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Multivariate analysis of protein profiles of metal hyperaccumulator Thlaspi caerulescens accessions.

Thlaspi caerulescens is increasingly acknowledged as one of the best models for studying metal hyperaccumulation in plants. In order to study the mechanisms underlying metal hyperaccumulation, we used proteomic profiling to identify differences in protein intensities among three T. caerulescens accessions with pronounced differences in tolerance, uptake and root to shoot translocation of Zn and Cd. Proteins were separated using two-dimensional electrophoresis and stained with SYPRO Orange. Intensity values and quality scores were obtained for each spot by using PDQuest software. Principal component analysis was used to test the separation of the protein profiles of the three plant accessions at various metal exposures, and to detect groups of proteins responsible for the differences. Spot sets representing individual proteins were analysed with the analysis of variance and non-parametric Kruskal-Wallis test. Clearest differences were seen among the Thlaspi accessions, while the effects of metal exposures were less pronounced. The 48 tentatively identified spots represent core metabolic functions (e.g. photosynthesis, nitrogen assimilation, carbohydrate metabolism) as well as putative signalling and regulatory functions. The possible roles of some of the proteins in heavy metal accumulation and tolerance are discussed.

Cadmium↗

Distinguishing patients with senile dementia of Alzheimer type and normal elderly subjects utilizing xenon CT-CBF and multivariate analysis.

Local cerebral blood flow (LCBF) was measured in 17 patients with senile dementia of Alzheimer type (SDAT) and 17 normal controls, utilizing stable xenon computed tomography (Xe CT-CBF). In patients with SDAT, LCBF values were decreased in the cerebral cortex and subcortical structures including the thalamus, basal ganglia and white matter of both hemispheres. Linear discriminant function analysis of LCBF values separated patients with SDAT from normal elderly subjects, with an error of 8.8%. Variables helpful in distinguishing SDAT patients from normal subjects were LCBF values for the frontal and temporal cortex. Multiple regression equation for predicting cognitive performance scores from LCBF values showed the best correlations with LCBF values for the frontal and occipital cortex and thalamus. Xe CT-CBF measurements provide useful information concerning diagnosis and brain function in patients with SDAT.

Aged↗

[Statistical models and multivariable analysis].

Most clinical research can be simplified as an investigation of an input/output relationship. The inputs are called explanatory (independent) variables or predictors and are thought to be related to the outcome, or response (independent) variable. This relationship is usually complicated by other factors related to both the input and the output (presence of confounding) and can vary according to the levels of the other variables (presence of interaction). This input/output relationship is usually described by statistical models that include a fit part and a residual component or difference between the data and the fit. The most popular models are the general linear models, which can be considered the paradigm of all models used in multi-variable analyzes.

Biomedical Research↗

Results of 90 consecutive hepatectomies for hepatocellular carcinoma: a multivariate analysis of survival.

The surgical results and postoperative management of 90 patients with hepatocellular carcinoma (HCC) who underwent hepatectomy were reviewed, and clinical factors relating to HCC were analyzed to determine what type of HCC responds best to hepatectomy. The patients consisted of 69 men and 21 women. Serum anti-hepatitis C virus was positive in 76.9% of patients and hepatitis B surface antigen was positive in 18.9%. The operative procedures consisted of right lobectomy in six patients, left lobectomy in seven, right hepatic segmentectomy in eight, left lateral segmentectomy in 13, two adjoining subsegmentectomy in 17, subsegmentectomy in 29, and partial hepatectomy in 10. Liver cirrhosis was confirmed histopathologically in 63 patients. There were two operative deaths and two other in-hospital deaths. During the follow-up period, HCC recurred in 64 of the remaining 86 patients at the following sites: liver in 56 patients (87.5%), bones in four (6.3%), lymph nodes in three (4.7%), and lung in one (1.6%). Transcatheter arterial chemoembolization was performed in 22 of the patients with recurrence, transcatheter arterial chemoembolization in combination with percutaneous ethanol injection was performed in 14, hepatectomy was performed in six, and irradiation with Linac x-rays was performed in eight. The cumulative 3- and 5-year survival rates were 63.8% and 37.8%, respectively. Univariate and multivariate analyses of factors influencing survival disclosed that having a single HCC nodule of up to a maximal diameter of 4.0 cm, an absence of intrahepatic metastasis, and a functional liver reserve estimated as clinical stage I contributed significantly and independently to increasing the survival rate.

Adult↗

Cisplatin nephrotoxicity: a multivariate analysis of potential predisposing factors.

