations (risk ratio [RR] 1.13, 95% confidence interval [CI] 1.03-1.25), unplanned visits for asthma (RR 1.98, 95% CI 1.07-3.66), and emergency visits for asthma (RR 7.17, 95% CI 1.26-40.80). Cluster 4 had an increased risk of unplanned visits (RR 2.22, 95% CI 1.02-4.81), and cluster 5 had increased emergency visits (RR 12.72, 95% CI 1.95-69.78). Kaplan-Meier analysis confirmed that cluster grouping was predictive of time to the first asthma exacerbation, unplanned visit, emergency visit, and hospital admission (P clusters as "allergic asthma," "fixed airflow limitation," and "low socioeconomic status" phenotypes that are at high risk of severe asthma exacerbations and that have management implications for clinical practice in developing countries. Copyright © 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  15. SURVIVAL ANALYSIS OF CANCER CASES FROM QIDONG CANCER REGISTRY

    Institute of Scientific and Technical Information of China (English)

    CHEN Jian-guo; Sankaranarayanan R; SHEN Zhuo-cai; Black RJ; YAO Hong-yu; LI Wen-guang; Parkin DM

    1999-01-01

    Objective: 16,922 patients with cancers from 15 sites of Qidong population-based cancer registry in the period of 1982-1991 were analyzed for evaluation of cancer survival as well as different cancer control measures.Methods: Observed survival rate (OS) was computed by the Kaplan-Meier method using EGRET statistical software package. Relative survival (RS) which is the ratio of the OS to the expected rate was calculated by using Qidong life table with respect to sex, age and calendar period of observation. Results: The five-year OS for the 5 leading sites of cancers, liver, stomach, lung,oesophagus, and rectum were 1.8%, 11.6%, 3.0% 3.3%,and 19.9%, respectively. The five-year RS for the 5 sites were 1.9%, 14.0%, 3.6%, 4.2%, and 23.7%, respectively,in which, 1.7%, 14.8%, 3.4%, 4.2%, and 26.0% for males, and 2.7%, 12.7%, 4.1%, 4.0%, and 22.0% for females, respectively. Female patients with breast cancer and cervix cancer had 5-year RS of 54.6% and 33.0%.Conclusion: Cancer survival rates for all sites are poor,in which that of the liver is the lowest, while that of the breast, the highest. The survivals of cancers for all sites,especially for breast, cervix, and leukemia are seen to be lower than those of European countries except for oesophagus, pancreas and lung cancer which do not achieve improved survival both in developing and developed countries. There will be a long way to improve the total cancer survival, as well as the cancer treatment in the developing countries.

  16. Digital Architecture – Results From a Gap Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Oxstrand, Johanna Helene [Idaho National Lab. (INL), Idaho Falls, ID (United States); Thomas, Kenneth David [Idaho National Lab. (INL), Idaho Falls, ID (United States); Fitzgerald, Kirk [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-09-01

    The digital architecture is defined as a collection of IT capabilities needed to support and integrate a wide-spectrum of real-time digital capabilities for nuclear power plant performance improvements. The digital architecture can be thought of as an integration of the separate I&C and information systems already in place in NPPs, brought together for the purpose of creating new levels of automation in NPP work activities. In some cases, it might be an extension of the current communication systems, to provide digital communications where they are currently analog only. This collection of IT capabilities must in turn be based on a set of user requirements that must be supported for the interconnected technologies to operate in an integrated manner. These requirements, simply put, are a statement of what sorts of digital work functions will be exercised in a fully-implemented seamless digital environment and how much they will be used. The goal of the digital architecture research is to develop a methodology for mapping nuclear power plant operational and support activities into the digital architecture, which includes the development of a consensus model for advanced information and control architecture. The consensus model should be developed at a level of detail that is useful to the industry. In other words, not so detailed that it specifies specific protocols and not so vague that it is only provides a high level description of technology. The next step towards the model development is to determine the current state of digital architecture at typical NPPs. To investigate the current state, the researchers conducted a gap analysis to determine to what extent the NPPs can support the future digital technology environment with their existing I&C and IT structure, and where gaps exist with respect to the full deployment of technology over time. The methodology, result, and conclusions from the gap analysis are described in this report.

  17. Plutonium Mobility Studies: 216-Z-9 Trench Sample Analysis Results

    Energy Technology Data Exchange (ETDEWEB)

    Cantrell, Kirk J.; Geiszler, Keith N.; Arey, Bruce W.

    2008-09-05

    A variety of analyses were conducted on selected sediment samples collected from two wells (299 W15-46 and 299-W15-48) drilled near the 216-Z-9 Trench to elucidate the form and potential for Pu and Am to be mobilized under present conditions and those that could be expected in future remediation scenarios. Analyses included moisture content, determination of the less than sand size fraction (silt plus clay), carbon analysis, SEM/EDS analysis, microwave-assisted acid digestions for total element analysis, and extraction tests using Hanford groundwater as the leachate. Results of the extraction tests were used as input to conduct equilibrium geochemical modeling of the solutions with Geochemist’s Workbench®. Geochemical modeling results for Pu were evaluated in terms of recent conclusions regarding the solubility and redox reactions of Pu by Neck et al. (2007a, 2007b). It was found that the highest concentrations of Pu and Am were associated with sediments of low silt/clay content and occur above silt/clay rich layers within the sediment profile. It was also found that the Pu and Am were relatively enriched in the silt/clay portion of these samples. The fact that the highest concentrations of Pu and Am occurred in sediments with low silt/clay contents suggests that waste solutions had perched on top of the low permeability silt/clay rich layers and interactions with the high silt/clay layers was minimal. SEM/EDS analysis indicated that the Pu and Am in these sediments does not occur as discrete micron size particles, and therefore must occur as mononuclear or polynuclear/ nanoclusters size particles adsorbed throughout the sediment samples. Leaching of these samples with Hanford groundwater indicates that release of Pu and Am from the sediments is correlated most significantly with the acidity of the water and not the initial concentrations of Pu and Am in the sediments. Only extracts that were acidic after contact with the sediments (pH 4.3 to 5.4) contained

  18. Results and Analysis from Space Suit Joint Torque Testing

    Science.gov (United States)

    Matty, Jennifer E.; Aitchison, Lindsay

    2009-01-01

    A space suit s mobility is critical to an astronaut s ability to perform work efficiently. As mobility increases, the astronaut can perform tasks for longer durations with less fatigue. The term mobility, with respect to space suits, is defined in terms of two key components: joint range of motion and joint torque. Individually these measures describe the path which in which a joint travels and the force required to move it through that path. Previous space suits mobility requirements were defined as the collective result of these two measures and verified by the completion of discrete functional tasks. While a valid way to impose mobility requirements, such a method does necessitate a solid understanding of the operational scenarios in which the final suit will be performing. Because the Constellation space suit system requirements are being finalized with a relatively immature concept of operations, the Space Suit Element team elected to define mobility in terms of its constituent parts to increase the likelihood that the future pressure garment will be mobile enough to enable a broad scope of undefined exploration activities. The range of motion requirements were defined by measuring the ranges of motion test subjects achieved while performing a series of joint maximizing tasks in a variety of flight and prototype space suits. The definition of joint torque requirements has proved more elusive. NASA evaluated several different approaches to the problem before deciding to generate requirements based on unmanned joint torque evaluations of six different space suit configurations being articulated through 16 separate joint movements. This paper discusses the experiment design, data analysis and results, and the process used to determine the final values for the Constellation pressure garment joint torque requirements.

  19. Advanced Thermal Simulator Testing: Thermal Analysis and Test Results

    Science.gov (United States)

    Bragg-Sitton, Shannon M.; Dickens, Ricky; Dixon, David; Reid, Robert; Adams, Mike; Davis, Joe

    2008-01-01

    Work at the NASA Marshall Space Flight Center seeks to develop high fidelity, electrically heated thermal simulators that represent fuel elements in a nuclear reactor design to support non-nuclear testing applicable to the development of a space nuclear power or propulsion system. Comparison between the fuel pins and thermal simulators is made at the outer fuel clad surface, which corresponds to the outer sheath surface in the thermal simulator. The thermal simulators that are currently being tested correspond to a SNAP derivative reactor design that could be applied for Lunar surface power. These simulators are designed to meet the geometric and power requirements of a proposed surface power reactor design, accommodate testing of various axial power profiles, and incorporate imbedded instrumentation. This paper reports the results of thermal simulator analysis and testing in a bare element configuration, which does not incorporate active heat removal, and testing in a water-cooled calorimeter designed to mimic the heat removal that would be experienced in a reactor core.

  20. Estimation of Morphological Tables Using Text Analysis Results

    Directory of Open Access Journals (Sweden)

    Illia Savchenko

    2016-08-01

    Full Text Available This paper proposes methods for obtaining input data, necessary for the modified morphological analysis method, from the text sources of data using text analysis tools. Several methods are described that are suitable for calculating initial estimates of alternatives and cross-consistency matrix values based on processing text fragments by rule-based categorization and sentiment analysis tools. A practical implementation of this tool set for assessing statements in news regarding Ukraine is considered.

  1. Estimation of Morphological Tables Using Text Analysis Results

    OpenAIRE

    Illia Savchenko

    2016-01-01

    This paper proposes methods for obtaining input data, necessary for the modified morphological analysis method, from the text sources of data using text analysis tools. Several methods are described that are suitable for calculating initial estimates of alternatives and cross-consistency matrix values based on processing text fragments by rule-based categorization and sentiment analysis tools. A practical implementation of this tool set for assessing statements in news regarding Ukraine is co...

