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 evaluate the oncological outcome of histologic variants in bladder cancer patients who underwent radical cystectomy. MATERIALS AND METHODS: We identified 393 bladder cancer patients who underwent radical cystectomy at single center between January 2007 and August 2014. Patients were divided into 4 groups according to histologic types: pure urothelial cell carcinoma (UC) and squamous, micropapillary, and other variants. Kaplan-Meier analysis was performed to assess recurrence-free (RFS) and overall survivals (OS). The patients were divided into those with pathologic stage and nodal status. RESULTS: Among 393 bladder cancer patients, squamous, micropapillary histologic variants were observed in 38 (9.7%), 26 (6.6%), respectively, whereas 39 had other variant types. Stage T3 cancer occurred in more patients with histologic variant compared with those with pure UC. Pathologic positive nodal status was also frequently found in the histologic variant groups. Subgroup analysis according to T stage and nodal status showed no significant difference in RFS and OS. On multivariate analysis, pathologic T stage (stage T2: hazard ratio [HR], 2.75; 95% confidence interval [CI], 1.34–5.63; p=0.005; stage ≥T3: HR, 3.20; 95% CI, 1.62–6.30; p=0.001) and nodal status (HR, 1.85; 95% CI, 1.05–2.56; p=0.028) were prognostic factors for RFS. CONCLUSIONS: In patients who underwent radical cystectomy, histologic variants were detected more often at advanced pathologic stage. Although histologic variants have been identified in the radical cystectomy specimen, treatment should be performed according to the pathologic stage.
Cystectomy* ; Humans ; Kaplan-Meier Estimate ; Multivariate Analysis ; Urinary Bladder Neoplasms* ; Urinary Bladder*

OBJECTIVE: Several scales are currently used to assess occlusion rates of coiled cerebral aneurysms. This study compared these scales as predictors of recanalization. METHODS: Clinical data of 827 patients harboring 901 aneurysms treated by coiling were retrospectively reviewed. Occlusion rates were assessed using angiographic grading scale (AGS), two-dimensional percent occlusion (2DPO), and volumetric packing density (vPD). Every scale had 3 categories. Followed patients were dichotomized into either presence or absence of recanalization. Kaplan-Meier analysis was conducted, and Cox proportional hazards analysis was performed to identify surviving probabilities of recanalization. Lastly, the predictive accuracies of three different scales were measured via Harrell's C index. RESULTS: The cumulative risk of recanalization was 7% at 12-month, 10% at 24-month, and 13% at 36-month of postembolization, and significantly higher for the second and third categories of every scale (p<0.001). Multivariate-adjusted hazard ratios (HRs) of the second and third categories as compared with the first category of AGS (HR : 3.95 and 4.15, p=0.004 and 0.001) and 2DPO (HR : 4.87 and 3.12, p<0.001 and 0.01) were similar. For vPD, there was no association between occlusion rates and recanalization. The validated and optimism-adjusted C-indices were 0.50 [confidence (CI) : -1.09-2.09], 0.47 (CI : -1.10-2.09) and 0.44 (CI : -1.10-2.08) for AGS, 2DPO, and vPD, respectively. CONCLUSION: Total occlusion should be reasonably tried in coiling to maximize the benefit of the treatment. AGS may be the best to predict recanalization, whereas vPD should not be used alone.
Aneurysm ; Humans ; Intracranial Aneurysm ; Kaplan-Meier Estimate ; Retrospective Studies ; Weights and Measures

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

PURPOSE: We analyzed outcomes of patients with prostate cancer undergoing either radical retropubic prostatectomy (RRP) +/- salvage radiation or definitive radiation therapy (RT) +/- androgen deprivation. MATERIALS AND METHODS: From 2003-2010 there were 251 patients who underwent RRP and 469 patients who received RT (> or =7,560 cGy) for prostate cancer. Kaplan-Meier analysis was performed with the log-rank test to compare biochemical control (bCR), distant metastatic-free survival (DMPFS), and prostate cancer-specific survival (PCSS) between the two groups. RESULTS: The median follow-up was 70 months and 61.3% of the men were African American. For low risk disease the 6-year bCR were 90.3% for RT and 85.6% for RRP (p = 0.23) and the 6-year post-salvage bCR were 90.3% vs. 90.9%, respectively (p = 0.84). For intermediate risk disease the 6-year bCR were 82.6% for RT and 59.7% for RRP (p < 0.001) and 82.6% vs. 74.0%, respectively, after including those salvaged with RT (p = 0.06). For high risk disease, the 6-year bCR were 67.4% for RT and 41.3% for RRP (p < 0.001) and after including those salvaged with RT was 67.4% vs. 43.1%, respectively (p < 0.001). However, there were no significant differences between the two groups in regards to DMPFS or PCSS. CONCLUSION: Treatment approaches utilizing RRP +/- salvage radiation or RT +/- androgen deprivation yielded equivalent DMPFS and PCSS outcomes. Biochemical control rates, using their respective definitions, appeared equivalent or better in those who received treatment with RT.
Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Male ; Prostate ; Prostatectomy* ; Prostatic Neoplasms*

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

Antimetabolites that inhibit postoperative fibroblast proliferation increases the success of glaucoma filtration surgery. However, the use of mitomycin C in young patients has not been extensively studied. The effectiveness of initialtrabeculectomy with mitomycin C or uncomplicated glaucoma in patients age 40 years or younger was evaluated in a consecutive series of 15 eyes of 10 patients. Thirteen eyes had juvenile primary open-angle glaucoma and 2 eyes had steroid induced glaucoma. Mitomycin C (0.002%) was applied for 2 to 4 minutes during the surgery. The success rate was evaluated with Kaplan-Meier analysis, and it was 78% at postoperative 9 months. Complications included postoperative hyphema(7 eyes), hypotony (2 eyes), and bleb-related endophthalmitis.
Antimetabolites ; Endophthalmitis ; Fibroblasts ; Filtering Surgery ; Glaucoma ; Glaucoma, Open-Angle ; Humans ; Kaplan-Meier Estimate ; Mitomycin* ; Trabeculectomy*

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.
Humans ; Kaplan-Meier Estimate ; Ligation ; Prospective Studies ; Research Design ; Survival Analysis* ; Survival Rate

The prognostic factors for extrahepatic biliary atresia (EHBA) after Kasai portoenterostomy include the patient's age at portoenterostomy (age), size of bile duct in theporta hepatis (size), clearance of jaundice after operation (clearance) and the surgeon's experience. The aim of this study is to examine the most significant prognostic factor of EHBA after Kasai portoenterostomy. This retrospective study was done in 51 cases of EHBA that received Kasai portoenterostomy by one pediatric surgeon. For the statistical analysis, Kaplan-Meier method, Logrank test and Cox regression test were used. A p value of less than 0.05 was considered to be significant. Fifteen patients were regarded as dead in this study, including nine cases of liver transplantation. There was no significant difference of survival to age. The age is also not a significant risk factor for survival in this study (Cox Regression test; p = 0.63). There was no significant difference in survival in relation to the size of bile duct. However, bile duct size was a significant risk factor for survival (Cox Regression test; p = 0.002). There was a significant difference in relation to survival and clearance (Kaplan-Meier method; p = 0.02). The clearing was also a significant risk factor for survival (Cox Regression test; p = 0.001). The clearance of jaundice is the most significant prognostic factor of EHBA after Kasai portoenterostomy.
Bile Ducts ; Biliary Atresia* ; Humans ; Jaundice ; Kaplan-Meier Estimate ; Liver Transplantation ; Prognosis ; Retrospective Studies ; Risk Factors