OBJECTIVE: We report a retrospective investigation of the prognostic value of bcl-2 and bax expression, and Ki-67 proliferative index in 42 astrocytic tumors. METHODS: We classified the astrocytic tumors and reviewed the clinical information and survival time. The sections were taken from surgically resected paraffin-embedded tissue and performed immunohistochemical stains for bcl-2, bax and Ki-67. RESULTS: The immunohistochemical stain for bcl-2 revealed a positivity in only two(4.76%) among forty-two cases. The immunostain for bax was positive in 35 cases(83.3%). However, the correlation between bcl-2 & bax expression and age, sex, tumor location, size, and histologic grade was not found. By Kaplan-Meier analysis, bcl-2 & bax expression and survival time in astrocytic tumors was no significance in log rank test(p>0.05). There were prognostic values between Ki-67 LI and histologic grade and between Ki-67 LI and survival time, respectively(p<0.05). CONCLUSION: Bcl-2 and bax are not significant, whereas Ki-67 LI is suggested as a significant prognostic factor, associated with histologic grade and survival time of astrocytic tumors.
Coloring Agents ; Kaplan-Meier Estimate ; Prognosis* ; Retrospective Studies

OBJECTIVE: To investigate the expression and gene function of methyltransferase-like protein 27 (METTL27) in colon cancer, its association with immune infiltration and its prognostic significance. METHODS: We analyzed the expression levels of METTL27 in 33 cancers using R language and identified METTL27 as a differential gene in colon cancer. The related signaling pathways of METTL27 were analyzed by gene functional annotation and enrichment. SsGSEA algorithm was used to analyze immune infiltration, and logistic analysis was used to evaluate the correlation between METTL27 expression and clinicopathological features of the patients. Kaplan-meier analysis, univariate and multivariate Cox regression analysis were performed to construct a nomogram for evaluating the correlation between METTL27 expression and clinical prognosis. The expression level of METTL27 was further verified in colorectal cancer cell lines and 16 clinical specimens of colorectal cancer tissues using qPCR and Western blotting. RESULTS: METTL27 was highly expressed in 21 cancers, and its expression was significantly higher in colon cancer than in adjacent tissues (P < 0.001). METTL27-related genes were identified by differential analysis, and functional annotation revealed that METTL27 was significantly enriched in transmembrane transport and lipid metabolism, and 5 related signaling pathways were identified by GSEA. METTL27 expression was negatively correlated with different T helper cells and central memory T cells (P < 0.001). The patients with a high METTL27 mRNA expression had a poor survival outcome. Cox regression analysis showed that METTL27 expression was an independent prognostic factor of the overall survival. The expression level of METTL27 was significantly higher in the colorectal cancer cell line than in normal cells (P < 0.05). CONCLUSION METTL27 is overexpressed in colon cancer and is associated with a poor prognosis of the patients. A high expression of METTL27 showed is associated less T cell immune infiltration, suggesting the potential of METTL27 as a prognostic marker of colon cancer.
Colonic Neoplasms/pathology* ; Humans ; Kaplan-Meier Estimate ; Prognosis ; RNA, Messenger

PURPOSE: To determine the malignant potential in clinically localised small renal cell carcinoma (RCC) (≤4cm) in patients using postoperative pathologic outcomes. MATERIALS AND METHODS: We performed a retrospective analysis of 2,085 patients in 7 urology centres with clinical T1a RCC who underwent nephrectomy. The pathologic upstaging group (PUG) was defined by pathologic T3a after the operation. Multivariate analyses were used to examine predicting factors for the risk of PUG. Next, Kaplan-Meier analysis was used to examine the PUG for worse recurrence-free survival during the follow-up period. RESULTS: The PUG had 73 patients (3.5%); they were older and had a larger tumour size than the other patients (all p<0.001). After adjusting for clinical characteristics, age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.02–1.06) and tumour size greater than 3 cm (OR, 1.94; 95% CI, 1.21–3.11) were found to be independent predictors for the PUG after nephrectomy. Furthermore, the PUG had worse recurrence-free survival during the follow-up period. CONCLUSIONS: In this multi-institution analysis, RCC 3 cm or greater in older patients had a high malignant potential compared to relatively small tumours in younger patients. These results may be helpful for stratifying patients to manage small renal masses.
Carcinoma, Renal Cell* ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Multivariate Analysis ; Nephrectomy ; Retrospective Studies ; Urology