  2. African Primary Care Research: qualitative data analysis and writing results.

    Science.gov (United States)

    Mabuza, Langalibalele H; Govender, Indiran; Ogunbanjo, Gboyega A; Mash, Bob

    2014-06-05

    This article is part of a series on African primary care research and gives practical guidance on qualitative data analysis and the presentation of qualitative findings. After an overview of qualitative methods and analytical approaches, the article focuses particularly on content analysis, using the framework method as an example. The steps of familiarisation, creating a thematic index, indexing, charting, interpretation and confirmation are described. Key concepts with regard to establishing the quality and trustworthiness of data analysis are described. Finally, an approach to the presentation of qualitative findings is given.

  3. Veneered zirconia inlay-retained fixed dental prostheses: 10-Year results from a prospective clinical study.

    Science.gov (United States)

    Rathmann, Friederike; Bömicke, Wolfgang; Rammelsberg, Peter; Ohlmann, Brigitte

    2017-09-01

    The purpose of this study was to evaluate the 10-year clinical performance of zirconia-based inlay-retained fixed dental prostheses (IRFDP). For replacement of a molar in 27 patients, 30 IRFDP were luted by use of different cements, Panavia F (Kuraray Europe GmbH) or Multilink Automix (Ivoclar Vivadent GmbH), with use of inlay/inlay, inlay/full-crown, or inlay/partial-crown retainers for anchorage. Frameworks were milled from yttria-stabilized zirconia (IPS e.maxZirCAD; Ivoclar Vivadent GmbH) and fully veneered with pressable ceramic (IPS e.max ZirPress; Ivoclar Vivadent GmbH). Before luting, the IRFDP were silica-coated (Rocatec; 3M Espe) and silanized (Monobond S; Ivoclar Vivadent GmbH). Complications (for example, chipping or delamination of the veneering ceramic, debonding, secondary caries, endodontic treatment, and abutment tooth fracture) and failure were reported, by use of standardized report forms, 2 weeks, 6 months, and 1, 2, and 10 years after cementation. Statistical analysis included Kaplan-Meier survival and success (complication-free survival) and Cox regression analysis (α=0.05 for all). During the 10-year observation period, the complications most often observed were chipping of the veneer and debonding. Twenty-five restorations failed and one participant dropped out. Cumulative 10-year survival and success were 12.1% and 0%, respectively. The design of the retainer, use of a dental dam, choice of cement, and location in the dental arch had no statistically significant effect on the occurrence of complications. Use of fully veneered zirconia-based IRFDP with this technique cannot be recommended. A large incidence of complications and poor survival were observed for fully veneered zirconia-based IRFDP, revealing an urgent need for further design improvements for this type of restoration. This, again, emphasizes the need for testing of new restoration designs in clinical trials before implementation in general dental practice. Copyright © 2017

  4. Estudo clínico-patológico, da proliferação celular e da apoptose no adenocarcinoma gástrico da cárdia Analysis of clinicopathological, tumor cell proliferation and apoptosis parameters in adenocarcinoma of the gastric cardia

    Directory of Open Access Journals (Sweden)

    Ana Maria Amaral Antonio Mader

    2006-09-01

    de grande aumento. Houve correlação positiva entre a apoptose e PCNA tumorais. A sobrevida média foi de 28,41 meses. A idade (acima de 63 e o índice apoptótico (acima de 7,05, em análise multivariada, mostraram correlação negativa com a sobrevida. CONCLUSÕES: O adenocarcinoma da cárdia ocorreu mais nos indivíduos do sexo masculino, com idade média de 61 anos, com predomínio do tipo difuso e estádios mais avançados. A sobrevivência ainda é baixa. Houve correlação positiva entre a apoptose e proliferação celular tumoral. Tanto a idade como a apoptose foram fatores prognósticos independentes no câncer da cárdia.BACKGROUND/AIMS: In view of the increased incidence of carcinoma of the cardia over recent years, this work had the aim of studying the clinicopathological aspects, cell proliferative and tumor apoptotic indices of this neoplasm, their interrelations and possible influences on the prognosis. MATERIAL AND METHODS: Forty cases of adenocarcinoma of the cardia were studied between 1988 and 2001, with a minimum clinical follow-up of 3 years. Patients were excluded if they had previous chemotherapy or radiotherapy treatment, presented early neoplasia, or died during the operations or for other reasons unrelated to cancer. Gender; age, Laurén and Ming histological type, staging, and the presence or absence of intestinal metaplasia, epithelial dysplasia and Helicobacter pylori in the adjacent mucosa were analyzed. The apoptotic index was evaluated via hematoxylin-eosin in the primary tumor. To analyze the cell proliferation tumor, PCNA was utilized. The immunohistochemical technique utilized was streptavidin-biotin-peroxidase. For the survival analysis, cases with distant metastasis upon diagnosis were excluded. For the statistical analysis, the Student t and Mann-Whitney tests, Kaplan-Meier curves and Cox regression model were utilized. RESULTS: The mean age was 61 years (median: 63. There was predominance of the male gender (72.5%, diffuse

  5. Risk factors analysis of prognosis of microalbuminuria IgA nephropathy patients with decreased ;serum C3 level%表现为微量白蛋白尿IgA肾病伴低C3血症患者的预后危险因素分析

    Institute of Scientific and Technical Information of China (English)

    郭宗运; 李霞; 周世菊; 赵东; 刘金彦; 吴玉梅

    2016-01-01

    Objective To analyze the clinical and pathological data and prognosis of microalbuminuria IgA nephrology patients with decreased serum C3 level, and investigate the significance of decreased serum C3 level in microalbuminuria IgA nephrology patients. Methods Clinical and pathological data of microalbuminuria IgA nephrology patients confirmed by renal biopsy and followed up more than 6 months were reviewed. The patients were divided into decreased serum C3 level group (34 cases, 25.19%) and normal serum C3 level group (101 cases, 74.81%) according to the serum C3 level. Twenty-four hours urine protein quantitative > 1 g, or normal serum creatinine level turning into abnormal level at renal biopsy, or doubling of serum creatinine level was defined as the end point of follow-up. Renal survival was calculated by Kaplan-Meier survival analysis and risk factors of progression were analyzed by Cox regression models. Results Total of 135 microalbuminuria IgA nephrology patients were followed up successfully, with an average follow-up time (53.4 ± 21.9) months. There were 27 cases (79.41%) and 32 cases (31.68%) in the decreased serum C3 level group and the normal serum C3 level group respectively at the endpoint. Kaplan-Meier survival analysis showed that the median survival time was significantly shorter in decreased serum C3 level group compared with that in normal C3 level group: (46.7 ± 9.1) months vs. (68.4 ± 9.9) months, P =0.014. Cox regression analysis showed that abnormal serum creatinine (RR = 1.147, 95% CI: 1.129-1.395, P = 0.008), decreased serum C3 level (RR=1.028, 95%CI:0.672-1.495, P=0.039), urine protein quantitative>1 g/24 h (RR=2.066, 95%CI:1.242-3.838, P=0.006) and renal biopsy pathological indicators Lee classⅢ-Ⅴ(RR=2.820, 95%CI:1.249-5.638, P=0.041), glomerular sclerosis or adhesions (RR=1.232, 95%CI: 1.065-1.520, P = 0.040), renal interstitial atrophy or interstitial fibrosis (RR = 2.604, 95% CI:1.748- 4.104, P = 0.037), endocapillary cell

  6. Time-varying pattern of postoperative recurrence risk of early-stage (T1a-T2bN0M0) non-small cell lung cancer (NSCLC): results of a single-center study of 994 Chinese patients.

    Science.gov (United States)

    Zhu, Jian-fei; Feng, Xing-yu; Zhang, Xue-wen; Wen, Ying-sheng; Lin, Peng; Rong, Tie-hua; Cai, Ling; Zhang, Lan-jun

    2014-01-01

    The aim of this study was to analyze the time-varying pattern of recurrence risk of early-stage (T1a-T2bN0M0) non-small cell lung cancer (NSCLC) after surgery using the hazard function and identify patients who might benefit from adjuvant chemotherapy. This retrospective study enrolled 994 patients with early-stage NSCLC who underwent radical surgical resection between January 1999 and October 2009. Survival curves were generated using the Kaplan-Meier method, and the annual recurrence hazard was estimated using the hazard function. The median recurrence-free survival (RFS) was 8.8 years. The life table survival analysis showed that the 1-year, 3-year, 5-year and 10-year recurrence rates were 82.0%, 67.0%, 59.0% and 48.0%, respectively. Approximately 256 (25.7%) patients experienced relapse [locoregional: 32 (3.2%) and distant: 224 (22.5%)], and 162 patients died from cancer. The annual recurrence hazard curve for the entire population showed that the first major recurrence surge reached a maximum 1.6 years after surgery. The curve subsequently declined until reaching a nadir at 7.2 years. A second peak occurred at 8.8 years. An analysis of clinical-pathological factors demonstrated that this double-peaked pattern was present in several subgroups. The presence of a double-peaked pattern indicates that there is a predictable temporal distribution of the recurrence hazard of early-stage NSCLC. The annual recurrence hazard may be an effective method of selecting patients at high risk of recurrence, who may benefit from adjuvant therapy.

  7. Time-to-event analysis of individual variables associated with nursing students' academic failure: a longitudinal study.

    Science.gov (United States)

    Dante, Angelo; Fabris, Stefano; Palese, Alvisa

    2013-12-01

    Empirical studies and conceptual frameworks presented in the extant literature offer a static imagining of academic failure. Time-to-event analysis, which captures the dynamism of individual factors, as when they determine the failure to properly tailor timely strategies, impose longitudinal studies which are still lacking within the field. The aims of this longitudinal study were to investigate the time which elapses from a nursing student's admission to a Bachelor of Nursing program to their academic failure and to estimate the predictive power of individual variables on academic failure. Enrolled students (n = 170) in two Italian nursing degree programs during academic year 2008-2009, received at the beginning of each years a questionnaire which evaluated individual variables. Academic failure rate was 37.2 %. Time-to-event analysis has shown that academic failure occurred after an average of 664.52 days of course attendance ((95 %)CI = 623.2-705.8). Kaplan-Meier analyses demonstrated a high likelihood of failure among males (χ(2) 7.790, p 0.005) and among those who had obtained a final average grade in their secondary education ≤73/100 (χ(2)11.676, p 0.001). Cox regression analysis confirmed an increased likelihood of failure over time among males as compared to females (HR 1.931, (95 %)CI = 1.017-3.670), and among students living more than a 30 min commute from their place of study (HR 1.898, (95 %)CI = 1.015-3.547). The effect of these two factors on academic failure has been seen to manifest primarily toward the end of students' second academic year; students at risk might be supported by the appropriate university staff prior to this period.

  8. Risk of peptic ulcer, oesophagitis, pancreatitis or gallstone in patients with unexplained chest/epigastric pain and normal upper endoscopy: a 10-year Danish cohort study

    DEFF Research Database (Denmark)

    Munk, E M; Drewes, A M; Gorst-Rasmussen, Anders;

    2007-01-01

    : This Danish 10-year cohort study focused on UCEP patients (n = 386), diagnosed in 1992-93. Ten age- and gender-matched controls were selected per patient from Denmark's Civil Registration System (n = 3860). Kaplan-Meier analysis and Cox's regression analysis was used to calculate the risk of hospitalization...

  9. Obesity paradox in group 1 pulmonary hypertension: analysis of the NIH-Pulmonary Hypertension registry.

    Science.gov (United States)

    Mazimba, S; Holland, E; Nagarajan, V; Mihalek, A D; Kennedy, J L W; Bilchick, K C

    2017-08-01

    The 'obesity paradox' refers to the fact that obese patients have better outcomes than normal weight patients. This has been observed in multiple cardiovascular conditions, but evidence for obesity paradox in pulmonary hypertension (PH) remains sparse. We categorized 267 patients from the National Institute of Health-PH registry into five groups based on body mass index (BMI): underweight, normal weight, overweight, obese and morbidly obese. Mortality was compared in BMI groups using the χ(2) statistic. Five-year probability of death using the PH connection (PHC) risk equation was calculated, and the model was compared with BMI groups using Cox proportional hazards regression and Kaplan-Meier (KM) survival curves. Patients had a median age of 39 years (interquartile range 30-50 years), a median BMI of 23.4 kg m(-)(2) (21.0-26.8 kg m(-2)) and an overall mortality at 5 years of 50.2%. We found a U-shaped relationship between survival and 1-year mortality with the best 1-year survival in overweight patients. KM curves showed the best survival in the overweight, followed by obese and morbidly obese patients, and the worst survival in normal weight and underweight patients (log-rank P=0.0008). In a Cox proportional hazards analysis, increasing BMI was a highly significant predictor of improved survival even after adjustment for the PHC risk equation with a hazard ratio for death of 0.921 per kg m(-2) (95% confidence interval: 0.886-0.954) (Pparadox' than an 'obesity paradox'. This has implications for risk stratification and prognosis in group 1 PH patients.

  10. Utilization and impact of adjuvant therapy in anaplastic oligodendroglioma: an analysis on 1692 patients.

    Science.gov (United States)

    Shin, Jacob Y; Diaz, Aidnag Z

    2016-09-01

    The aim of this study was to determine the utilization rates and impact of adjuvant therapy on overall survival (OS) for anaplastic oligodendroglioma (AO). Data were extracted from the National Cancer Data Base (NCDB). Chi square test, Kaplan-Meier method, and Cox regression models were employed in SPSS 22.0 (Armonk, NY: IBM Corp.) for data analyses. 1692 patients with AO who underwent surgery were identified. 945 (55.9 %) received adjuvant radiotherapy with concomitant chemotherapy (chemoRT), 102 (6.0 %) adjuvant radiotherapy (RT) sequentially followed by chemotherapy, 244 (14.4 %) adjuvant RT alone, and 401 (23.7 %) received no adjuvant therapy. Patients were more likely to receive adjuvant chemoRT if they were diagnosed in 2009-2013 vs. 2004-2008 (p 70 vs. <70 (p = 0.018), had private insurance vs. Medicaid vs. no insurance (p < 0.001), or had median income ≥$63,000 vs. <$63,000 (p = 0.014). Those who received adjuvant chemoRT (concomitant or sequential) had significantly better 5-year OS than those who received adjuvant RT alone or no adjuvant therapy (59.8 % vs. 65.0 % vs. 44.9 % vs. 45.6 %, p < 0.001). This significant 5-year OS benefit was also observed regardless of age. There was no difference in OS when comparing concomitant chemoRT to sequential RT and chemotherapy (p = 0.481). On multivariate analysis, receipt of adjuvant chemoRT (concomitant or sequential) remained an independent prognostic factor for improved OS. Adjuvant chemoRT (concomitant or sequential) is an independent prognostic factor for improved OS in anaplastic oligodendroglioma and should be considered for all clinically suitable patients who have undergone surgery for the disease.

  11. Long-term results of «Universal» total knee endoprosthesis

    Directory of Open Access Journals (Sweden)

    J. Pilny

    2015-01-01

    patients (1.6% experienced a periprosthetic femur fracture during the period of observation. It was possible to resolve this state by the distal femoral nail osteosynthesis. Upon assessing the results via the Kaplan-Meier curve method, the survival index was 98.7% after 7 years, 94.3% - after 22 years and 91.8% - after 22 years. Conclusion. The result of this study had showed the reliability of «Universal» prosthesis which can be recommended for the treatment of patients with degenerative knee disea;

  12. Results of a Citation Analysis of Knowledge Management in Education

    Science.gov (United States)

    Uzunboylu, Huseyin; Eris, Hasan; Ozcinar, Zehra

    2011-01-01

    The purpose of this study was to examine research and trends in knowledge management in education (KME) published in selected professional sources during the period 1990-2008. Citation analysis was used in this study to investigate documents related to KME, which were indexed in the Web of Science, Education Researches Information Center and…

  13. Results of a Citation Analysis of Knowledge Management in Education

    Science.gov (United States)

    Uzunboylu, Huseyin; Eris, Hasan; Ozcinar, Zehra

    2011-01-01

    The purpose of this study was to examine research and trends in knowledge management in education (KME) published in selected professional sources during the period 1990-2008. Citation analysis was used in this study to investigate documents related to KME, which were indexed in the Web of Science, Education Researches Information Center and…

  14. Prognostic analysis of uterine cervical cancer treated with postoperative radiotherapy: importance of positive or close parametrial resection margin

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yi Jun; Lee, Kyung Ja; Park, Kyung Ran [Dept. of Radiation Oncology, (Korea, Republic of); and others

    2015-06-15

    To analyze prognostic factors for locoregional recurrence (LRR), distant metastasis (DM), and overall survival (OS) in cervical cancer patients who underwent radical hysterectomy followed by postoperative radiotherapy (PORT) in a single institute. Clinicopathologic data of 135 patients with clinical stage IA2 to IIA2 cervical cancer treated with PORT from 2001 to 2012 were reviewed, retrospectively. Postoperative parametrial resection margin (PRM) and vaginal resection margin (VRM) were investigated separately. The median treatment dosage of external beam radiotherapy (EBRT) to the whole pelvis was 50.4 Gy in 1.8 Gy/fraction. High-dose-rate vaginal brachytherapy after EBRT was given to patients with positive or close VRMs. Concurrent platinum-based chemoradiotherapy (CCRT) was administered to 73 patients with positive resection margin, lymph node (LN) metastasis, or direct extension of parametrium. Kaplan-Meier method and log-rank test were used for analyzing LRR, DM, and OS; Cox regression was applied to analyze prognostic factors. The 5-year disease-free survival was 79% and 5-year OS was 91%. In univariate analysis, positive or close PRM, LN metastasis, direct extension of parametrium, lymphovascular invasion, histology of adenocarcinoma, and chemotherapy were related with more DM and poor OS. In multivariate analysis, PRM and LN metastasis remained independent prognostic factors for OS. PORT after radical hysterectomy in uterine cervical cancer showed excellent OS in this study. Positive or close PRM after radical hysterectomy in uterine cervical cancer correlates with poor prognosis even with CCRT. Therefore, additional treatments to improve local control such as radiation boosting need to be considered.

  15. Supervised multi-view canonical correlation analysis (sMVCCA): integrating histologic and proteomic features for predicting recurrent prostate cancer.

    Science.gov (United States)

    Lee, George; Singanamalli, Asha; Wang, Haibo; Feldman, Michael D; Master, Stephen R; Shih, Natalie N C; Spangler, Elaine; Rebbeck, Timothy; Tomaszewski, John E; Madabhushi, Anant

    2015-01-01

    In this work, we present a new methodology to facilitate prediction of recurrent prostate cancer (CaP) following radical prostatectomy (RP) via the integration of quantitative image features and protein expression in the excised prostate. Creating a fused predictor from high-dimensional data streams is challenging because the classifier must 1) account for the "curse of dimensionality" problem, which hinders classifier performance when the number of features exceeds the number of patient studies and 2) balance potential mismatches in the number of features across different channels to avoid classifier bias towards channels with more features. Our new data integration methodology, supervised Multi-view Canonical Correlation Analysis (sMVCCA), aims to integrate infinite views of highdimensional data to provide more amenable data representations for disease classification. Additionally, we demonstrate sMVCCA using Spearman's rank correlation which, unlike Pearson's correlation, can account for nonlinear correlations and outliers. Forty CaP patients with pathological Gleason scores 6-8 were considered for this study. 21 of these men revealed biochemical recurrence (BCR) following RP, while 19 did not. For each patient, 189 quantitative histomorphometric attributes and 650 protein expression levels were extracted from the primary tumor nodule. The fused histomorphometric/proteomic representation via sMVCCA combined with a random forest classifier predicted BCR with a mean AUC of 0.74 and a maximum AUC of 0.9286. We found sMVCCA to perform statistically significantly (p state-of-the-art data fusion strategies for predicting BCR. Furthermore, Kaplan-Meier analysis demonstrated improved BCR-free survival prediction for the sMVCCA-fused classifier as compared to histology or proteomic features alone.