BACKGROUND: CD9, a member of the tetraspanin superfamily, is a tumor suppressor in many malignancies. The aim of this study was to evaluate the immunohistochemical expression of CD9 in colorectal carcinomas (CRCs) and determine clinicopathological and prognostic significance of its expression. METHODS: The CD9 expression status of 305 CRCs was evaluated using a semi-quantitative scoring system in tumor cells (T-CD9) and immune cells (I-CD9) by classifying the results as high and low expression. RESULTS: High T-CD9 (T-CD9 [+]) expression was detected in 175 samples (57.6%) and high I-CD9 (I-CD9 [+]) expression was detected in 265 samples (86.9%). Using Kaplan-Meier survival analysis, the T-CD9 (+) group showed a tendency for better disease-free survival (DFS) (p = .057). In left-sided tumors, DFS was significantly longer in the T-CD9 (+) group (p = .021) but no statistical significance was observed with right-sided tumors (p = .453). I-CD9 (+) CRCs significantly correlated with well/moderately differentiation (p = .014). In Kaplan-Meier analysis, the I-CD9 (+) group had a tendency towards worse DFS compared to the I-CD9 (–) group (p = .156). In combined survival analysis of T-CD9 and I-CD9, we found that the longest DFS was among patients in the T-CD9 (+)/I-CD9 (–) group, whereas the T-CD9 (–)/I-CD9 (+) group showed the shortest DFS (p = .054). CONCLUSIONS: High expression of T-CD9 was associated with a favorable DFS, especially in left-sided CRCs. Combined evaluation of T-CD9 and I-CD9 is required to determine the comprehensive prognostic effect of CD9 in CRCs.
Antigens, CD9 ; Colorectal Neoplasms* ; Disease-Free Survival ; Humans ; Kaplan-Meier Estimate ; Prognosis

PURPOSE: The aim of the present study was to assess the association between the pre-operative plasma fibrinogen level and the adjacent organ involvement in advanced gastric cancer. MATERIALS AND METHODS: A total of 923 pre-operative plasma samples were obtained from 923 patients diagnosed clinically as having advanced gastric cancer, and fibrinogen levels were measured by immunoassay. Associations between fibrinogen levels and clinicopathologic findings (depth of tumor, adjacent organ involvement, and lymph node metastasis), along with survival were examined by univariate and multivariate analyses. RESULTS: Tumor size, tumor depth, and the presence of lymph node metastasis were found to be positively correlated with the preoperative plasma fibrinogen levels (P<0.001). Fifty (5.4%) patients had adjacent organ involvement. Lymphatic invasion (P<0.001), tumor size (P<0.001), clinical T (depth of invasion) stage (P<0.001), and clinical nodal stage (P=0.018) were found to be associated with adjacent organ involvement. Univariate and multivariate regression analyses showed that a preoperatively elevated plasma fibrinogen level was associated with adjacent organ involvement (P<0.001, 0.028), and Kaplan-Meier analysis showed that it was associated with poorer survival (P<0.001). CONCLUSIONS: Plasma fibrinogen was found to be a clinically useful marker of adjacent organ involvement and overall survival. When a high fibrinogen level is encountered, preoperatively, adjacent organ involvement should be suspected in clinically advanced gastric cancer.
Fibrinogen ; Gastrectomy ; Humans ; Immunoassay ; Kaplan-Meier Estimate ; Lymph Nodes ; Neoplasm Metastasis ; Plasma ; Stomach Neoplasms