  16. Algorithmic three-dimensional analysis of tumor shape in MRI improves prognosis of survival in glioblastoma: a multi-institutional study.

    Science.gov (United States)

    Czarnek, Nicholas; Clark, Kal; Peters, Katherine B; Mazurowski, Maciej A

    2017-03-01

    In this retrospective, IRB-exempt study, we analyzed data from 68 patients diagnosed with glioblastoma (GBM) in two institutions and investigated the relationship between tumor shape, quantified using algorithmic analysis of magnetic resonance images, and survival. Each patient's Fluid Attenuated Inversion Recovery (FLAIR) abnormality and enhancing tumor were manually delineated, and tumor shape was analyzed by automatic computer algorithms. Five features were automatically extracted from the images to quantify the extent of irregularity in tumor shape in two and three dimensions. Univariate Cox proportional hazard regression analysis was performed to determine how prognostic each feature was of survival. Kaplan Meier analysis was performed to illustrate the prognostic value of each feature. To determine whether the proposed quantitative shape features have additional prognostic value compared with standard clinical features, we controlled for tumor volume, patient age, and Karnofsky Performance Score (KPS). The FLAIR-based bounding ellipsoid volume ratio (BEVR), a 3D complexity measure, was strongly prognostic of survival, with a hazard ratio of 0.36 (95% CI 0.20-0.65), and remained significant in regression analysis after controlling for other clinical factors (P = 0.0061). Three enhancing-tumor based shape features were prognostic of survival independently of clinical factors: BEVR (P = 0.0008), margin fluctuation (P = 0.0013), and angular standard deviation (P = 0.0078). Algorithmically assessed tumor shape is statistically significantly prognostic of survival for patients with GBM independently of patient age, KPS, and tumor volume. This shows promise for extending the utility of MR imaging in treatment of GBM patients.

  17. Texture analysis of {sup 18}F-FDG PET/CT to predict tumour response and prognosis of patients with esophageal cancer treated by chemoradiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Nakajo, Masatoyo; Jinguji, Megumi; Nakabeppu, Yoshiaki; Higashi, Ryutarou; Fukukura, Yoshihiko; Yoshiura, Takashi [Kagoshima University, Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima (Japan); Nakajo, Masayuki [Nanpuh Hospital, Department of Radiology, Kagoshima (Japan); Sasaki, Ken; Uchikado, Yasuto; Natsugoe, Shoji [Kagoshima University, Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical and Dental Sciences, Kagoshima (Japan)

    2017-02-15

    This retrospective study was done to examine whether the heterogeneity in primary tumour F-18-fluorodeoxyglucose ({sup 18}F-FDG) distribution can predict tumour response and prognosis of patients with esophageal cancer treated by chemoradiotherapy (CRT). The enrolled 52 patients with esophageal cancer underwent {sup 18}F-FDG-PET/CT studies before CRT. SUVmax, SUVmean, metabolic tumour volume (MTV, SUV ≥ 2.5), total lesion glycolysis (TLG) and six heterogeneity parameters assessed by texture analysis were obtained. Patients were classified as responders or non-responders according to Response Evaluation Criteria in Solid Tumors. Progression-free survival (PFS) and overall survival (OS) were calculated by the Kaplan-Meier method. Prognostic significance was assessed by Cox proportional hazards analysis. Thirty four non-responders showed significantly higher MTV (p = 0.006), TLG (p = 0.007), intensity variability (IV; p = 0.003) and size-zone variability (SZV; p = 0.004) than 18 responders. The positive and negative predictive values for non-responders were 77 % and 69 % in MTV, 76 % and 100 % in TLG, 78 % and 67 % in IV and 78 % and 82 % in SZV, respectively. Although PFS and OS were significantly shorter in patients with high MTV (PFS, p = 0.018; OS, p = 0.014), TLG (PFS, p = 0.009; OS, p = 0.025), IV (PFS, p = 0.013; OS, p = 0.007) and SZV (PFS, p = 0.010; OS, p = 0.007) at univariate analysis, none of them was an independent factor, while lymph node status, stage and tumour response status were independent factors at multivariate analysis. Texture features IV and SZV, and volumetric parameters MTV and TLG can predict tumour response, but all of them have limited value in prediction of prognosis of patients with esophageal cancer treated by CRT. (orig.)

  18. Endoscopic third ventriculostomy in children: prospective, multicenter results from the Hydrocephalus Clinical Research Network.

    Science.gov (United States)

    Kulkarni, Abhaya V; Riva-Cambrin, Jay; Holubkov, Richard; Browd, Samuel R; Cochrane, D Douglas; Drake, James M; Limbrick, David D; Rozzelle, Curtis J; Simon, Tamara D; Tamber, Mandeep S; Wellons, John C; Whitehead, William E; Kestle, John R W

    2016-10-01

    OBJECTIVE Endoscopic third ventriculostomy (ETV) is now established as a viable treatment option for a subgroup of children with hydrocephalus. Here, the authors report prospective, multicenter results from the Hydrocephalus Clinical Research Network (HCRN) to provide the most accurate determination of morbidity, complication incidence, and efficacy of ETV in children and to determine if intraoperative predictors of ETV success add substantially to preoperative predictors. METHODS All children undergoing a first ETV (without choroid plexus cauterization) at 1 of 7 HCRN centers up to June 2013 were included in the study and followed up for a minimum of 18 months. Data, including detailed intraoperative data, were prospectively collected as part of the HCRN's Core Data Project and included details of patient characteristics, ETV failure (need for repeat hydrocephalus surgery), and, in a subset of patients, postoperative complications up to the time of discharge. RESULTS Three hundred thirty-six eligible children underwent initial ETV, 18.8% of whom had undergone shunt placement prior to the ETV. The median age at ETV was 6.9 years (IQR 1.7-12.6), with 15.2% of the study cohort younger than 12 months of age. The most common etiologies were aqueductal stenosis (24.8%) and midbrain or tectal lesions (21.2%). Visible forniceal injury (16.6%) was more common than previously reported, whereas severe bleeding (1.8%), thalamic contusion (1.8%), venous injury (1.5%), hypothalamic contusion (1.5%), and major arterial injury (0.3%) were rare. The most common postoperative complications were CSF leak (4.4%), hyponatremia (3.9%), and pseudomeningocele (3.9%). New neurological deficit occurred in 1.5% cases, with 0.5% being permanent. One hundred forty-one patients had documented failure of their ETV requiring repeat hydrocephalus surgery during follow-up, 117 of them during the first 6 months postprocedure. Kaplan-Meier rates of 30-day, 90-day, 6-month, 1-year, and 2-year failure

  19. Five-year results of a cementless short-hip-stem prosthesis

    Directory of Open Access Journals (Sweden)

    Ralf H. Wittenberg

    2013-03-01

    Full Text Available Hip prosthesis stems with a short stem length and proximal fixation geometry support a bone-preserving and muscle-sparing implantation and should also allow for revision surgery with a standard hip stem. We present 250 prospectively documented clinical and radiological results from the Metha Short Hip Stem prosthesis (B. Braun-Aesculap, Tuttlingen, Germany after an average follow-up of 4.9 years. The average patient age at surgery was 60 years. Indication for total hip replacement was primary osteoarthrosis (OA (78% of patients, OA based on developmental dyspla- sia of the hip (16%, and other indications (6%. At the last follow-up, the average Harris Hip Score was 97 points. 85% of patients were very satisfied and 14% were satisfied after surgery, whereas 1% were dissatisfied. Pain according to the Visual Analogue Scale improved from 7.4 (min 1.6, max 9.5 pre-operatively to 0.23 (min 0, max 6.6. No joint dislocations occurred when predominantly using 28 mm and 32 mm prosthesis heads. Nine short-stems were revised: three after bacterial infections, two after primary via valsa with penetration of the femoral cortex two and three months after surgery, and three after early aseptic cases of loosening within the first year. A further nine osseously consolidated short-stems had to be replaced due to breakage of the modular titanium cone adapter after an average of 3.1 years (min 1.9, max 4.4. All surgical revisions were performed using primary standard stems. Without taking the material-related adapter failures into account, a five year Kaplan-Meier survival rate of 96.7% (95% confidence interval 93.4-98.3 was determined for the short-stem prostheses. There were no radiological signs of loosening in any of the short-stem prostheses at the last examination. Fine sclerotic lines were detected in Gruen’s AP zones 1 (19% and 2 (10.5%, individual hypertrophies in zone 3 (3.5%, fine seams in zones 4 (5.5% and 5 (4%, without pedestal formations in zone 4

  20. Analysis of the Clinicopathologic Features and Prognosis in Triple-Negative Breast Cancer

    Institute of Scientific and Technical Information of China (English)

    Dehong Yang; Hong Liu; Jing Zhao

    2008-01-01

    OBJECTIVE To investigate the clinical and pathological features,as well as prognosis in triple-negative breast cancer patients.METHODS A total of 509 cases of operable breast cancer from January,2002 to June,2002 treated in the Cancer Hospital of Tianjin Medical University were analyzed.The Her-2,ER and PR status was determined using immunohistochemistry.Of the total cases,one group was identified as triple negative breast cancer,ie defined as ER,PR and Her-2 negative.The other group was nontriple-negative breast cancer.Clinicopathologic features of the groups were compared and 5-year disease-free survival (DFS)analyzed by the Kaplan-Meier method.RESULTS Of the total cases,21.4% (109/509) of cases were found to be triple- negative while 78.6% (400/509) were non-triplenegative.The triple negative group had higher incidence rates than the non-triple-negative group of the medullary type and Grade Ⅲ tumors (P < 0.05).There was no other difference in the clinicopathologic features between the 2 groups.From follow-up to June,2007,21.1% (23/109) of the triple-negative group and 12.7%(51/400) of the non-triple negative group had a local recurrence or distant metastasis,resulting in a significant difference (P < 0.05).In the triple-negative group and non-triple-negative group,5-year DFS were 78.9% and 87.3% respectively.There was a statistically significant difference between the 2 groups (P = 0.031).CONCLUSION Compared with non-triple-negative breast cancer,triple-negative breast cancer patients have an increased likehood of a local recurrence or distant metastasis and a poorer prognosis.

  1. UPVapor: Cofrentes nuclear power plant production results analysis software

    Energy Technology Data Exchange (ETDEWEB)

    Curiel, M. [Logistica y Acondicionamientos Industriales SAU, Sorolla Center, local 10, Av. de las Cortes Valencianas No. 58, 46015 Valencia (Spain); Palomo, M. J. [ISIRYM, Universidad Politecnica de Valencia, Camino de Vera s/n, Valencia (Spain); Baraza, A. [Iberdrola Generacion S. A., Central Nuclear Cofrentes, Carretera Almansa Requena s/n, 04662 Cofrentes, Valencia (Spain); Vaquer, J., E-mail: m.curiel@lainsa.co [TITANIA Servicios Tecnologicos SL, Sorolla Center, local 10, Av. de las Cortes Valencianas No. 58, 46015 Valencia (Spain)

    2010-10-15

    UPVapor software version 02 has been developed for the Cofrentes nuclear power plant Data Analysis Department (Spain). It is an analysis graphical environment in which users have available all the plant variables registered in the process computer system (SIEC). In order to perform this, UPVapor software has many advanced graphic tools for work simplicity, as well as a friendly environment easy to use and with many configuration possibilities. Plant variables are classified in the same way that they are in SIEC computer and these values are taken from it through the network of Iberdrola. UPVapor can generate two different types of graphics: evolution graphs and X Y graphs. The first ones analyse the evolution up to twenty plant variables in a user's defined time period and according to historic plant files. Many tools are available: cursors, graphic configuration, mobile means, non valid data visualization ... Moreover, a particular analysis configuration can be saved, as a pre selection, giving the possibility of charging pre selection directly and developing quick monitoring of a group of preselected plant variables. In X Y graphs, it is possible to analyse a variable value against another variable in a defined time. As an option, users can filter previous data depending on a variable certain range, with the possibility of programming up to five filters. As well as the other graph, X Y graph has many configurations, saving and printing options. With UPVapor software, data analysts can save a valuable time during daily work and, as it is of easy utilization, it permits to other users to perform their own analysis without ask the analysts to develop. Besides, it can be used from any work centre with access to network framework. (Author)

  2. Long-term results after primary infrapopliteal angioplasty for limb ischemia; Langzeitergebnisse nach Ballonangioplastie kruraler Arterien

    Energy Technology Data Exchange (ETDEWEB)

    Alfke, H. [Klinikum Luedenscheid (Germany). Klinik fuer Diagnostische und Interventionelle Radiologie; Marburg Univ. (Germany). Klinik fuer Strahlendiagnostik; Vannucchi, A. [Marburg Univ. (Germany). Klinik fuer Strahlendiagnostik; Froelich, J.J. [Marburg Univ. (Germany). Klinik fuer Strahlendiagnostik; Klinikum Bad Hersfeld (Germany). Klinik fuer Radiologie und Nuklearmedizin; El-Sheik, M.; Wagner, H.J. [Marburg Univ. (Germany). Klinik fuer Strahlendiagnostik; Vivantes-Klinikum im Friedrichshain (Germany). Inst. fuer Radiologie und Interventionelle Therapie

    2007-08-15

    Purpose: To evaluate the technical success rate, procedure-related complications, and clinical long-term results for patients who underwent infrapopliteal angioplasty. Materials and Methods: We retrospectively evaluated all patients who underwent infrapopliteal angioplasty to treat critical chronic limb ischemia or severe claudication from 1/1997 to 12/1999. We excluded patients with acute (< 2 weeks) limb ischemia. Procedure-related data were prospectively documented in a database and analyzed with a focus on the technical success rate and procedure-related complications. In addition all clinical documents were analyzed, and a follow-up examination was performed or telephone interviews were conducted with patients, relatives and referring doctors for follow-up. The primary end points were the limb salvage rate and patient survival rate. The secondary end points included the complication rate, technical success rate, and walking distance. Results: 112 patients with a mean age of 72 years (41 women, 71 men) underwent crural angioplasty on 121 limbs. Four patients suffered from severe claudication (Rutherford category 3) and all others had critical chronic limb ischemia (category 4 to 6). The complication rate was 2.7 %. The technical success rate was 92 %. The ankle brachial index increased from 0.59 to 0.88. The mean walking distance increased significantly from 52 {+-} 66 to 284 {+-} 346 meters at the time of follow-up. The limb salvage rate was 83.6 % after one year and 81.1 % after three years. The mean survival rate according to Kaplan-Meier was 79.4 %, 69.2 %, and 54.2 % at 1, 2, and 3 years, respectively. Patients with at least one patent run-off vessel after angioplasty had a significantly better limb salvage rate. Diabetes was not a risk factor for limb salvage. Conclusion: Infrapopliteal angioplasty shows a high technical success rate with an acceptable complication rate. The clinical long-term success seems favorable if a least one open run-off vessel was

  3. Adenocarcinoma of the esophagogastric junction. Neoadjuvant radiochemotherapy and radical surgery. Early results and toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Leibl, Bernhard J. [Klinikum Coburg (Germany). Dept. of Surgery; Coburg Cancer Center, Coburg (Germany); Vitz, Stephanie; Schaefer, Wolfgang; Alfrink, Martin; Grabenbauer, Gerhard G. [DiCura Coburg, Coburg (Germany). Dept. of Radiation Oncology; Coburg Cancer Center, Coburg (Germany); Geschwendtner, Andreas [Klinikum Coburg (Germany). Dept. of Pathology; Coburg Cancer Center, Coburg (Germany)

    2011-04-15

    Purpose: To retrospectively evaluate treatment results and toxicity following a combined approach consisting of neoadjuvant radiochemotherapy and radical surgery in advanced adenocarcinoma of the esophagus and gastroesophageal junction. Patients and Methods: Between 2005 and 2009, a total of 41 consecutive patients with newly diagnosed nonmetastatic adenocarcinoma of the esophagus and the esophagogastric junction were evaluated, of whom 23 received neoadjuvant radiochemo-therapy (RCT). A total dose of 50.4 Gy with 2 cycles of simultaneous cisplatin/5-fluorouracil (FU) or Taxol/FU-chemotherapy were applied. A radical transthoracic subtotal esophageal and proximal gastric resection through a right thoracoabdominal laparotomy with intrathoracic anastomosis was performed 6-8 weeks following RCT. This was combined with a two-field lymphadenectomy of mediastinal and abdominal lymph nodes. Standard histopathological evaluation included the application of regression grading according to Werner and Hoefler. Toxicity was recorded on the basis of CTC criteria; survival curves were calculated according to Kaplan-Meier. V10, V15, and V20 data were correlated with pulmonary toxicity. Results: Overall survival for all 23 patients was 61% at 3 years. Of the original 23 patients, 18 (78%) patients proceeded to radical surgery. Reasons for no surgery included advanced age of 79, 82, and 86 years (n = 3), severe comorbidity (n = 1), and progression during radiochemotherapy (n = 1). Surgical morbidity (grade 3-4) and mortality rates were 35% and 6%, respectively. Resurgery was necessary in 3 cases (18%). Clear resection margins were achieved in 17 of 18 patients (94%). Twelve of 18 (67%) patients initially diagnosed with T3 tumors and 3 of 3 patients with T4 tumors experienced downstaging. The ypN0 rate was 12 of 18 patients (67%). Out of a total of 18 patients, regression grading revealed < 10% viable cells in 8 (44%) including 3 cases (17%) with complete regression, 10-50% viable

  4. Refined analysis results for multimedia network costs and profits

    DEFF Research Database (Denmark)

    Tahkokorpi, M.; Falch, Morten; Skouby, Knud Erik

    This deliverable describes the techno-economic business model developed in EURORIM WP3 and presents the refined results of the multimedia service delivery cost-profit calculations......This deliverable describes the techno-economic business model developed in EURORIM WP3 and presents the refined results of the multimedia service delivery cost-profit calculations...

  5. Analysis of swimming pool accidents resulting in spinal cord injury.

    Science.gov (United States)

    Green, B A; Gabrielsen, M A; Hall, W J; O'Heir, J

    1980-04-01

    This paper is a summary of a study of 72 cases of swimming-pool accidents resulting in serious injuries with the potential of permanent disability. Sixty-four of the 72 cases resulted in spinal cord injuries, 57 of which involved quadriplegic lesions. The authors observed that the majority of these injuries resulted from a lack of good judgement and common sense rather than from intoxication or pool structural deficiencies. Also of note was the lack of appropriate first-aid and extrication rendered, as well as the absence of uniform treatment and care received by the majority of the patients.