BACKGROUND/AIMS: Mucosal healing (MH) is a proposed therapeutic goal for patients with ulcerative colitis (UC). Whether MH is the final goal for UC, however, remains under debate. Therefore, to elucidate clinical variables predicting relapse after MH in UC could be useful for establishing further therapeutic strategy. The aim of this study is to evaluate the predictive variables for relapse in UC-patients after achieving MH. METHODS: From April 2010 to February 2015, 298 UC-patients treated at Kitano Hospital were retrospectively analyzed. MH was defined as Mayo endoscopic subscore of 0 or 1. The cumulative relapse free rate after achieving MH was evaluated. Predictive variables for relapse in UC-patients were assessed by Cox regression analysis. RESULTS: Of 298 UC-patients, 88 (29.5%) achieved MH. Of the 88 UC patients who achieved MH, 21 (23.9%) experienced UC-relapse. Based on Kaplan-Meier analysis, the cumulative relapse free rate at 1, 3, and 5 years after achieving MH was 87.9%, 70.2%, and 63.8%, respectively. The cumulative relapse free rate tended to be higher in the Mayo-0 group (76.9%) than in the Mayo-1 group (54.1%) at 5 years, although the difference was not statistically significant (P=0.313). Cox regression analysis indicated that the use of an immunomodulator was a predictive variable for relapse in UC-patients after achieving MH (P=0.035). CONCLUSIONS: Our data demonstrated that the prognosis of UC patients after achieving endoscopic MH could be based on UC refractoriness requiring an immunomodulator.
Colitis, Ulcerative* ; Endoscopy ; Humans ; Kaplan-Meier Estimate ; Prognosis ; Recurrence* ; Retrospective Studies ; Ulcer*

OBJECTIVE: The authors evaluated the effect of direct bypass (superficial temporal artery-middle cerebral artery bypass) in the prevention of rebleeding episodes in patients suffering from hemorrhagic moyamoya disease by comparing this method with indirect bypass. METHODS: Fifteen patients who had hemorrhagic moyamoya without aneurysm comprised the study group. The mean age of patients was 44.4 years and follow up period ranged from 0.8 to 7.1 years (mean; 3.61 years). Revascularization surgery was performed in 21 sides in 15 patients. Direct bypass was performed in 17 sides and indirect bypass in the other 4 sides. RESULTS: During the follow-up period after the revascularization surgery, three sides (14.3%) of the 21 sides presented with rebleeding episode, one of 17 sides (mean follow-up periods; 2.94 years) treated with direct method and 2 of 4 sides (mean follow-up periods; 6.45 years) treated with indirect method. Kaplan-Meier analysis of rebleedingfree survival showed quite different between direct and indirect method but statistically insignificant (p=0.0541). CONCLUSION: Direct bypass may reduce the risk of hemorrhage more effectively than indirect bypass. However, direct bypass cannot always prevent rebleeding.
Aneurysm ; Cerebral Arteries ; Follow-Up Studies ; Hemorrhage* ; Humans ; Kaplan-Meier Estimate ; Moyamoya Disease*

PURPOSE: To evaluate the long-term outcomes of artificial urinary sphincter (AUS) implantation and to report the complication rates, including mechanical failure, erosion, and infection. MATERIALS AND METHODS: From June 1990 to May 2011, AUS (AMS 800) implantations were performed in 56 adult males by one surgeon. Various demographic and preoperative variables, surgical variables, and postoperative outcomes, including success and complication rates with a median follow-up of 96 months, were recorded retrospectively. RESULTS: The mean age of the patients at the time of AUS implantation was 61.8 (+/-14.2) years. During the follow-up period, the total complication rate was 41.1% (23 patients). The incidence of complications was significantly lower during the follow-up period after 48 months (p<0.05). Kaplan-Meier analysis revealed that 5- and 10-year failure-free rates were 50.3% and 45.2%, respectively. CONCLUSIONS: Long-term durability and functional outcomes are achievable for the AMS 800, but there are appreciable complication rates for erosion, mechanical failure, and infection of up to 30%.
Adult ; Follow-Up Studies ; Humans ; Incidence ; Kaplan-Meier Estimate ; Male ; Urinary Incontinence ; Urinary Sphincter, Artificial

BACKGROUND AND OBJECTIVES: Although circadian variation in the onset of acute myocardial infarction (AMI) has been reported in a number of studies, not much is known about the impact of circadian variation on 12-month mortality. The aim of this study was to investigate the impact of circadian variation on 12-month mortality in patients with AMI. SUBJECTS AND METHODS: Eight hundred ninety two patients (mean age 67+/-12; 66.1% men) with AMI who visited Kyungpook National University Hospital from November 2005 to December 2007 were included in this study. Patients were divided into groups based on four 6-hours intervals: overnight (00:00-05:59); morning (06:00-11:59); afternoon (12:00-17:59) and evening (18:00-23:59). RESULTS: Kaplan-Meier survival curves showed 12-month mortality rates of 9.6%, 9.1%, 12.1%, and 16.7% in the overnight, morning, afternoon, evening-onset groups, respectively (p=0.012). Compared with the morning-onset AMI group, the serum creatinine levels (p=0.002), frequency of Killip class > or =3 (p=0.004), and prescription rate of diuretics (p=0.011) were significantly higher in the evening-onset AMI group, while the left ventricular ejection fraction (p=0.012) was significantly lower. The proportion of patients who arrived in the emergency room during routine duty hours was significantly lower in evening-onset groups irrespective of the presence or absence of ST-segment elevation (p<0.001). According to univariate analysis, the 12-month mortality rate in the evening group was significantly higher compared to the morning group (hazard ratio 1.998, 95% confidence interval 1.196 to 3.338, p=0.008). CONCLUSION: Patients with evening-onset AMI had poorer baseline clinical characteristics, and this might affect the circadian impact on 12-month mortality. Further studies are needed to clarify the role of circadian variation on the long-term outcome of AMI.
Circadian Rhythm ; Creatinine ; Diuretics ; Emergencies ; Humans ; Kaplan-Meier Estimate ; Myocardial Infarction ; Prescriptions ; Stroke Volume

PURPOSE: Tumor volume has been thought to be an important predictive factor for significant prostate cancer. We assessed the impact of the tumor volume(TV) and the tumor percentage(TP) of radical prostatectomy specimens on the pathological variables and the oncological outcome. MARERIALS AND METHODS: The tumor percentage and tumor volume were calculated for 525 cases by a single pathologist who determined the volume based on the surface area of the slides involved by tumor of the prostate. Univariate and multivariate logistic regression analyses were used to characterize the association of TP categories(<5%, 5-10%, 11-20% and >20%) and TV(<1.8cc, 1.8-3.7cc, 3.8-7.5cc, >7.5cc) with the clinicopathological variables. Biochemical recurrence(BCR) was estimated using Kaplan-Meier analysis and Cox's hazard regression model. RESULTS: The mean prostate cancer volume was 6.5+/-8.5cc(median: 3.8, range: 0.04-73.8) and the mean percent tumor composition was 0.17+/-0.19 (median: 0.1, range: 0.01-0.95). A higher tumor volume and a higher tumor percentage were associated with extra-capsular extension(ECE), a positive surgical margin(PSM), a higher pT stage and a higher prostate-specific antigen(PSA) Gleason score(all p<0.05). In addition, TP was the independent predictor of ECE(adjusted odds ratio(OR): 22.66, 95% confidence interval(CI): 1.801-285.079, p=0.016), but the tumor volume was not associated with ECE on the multivariate logistic analyses. On the Kaplan-Meier analysis, but not on the Cox-hazard analyses, the TP did demonstrate a significant association with biochemical recurrence(p=0.035), yet the TV did not reach statistical significance(p=0.190). CONCLUSIONS: Our data indicates that the tumor percentage had a significant effect on the BCR on the Kaplan-Meier analysis. The tumor percentage rather than the tumor volume might be more useful to predict the prognosis of prostate cancer.
Kaplan-Meier Estimate ; Logistic Models ; Prognosis ; Prostate ; Prostatectomy ; Prostatic Neoplasms ; Recurrence ; Tumor Burden