  6. Persistence and adherence to overactive bladder medications in Japan: A large nationwide real-world analysis.

    Science.gov (United States)

    Kato, Daisuke; Uno, Satoshi; Van Schyndle, James; Fan, Alan; Kimura, Tomomi

    2017-10-01

    To evaluate persistence and adherence to mirabegron and antimuscarinics in Japan using data from two administrative databases. The present retrospective study evaluated insurance claims for employees and dependents aged ≤75 years, and pharmacy claims for outpatients. From October 2012 to September 2014, new users of mirabegron or five individual antimuscarinics indicated for overactive bladder in Japan (fesoterodine, imidafenacin, propiverine, solifenacin and tolterodine) were identified and followed for 1 year. Persistence with mirabegron and antimuscarinics were evaluated using Kaplan-Meier methods. Any associations between baseline characteristics (age, sex and previous medication use) and persistence were explored. Adherence was assessed using the medication possession ratio. In total, 3970 and 16 648 patients were included from the insurance and pharmacy claims databases, respectively. Mirabegron treatment was associated with longer median persistence compared with antimuscarinics (insurance claims: 44 [95% confidence intervals 37-56] vs 21 [14-28] to 30 [30-33] days, pharmacy claims: 105 [96-113] vs 62 [56-77] to 84 [77-86] days). The results were consistent when patients were stratified by age, sex and previous medication. Persistence rate at 1 year was higher for mirabegron (insurance claims: 14.0% [11.5-16.8%] vs 5.4% [4.1-7.0%] to 9.1% [5.3-14.2%], pharmacy claims: 25.9% [24.6-27.3%] vs 16.3% [14.0-18.6%] to 21.3% [20.2-22.4%]). Compared with each antimuscarinic, a higher proportion of mirabegron-treated patients had medication possession ratios ≥0.8. This large nationwide Japanese study shows that persistence and adherence are greater with mirabegron compared with five antimuscarinics. © 2017 The Japanese Urological Association.

  7. Combined Lung-Kidney Transplantation: An Analysis of the UNOS/OPTN Database.

    Science.gov (United States)

    Reich, Heidi J; Chan, Joshua L; Czer, Lawrence S C; Mirocha, James; Annamalai, Alagappan A; Cheng, Wen; Jordan, Stanley C; Chaux, George; Ramzy, Danny

    2015-10-01

    Poor outcomes after thoracic transplantation with concurrent renal dysfunction are well described: without transplantation or with thoracic-only transplantation, patients face unacceptably high mortality. Outcomes after combined lung-kidney transplantation (LKT) remain largely uninvestigated. The United Network for Organ Sharing/Organ Procurement and Transplantation Network database was queried to identify all LKTs, lung transplantations (LTs), and kidney transplantations (KTs) performed in the United States from 1995 to 2013. Survival was calculated using the Kaplan-Meier method and compared using log-rank tests or Cox regression models. Thirty-one LKTs were performed. Mean recipient age was 45.4 ± 13.5 years; 48.3 per cent were male. Retransplantation for graft failure was the leading indication for LT (n = 13) and the most common renal indication was calcineurin inhibitor nephrotoxicity (n = 11). Mean lung allocation score was 46.6 ± 14.4, mean creatinine was 3.7 ± 2.8 g/dL, and glomerular filtration rate was 23.1 (interquartile range 11.9, 38.3) mL/min/1.7 m(2), and 11 (35.5%) were dialysis dependent. Patient survival after LKT was 92.9 per cent, 71.0 per cent, and 71.0 per cent at one month, six months, and one year, with a median survival of 95.2 months. One- and five-year survival after LKT, 71.0 per cent and 59.9 per cent, were similar to LT (n = 23,913), 81.7 per cent and 51.4 per cent (P = 0.061 and 0.55), and inferior to KT (n = 175,269), 94.9 per cent and 82.8 per cent (P < 0.0001), respectively. Patient survival after LKT was similar to isolated LT, and these results suggest that LKT is a feasible therapeutic option for LT candidates with significant renal dysfunction.

  8. Aortic Counterpulsation Therapy in Patients with Advanced Heart Failure: Analysis of the TBRIDGE Registry

    Directory of Open Access Journals (Sweden)

    Cristiano Guedes Bezerra

    2016-01-01

    Full Text Available Abstract Background: The use of aortic counterpulsation therapy in advanced heart failure is controversial. Objectives: To evaluate the hemodynamic and metabolic effects of intra-aortic balloon pump (IABP and its impact on 30-day mortality in patients with heart failure. Methods: Historical prospective, unicentric study to evaluate all patients treated with IABP betwen August/2008 and July/2013, included in an institutional registry named TBRIDGE (The Brazilian Registry of Intra-aortic balloon pump in Decompensated heart failure - Global Evaluation. We analyzed changes in oxygen central venous saturation (ScvO2, arterial lactate, and use of vasoactive drugs at 48 hours after IABP insertion. The 30-day mortality was estimated by the Kaplan-Meier method and diferences in subgroups were evaluated by the Log-rank test. Results: A total of 223 patients (mean age 49 ± 14 years were included. Mean left ventricle ejection fraction was 24 ± 10%, and 30% of patients had Chagas disease. Compared with pre-IABP insertion, we observed an increase in ScvO2 (50.5% vs. 65.5%, p < 0.001 and use of nitroprusside (33.6% vs. 47.5%, p < 0.001, and a decrease in lactate levels (31.4 vs. 16.7 mg/dL, p < 0.001 and use of vasopressors (36.3% vs. 25.6%, p = 0.003 after IABP insertion. Thirty-day survival was 69%, with lower mortality in Chagas disease patients compared without the disease (p = 0.008. Conclusion: After 48 hours of use, IABP promoted changes in the use of vasoactive drugs, improved tissue perfusion. Chagas etiology was associated with lower 30-day mortality. Aortic counterpulsation therapy is an effective method of circulatory support for patients waiting for heart transplantation.

  9. Hepatocellular carcinoma in extremely elderly patients: An analysis of clinical characteristics, prognosis and patient survival

    Institute of Scientific and Technical Information of China (English)

    Gengo Tsukioka; Akira Kojima; Yuichi Yamazaki; Toshiyuki Otsuka; Yutaka Matsuzaki; Fujio Makita; Daisuke Kanda; Katsuhiko Horiuchi; Tetsuya Hamada; Mieko Kaneko; Hideyuki Suzuki; Satoru Kakizaki; Masatomo Mori; Naondo Sohara; Ken Sato; Hitoshi Takagi; Hirotaka Arai; Takehiko Abe; Mitsuo Toyoda; Kenji Katakai

    2006-01-01

    AIM: To identify the clinical and prognostic features of patients with hepatocellular carcinoma (HCC) aged 80years or more.METHODS: A total of 1310 patients with HCC were induded in this study. Nin ety-one patients aged 80 years or more at the time of diagnosis of HCC were defined as the extremely elderly group. Two hundred and thirty-four patients aged ≥ 50 years but less than 60 years were regarded as the non-elderly group.RESULTS: The sex ratio (male to female) was significantly lower in the extremely elderly group (0.90:1)than in the non-elderly group (3.9:1, P<0.001). The positive rate for HBsAg was significantly lower in the extremely elderly group and the proportion of patients negative for HBsAg and HCVAb obviously increased in the extremely elderly group (P<0.001). There were no significant differences in the following parameters:diameter and number of tumors, Child-Pugh grading,tumor staging, presence of portal thrombosis or ascites,and positive rate for HCVAb. Extremely elderly patients did not often receive surgical treatment (P<0.001) and they were more likely to receive conservative treatment (P<0.01). There were no significant differences in survival curves based on the Kaplan-Meier methods in comparison with the overall patients between the two groups. However, the survival curves were significantly worse in the extremely elderly patients with stage Ⅰ/Ⅱ,stage Ⅰ/Ⅱ and Child-Pugh grade A cirrhosis in comparison with the non-elderly group. The causes of death did not differ among the patients, and most cases died of liverrelated diseases even in the extremely elderly patients.CONCLUSION: In the patients with good liver functions and good performance status, aggressive treatment for HCC might improve the survival rate, even in extremely elderly patients.

  10. Software Application for Data Collection and Analysis in Acute Myeloid Leukemia

    Directory of Open Access Journals (Sweden)

    Anca BACÂREA

    2011-03-01

    Full Text Available Aim: It is important in the context of the informatics development and also of medical research, that new software technology to be integrated in order to achieve easier research. The aim of this study was to develop a software application that uses few resources, and that enable data collection, their primary processing in statistical terms (e.g. mean, median, etc., drawing of survival curves and survival Log Rank statistic testing according to the collected parameters. Material and Method: For this purpose, a database in SQLite3 was developed. Because the database engine is embedded in the Database Management System (DBMS this program allows absolute portability. Graphical interface was made in wxWidgets. Statistical calculations were obtained using R software (the `addons` E1071 was used for descriptive statistics and the `Survival `for testing survival and Northest for Kaplan Meier survival curve. Patients were cases admitted and treated in the Hematology Department of County Emergency Hospital Tîrgu Mureş hospitalized and treated during 2007-2010. Results: We created a GUI in wxWidgets to collect the desired medical data: age, date of diagnosis, date of death, blood count values, and the CD leukocyte markers detected by flow cytometry. Entwining of medical data collection and processing statistics (for acute myeloid leukemia - survival, prognostic factors evaluation is a further step in medical research. Conclusion: The tool presented is a useful for research. Application in acute myeloid leukemia derives from the author's interest in the subject; development of this tool in other directions is possible and desirable.

  11. Clinical Characteristics and Prognostic Analysis of 38 Patients 
with Pulmonary Sarcomatoid Carcinoma

    Directory of Open Access Journals (Sweden)

    Yuanyuan LI

    2015-09-01

    Full Text Available Background and objective Pulmonary sarcomatoid carcinoma is a rare histologic subtype of non-small cell lung cancer. The effective treatment for this disease has not well defined due to its extremely low morbidity. This study explores the clinicopathological characteristics and prognosis of 38 patients with PSC, so as to provide some clues for its diagnosis and treatment. Methods The study enrolled 38 patients with PSC that were diagnosed with histology or cytology in our hospital between January 2000 and December 2013. We retrospectively analyzed general clinical characteristics, smoking history, tumor size, TNM staging, pathology, immunohistochemistry, diagnostic method, treatment and prognosis. We used SPSS 19.0 statistical software and Kaplan-Meier method to analyze our data. Results Patients in this study were aged from 26 to 76 years old (the median age was 57.5 years old. Among all of them, the male to female ratio was 4:1, and 81.6% of patients had smoking history. Cough and hemoptysis were the most common primary symptoms. The median survival was 21 months, while one-year survival rate, three-year survival rate and five-year survival rate were 68.4%, 31.6% and 18.4% respectively. Tumor size, TNM staging, distant metastasis and surgery therapy were associated with the prognosis of patients. Conclusion Patients with PSC present with no special symptoms generally. According to our study, factors that affect patients’ prognosis include tumor size, TNM staging, distant metastasis and surgery. Complete resection is the key treatment for PSC patients, but comprehensive chemoradiotherapy needs further exploration in evidence-based medicine. Biological target therapy may give new insight into treatment for PSC.

  12. Population based analysis of survival in patients with renal cell carcinoma and venous tumor thrombus.

    Science.gov (United States)

    Whitson, Jared M; Reese, Adam C; Meng, Maxwell V

    2013-02-01

    To identify prognostic factors for renal cell carcinoma (RCC) with venous tumor thrombus (VTT) and determine the significance of thrombus level on survival. Patients within the Surveillance, Epidemiology, and End Results (SEER) database with RCC and VTT were identified and included if managed surgically. The Kaplan-Meier method and Cox regression analyses were performed to identify factors associated with disease-specific survival. A total of 1,875 patients met the inclusion criteria. One-year survival for patients undergoing surgery was 60% for patients with metastases and 90% for those without. Factors associated with worse survival included larger tumor size (HR 1.2, 95% CI 1.0-1.4), medullary, collecting duct, or sarcomatoid histology (HR 2.2, 95% CI 1.5-3.3), Fuhrman grade 3 (HR 2.2, 95% CI 1.5-3.3) or grade 4 (HR 2.9, 95% CI 1.8-4.5) tumors, positive lymph nodes (HR 1.5, 95% CI 1.0-2.0), and metastases (HR 3.5, 95% CI 2.6-4.8). Thrombus level above the diaphragm (T3c) was not significantly associated with worse survival (HR 1.4, 95% CI 0.8-2.5). In this large, population-based study of patients with RCC and VTT, we identify several disease-specific factors strongly associated with cancer-specific mortality. After controlling for adverse prognostic factors, thrombus level was not associated with worse outcome. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. STATISTICAL ANALYSIS OF SOME EXPERIMENTAL FATIGUE TESTS RESULTS

    OpenAIRE

    Adrian Stere PARIS; Gheorghe AMZA; Claudiu BABIŞ; Dan Niţoi

    2012-01-01

    The paper details the results of processing the fatigue data experiments to find the regression function. Application software for statistical processing like ANOVA and regression calculi are properly utilized, with emphasis on popular software like MSExcel and CurveExpert

  14. Investigation for Ensuring the Reliability of the MELCOR Analysis Results

    Energy Technology Data Exchange (ETDEWEB)

    Sung, Joonyoung; Maeng, Yunhwan; Lee, Jaeyoung [Handong Global Univ., Pohang (Korea, Republic of)

    2015-10-15

    Flow rate could be also main factor to be proven because it is in charge of a role which takes thermal balance through heat transfer in inner side of fuel assembly. Some problems about a reliability of MELCOR results could be posed in the 2{sup nd} technical report of NSRC project. In order to confirm whether MELCOR results are dependable, experimental data of Sandia Fuel Project 1 phase were used to be compared to be a reference. In Spent Fuel Pool (SFP) severe accident, especially in case of boil-off, partial loss of coolant accident, and complete loss of coolant accident; heat source and flow rate could be main points to analyze the MELCOR results. Heat source might be composed as decay heat and oxidation heat. Because heat source makes it possible to lead a zirconium fire situation if it is satisfied that heat accumulates in spent fuel rod and then cladding temperature could be raised continuously to be generated an oxidation heat, this might be a main factor to be confirmed. This work was proposed to investigate reliability of MELCOR results in order to confirm physical phenomena if SFP severe accident is occurred. Almost results showed that MELCOR results were significantly different by minute change of main parameter in identical condition. Therefore it could be necessary that oxidation coefficients have to be chosen as value to delineate real phenomena as possible.

  15. Analysis of organochlorine pesticides in human milk: preliminary results.

    Science.gov (United States)

    Campoy, C; Jiménez, M; Olea-Serrano, M F; Moreno-Frías, M; Cañabate, F; Olea, N; Bayés, R; Molina-Font, J A

    2001-11-01

    In the face of evidence of human milk contamination by organochlorine pesticides, an analysis was performed on samples of milk obtained from healthy lactating women in the provinces of Granada and Almeria in Southern Spain. The samples were obtained by the Neonate Section of the Department of Pediatrics of Granada University Hospital (Neonatology Division) and by the Neonatal Service of Poniente Hospital in El Ejido, Almería. A liquid-liquid extraction procedure was performed. The cleaning of the sample before gas chromatography-mass spectrometry (GC-MS) used silica Sep-Pak. Among other pesticides, aldrin, dieldrin, DDT and its metabolites, lindane, methoxychlor and endosulfan were identified. The presence of these products was confirmed by mass spectrometry. The identification and quantification of these organochlorine molecules is important because they have estrogenic effects.

  16. Safety Analysis Results for Cryostat Ingress Accidents in ITER

    Science.gov (United States)

    Merrill, B. J.; Cadwallader, L. C.; Petti, D. A.

    1997-06-01

    Accidents involving the ingress of air, helium, or water into the cryostat of the International Thermonuclear Experimental Reactor (ITER) tokamak design have been analyzed with a modified version of the MELCOR code for the ITER Non-site Specific Safety Report (NSSR-1). The air ingress accident is the result of a postulated breach of the cryostat boundary into an adjoining room. MELCOR results for this accident demonstrate that the condensed air mass and increased heat loads are not a magnet safety concern, but that the partial vacuum in the adjoining room must be accommodated in the building design. The water ingress accident is the result of a postulated magnet arc that results in melting of a Primary Heat Transport System (PHTS) coolant pipe, discharging PHTS water and PHTS water activated corrosion products and HTO into the cryostat. MELCOR results for this accident demonstrate that the condensed water mass and increased heat loads are not a magnet safety concern, that the cryostat pressure remains below design limits, and that the corrosion product and HTO releases are well within the ITER release limits.

  17. Analysis methodology and recent results of the IGS network combination

    Science.gov (United States)

    Ferland, R.; Kouba, J.; Hutchison, D.

    2000-11-01

    A working group of the International GPS Service (IGS) was created to look after Reference Frame (RF) issues and contribute to the densification and improvement of the International Terrestrial Reference Frame (ITRF). One important objective of the Reference Frame Working Group is to generate consistent IGS station coordinates and velocities, Earth Rotation Parameters (ERP) and geocenter estimates along with the appropriate covariance information. These parameters have a direct impact on other IGS products such as the estimation of GPS satellite ephemerides, as well as satellite and station clocks. The information required is available weekly from the Analysis Centers (AC) (cod, emr, esa, gfz, jpl, ngs, sio) and from the Global Network Associate Analysis Centers (GNAAC) (JPL, mit, ncl) using a "Software Independent Exchange Format" (SINEX). The AC are also contributing daily ERPs as part of their weekly submission. The procedure in place simultaneously combines the weekly station coordinates, geocenter and daily ERP estimates. A cumulative solution containing station coordinates and velocity is also updated with each weekly combination. This provides a convenient way to closely monitor the quality of the estimated station coordinates and to have an up to date cumulative solution available at all times. To provide some necessary redundancy, the weekly station coordinates solution is compared against the GNAAC solutions. Each of the 3 GNAAC uses its own software, allowing independent verification of the combination process. The RMS of the coordinate differences in the north, east and up components between the AC/GNAAC and the ITRF97 Reference Frame Stations are 4-10 mm, 5-20 mm and 6-25 mm. The station velocities within continental plates are compared to the NNR-NUVEL1A plate motion model (DeMets et al., 1994). The north, east and up velocity RMS are 2 mm/y, 3 mm/y and 8 mm/y. Note that NNR-NUVEL1A assumes a zero vertical velocity.

  18. Resultados a medio y largo plazo de la utilización de videotoracoscopia en la cirugía de resección de las metástasis pulmonares Medium and long-term results of the use of videothorascopy in surgery of pulmonary metastasis resection

    Directory of Open Access Journals (Sweden)

    W. Torre

    2005-01-01

    surgical interventions carried out in order to resect pulmonary metastases. Between January 1997 and December 2001, 56 patients were found whose pulmonary metastases had been resected by videothorascopy out of a total of 252 metastasectomies (22.2%. The primary tumours were classified in 4 groups: sarcoma (n=11; colorectal (n=25; renal (n=5; and others (n=15. Videothoroscopy was carried out on the right hemithorax (n=28, left hemithorax (n=22 or on both at once (n=6. Operational mortality was nil and the only morbidity attributable to the technique was a defect of re-expansion following the removal of the thoracic drainage in one patient. Using the Kaplan-Meier method, the probability of survival in this series of patients was 60.4% after 5 years, with an average survival time of 48 months. All of this data supports the use of videothorascopy in our milieu on patients with pulmonary metastases. However, in the light of the results, it is important in using this technique to place special emphasis on obtaining good margins of resection, due to the real risk of local recurrence on these margins in the medium term.

  19. Hearts transplanted after circulatory death in children: Analysis of the International Society for Heart and Lung Transplantation registry.

    Science.gov (United States)

    Kleinmahon, Jake A; Patel, Sonali S; Auerbach, Scott R; Rossano, Joseph; Everitt, Melanie D

    2017-09-21

    We aimed to describe worldwide DCD HT experience in children using the International Society for Heart and Lung Transplantation Registry. The Registry was queried for primary HT performed in children (2005-2014). Kaplan-Meier analysis was used to assess survival for recipients grouped by DCD or DBD hearts. Recipient characteristics were compared between DCD and DBD and between survivors and non-survivors of DCD HT. Among 3877 pediatric HT performed, 21 (0.5%) were DCD. DCD 1-year survival was 61% vs 91% DBD, P < .01. DCD recipients were more often supported by ECMO pre-HT (24% vs 6%, P < .001) and more often receiving inhaled nitric oxide (10% vs 0.6%, P < .001) compared to DBD. Older DCD recipients had significantly lower 1-year survival of 57% vs 93% for DBD, P < .01. Survival for infant DCD recipients was not statistically different to DBD recipients (survival 62% at 1 year and 62% at 5 years for DCD vs 85% at 1 year and 77% at 5 years for DBD, P = .15). Recipients of DCD HT who died were more often supported by ECMO pre-HT (56% non-survivors vs 0% survivors, P = .004) and receiving mechanical ventilation (44% vs 0%, P = .012). DCD HT is uncommon in children. DCD-independent factors in recipients may have contributed to worse survival as DCD recipients who died were more often supported by ECMO and mechanical ventilation. More research is needed to identify donor factors and recipient factors that contribute to mortality after DCD HT. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Using Survival Analysis to Identify Risk Factors for Treatment Interruption among New and Retreatment Tuberculosis Patients in Kenya.

    Science.gov (United States)

    Masini, Enos O; Mansour, Omar; Speer, Clare E; Addona, Vittorio; Hanson, Christy L; Sitienei, Joseph K; Kipruto, Hillary K; Githiomi, Martin Muhingo; Mungai, Brenda Nyambura

    2016-01-01

    Despite high tuberculosis (TB) treatment success rate, treatment adherence is one of the major obstacles to tuberculosis control in Kenya. Our objective was to identify patient-related factors that were associated with time to TB treatment interruption and the geographic distribution of the risk of treatment interruption by county. Data of new and retreatment patients registered in TIBU, a Kenyan national case-based electronic data recording system, between 2013 and 2014 was obtained. Kaplan-Meier curves and log rank tests were used to assess the adherence patterns. Mixed-effects Cox proportional hazards modeling was used for multivariate analysis. Records from 90,170 patients were included in the study. The cumulative incidence of treatment interruption was 4.5% for new patients, and 8.5% for retreatment patients. The risk of treatment interruption was highest during the intensive phase of treatment. Having previously been lost to follow-up was the greatest independent risk factor for treatment interruption (HR: 4.79 [3.99, 5.75]), followed by being HIV-positive not on ART (HR: 1.96 [1.70, 2.26]) and TB relapse (HR: 1.70 [1.44, 2.00]). Male and underweight patients had high risks of treatment interruption (HR: 1.46 [1.35, 1.58]; 1.11 [1.03, 1.20], respectively). High rates of treatment interruption were observed in counties in the central part of Kenya while counties in the northeast had the lowest risk of treatment interruption. A better understanding of treatment interruption risk factors is necessary to improve adherence to treatment. Interventions should focus on patients during the intensive phase, patients who have previously been lost to follow-up, and promotion of integrated TB and HIV services among public and private facilities.

  1. Immunohistochemical Analysis of ATRX, IDH1 and p53 in Glioblastoma and Their Correlations with Patient Survival.

    Science.gov (United States)

    Chaurasia, Ajay; Park, Sung-Hye; Seo, Jeong-Wook; Park, Chul-Kee

    2016-08-01

    Glioblastoma (GBM) can be classified into molecular subgroups, on the basis of biomarker expression. Here, we classified our cohort of 163 adult GBMs into molecular subgroups according to the expression of proteins encoded by genes of alpha thalassemia/mental retardation syndrome X-linked (ATRX), isocitrate dehydrogenase (IDH) and TP53. We focused on the survival rate of molecular subgroups, depending on each and various combination of these biomarkers. ATRX, IDH1 and p53 protein expression were evaluated immunohistochemically and Kaplan-Meier analysis were carried out in each group. A total of 15.3% of enrolled GBMs demonstrated loss of ATRX expression (ATRX-), 10.4% expressed an aberrant IDH1 R132H protein (IDH1+), and 48.4% exhibited p53 overexpression (p53+). Survival differences were statistically significant when single protein expression or different combinations of expression of these proteins were analyzed. In conclusion, in the case of single protein expression, the patients with each IDH1+, or ATRX-, or p53- GBMs showed better survival than patients with counterparts protein expressed GBMs. In the case of double protein pairs, the patients with ATRX-/p53-, ATRX-/IDH1+, and IDH1+/p53- GBMs revealed better survival than the patients with GBMs with the remained pairs. In the case of triple protein combinations, the patients with ATRX-/p53-/IDH+ showed statistically significant survival gain than the patients with remained combination of proteins-expression status. Therefore, these three biomarkers, individually and as a combination, can stratify GBMs into prognostically relevant subgroups and have strong prognostic values in adult GBMs.

  2. RESULTS OF 2011 STATE DUMA ELECTIONS: SOCIOLOGICAL ANALYSIS

    Directory of Open Access Journals (Sweden)

    Larisa Fedotova

    2012-01-01

    Full Text Available Abstract: Sociological forecasting of political processes arose as a powerful industry. Nevertheless, results of the polls conducted by the major agencies diverged significantly with the voting in 2011 State Duma elections. The article analyses major complications in forecasting results of elections using sociological data, including psychological factors, role of mass media and administrative resource. The author identifies strategies of the opposition, as well as proves predominant importance of Vladimir Putin for the electoral success of the ruling party on the basis of the polls.

  3. Differences in Childhood Leukemia Incidence and Survival between Southern Thailand and the United States: A Population-Based Analysis

    Science.gov (United States)

    Demanelis, Kathryn; Sriplung, Hutcha; Meza, Rafael; Wiangnon, Surapon; Rozek, Laura S.; Scheurer, Michael E.; Lupo, Philip J.

    2015-01-01

    BACKGROUND Childhood leukemia incidence and survival varies globally, and this variation may be attributed to environmental risk factors, genetics, and/or disparities in diagnosis and treatment. PROCEDURE We analyzed childhood leukemia incidence and survival trends in children age 0–19 years from 1990 to 2011 in Songkhla, Thailand (n=316) and compared these results to US data from the Surveillance, Epidemiology, and End Results (SEER) registry (n=6,738). We computed relative survival using Ederer II and estimated survival functions using the Kaplan-Meier method. Changes in incidence and five-year survival by year of diagnosis were evaluated using joinpoint regression and are reported as annual percent changes (APC). RESULTS The age-standardized incidence of leukemia was 3.2 and 4.1 cases per 100,000 in Songkhla and SEER-9, respectively. In Songkhla, incidence from 1990–2011 significantly increased for leukemia (APC=1.7%, p=0.031) and acute lymphoblastic leukemia (ALL) (APC=1.8%, p=0.033). Acute myeloid leukemia (AML) incidence significantly increased (APC=4.2%, p=0.044) and was significantly different from the US (p=0.026), where incidence was stable during the same period (APC=0.3%, p=0.541). The overall five-year relative survival for leukemia was lower than that reported in the US (43% vs. 79%). Five-year survival significantly improved by at least 2% per year from 1990–2011 in Songkhla for leukemia, ALL, and AML (p<0.050). CONCLUSIONS While leukemia and ALL incidence increased in Songkhla, differences in leukemia trends, particularly AML incidence, may suggest etiologic or diagnostic differences between Songkhla and the US. This work highlights the importance of evaluating childhood cancer trends in low- and middle-income countries. PMID:25962869

  4. Analysis of inadvertent microprocessor lag time on eddy covariance results

    Science.gov (United States)

    Karl Zeller; Gary Zimmerman; Ted Hehn; Evgeny Donev; Diane Denny; Jeff Welker

    2001-01-01

    Researchers using the eddy covariance approach to measuring trace gas fluxes are often hoping to measure carbon dioxide and energy fluxes for ecosystem intercomparisons. This paper demonstrates a systematic microprocessor- caused lag of 20.1 to 20.2 s in a commercial sonic anemometer-analog-to-digital datapacker system operated at 10 Hz. The result of the inadvertent...

  5. STATISTICAL ANALYSIS OF SOME EXPERIMENTAL FATIGUE TESTS RESULTS

    Directory of Open Access Journals (Sweden)

    Adrian Stere PARIS

    2012-05-01

    Full Text Available The paper details the results of processing the fatigue data experiments to find the regression function. Application software for statistical processing like ANOVA and regression calculi are properly utilized, with emphasis on popular software like MSExcel and CurveExpert

  6. SSL Adoption by Museums: Survey Results, Analysis, and Recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Perrin, T. E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Druzik, J. R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Miller, N. J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2014-11-01

    DOE Solid-State Lighting GATEWAY report that summarizes the results of a survey of the museum community regardi