STUDY OBJECTIVE: To evaluate the usefulness of biologic and pharmacologic parameters for early identification of cisplatin-induced renal dysfunction. DESIGN: Prospective evaluation of 62 consecutively admitted patients with cancer. SETTING: Cancer center. PATIENTS: Sixty-two consecutive patients with cancer (52 men, 10 women; mean age 61.9 yrs). INTERVENTIONS: Patients received cisplatin as a single short intravenous infusion every 3 weeks. One hundred twenty-one cycles were analyzed. The dosage in the first cycle ranged between 61 and 105 mg/m2 (mean 84 mg/m2). All patients received a standard hydration protocol. MEASUREMENTS AND MAIN RESULTS: Renal function was evaluated for each cycle before treatment (day 0) and before next cycle (day 21) based on the estimated creatinine clearance (Clcr). For each cycle, the weighted relative decrease (WD) of Clcr was calculated (WDClcr = 100 x [Clcr (day 0) - Clcr (day 21)]/[Clcr (day 0)](2). Total and ultrafilterable (UF) platinum were measured as a single-sample assay taken 16 hours after the end of cisplatin administration. The mean WDClcr was 0.07 min/100 ml (range -1.0 to +1.7 min/100 ml). The intensity of renal dysfunction evaluated by WDClcr was independent of cisplatin dosage, age, sex, body surface area, initial Clcr, and cycle number. Of interest, total and UF platinum concentrations were significantly correlated to WDClcr: the higher the platinum concentration, the greater the intensity of renal dysfunction. In stepwise regression analysis, UF platinum concentration was the only selected factor. The best prediction of UF platinum was obtained by stepwise regression including cisplatin dosage, initial Clcr, and cycle number (r=0.58, p<0.0001). CONCLUSION: We consider our results to be a first step toward a clinical strategy to identify patients at risk for renal dysfunction after cisplatin treatment.

Adult↗

[Multivariate analysis of significance of prognostic factors of immunological response and stomach tumor growth].

Significance of prognostic factors of immunological response, tumor growth and age was investigated in 708 patients with stomach cancer. Such factors as T-cell immunological response, functional status of lymph nodes and localization on either the greater or lesser curvature of the stomach were identified as the most significant while T-cell immunological response, tumor size and number of involved lymph nodes appeared less significant but more harmful as far as survival was concerned. No significant correlation between pattern of growth, depth of invasion, age and local immunological response, on the one hand, and survival, on the other, was established.

Humans↗

Prognostic markers in resectable non-small cell lung cancer: a multivariate analysis.

OBJECTIVE: To identify the prognostic significance of certain clinical, cellular and immunologic markers in resectable non-small cell lung cancer (NSCLC). DESIGN: A cohort of patients with resectable NSCLC was prospectively followed up for 8 years (100% follow-up). SETTING: A university hospital in a large Canadian city. PATIENTS: One hundred and thirteen consecutive patients who underwent surgical resection of primary NSCLC. MAIN OUTCOME MEASURES: Presence of peritumoral B lymphocytes (identified with antibody to CD20) and T lymphocytes (antibody to CD43), along with tumour markers (carcinoembryonic antigen [CEA], keratin, cytokeratin, S-100 protein, vimentin, chromogranin) and other factors such as age, sex, cell type, American Joint Committee on Cancer (AJCC) stage, histologic grade, DNA ploidy and S-phase fraction were correlated with survival. RESULTS: The mean age of patients in the study was 66.0 years; 60% were male. Histologic types of the tumours were: adenocarcinoma 57 (50.4%), squamous cell 47 (41.6%), adenosquamous 6 (5.3%) and large cell 3 (2.6%). AJCC stages were: I 66 (58.4%), II 20 (17.7%) and III 27 (23.9%). Histologic grades were: I (well differentiated) 31 (27.4%), II 50 (44.2%), III 29 (25.7%) and IV 3 (2.6%). Survival was 85% at 1 year (95% confidence interval [CI] 76%-90%), 44% at 5 years (95% CI 34%-53%) and 34% at 10 years (95% CI 22%-46%). Multivariate analyses using the Cox proportional hazards model for survival confirmed AJCC stage (p < 0.001) in all histologic subtypes to be the strongest factor of independent prognostic significance. It also revealed the presence of CD20-stained B lymphocytes (p = 0.04) in the peritumoral region of all tumours to be a positive prognostic factor. This relation was especially strong for nonsquamous cell carcinomas (p < 0.001). For squamous cell carcinomas, the immunohistochemical presence of CEA was of marginally negative prognostic value (p = 0.04). DNA ploidy and a high S-phase fraction showed no evidence of prognostic value for stage I tumours, but for stages II and III tumours there was strong evidence of prognostic value (p < 0.001 jointly). The evidence for DNA ploidy was especially strong in stages II and III squamous cell tumours (p = 0.008), and for a high S-phase fraction was strongest in stages II and III nonsquamous cell tumours (p = 0.002). CONCLUSIONS: AJCC stage remains the most important prognostic indicator from a variety of clinical variables and tumour markers in postoperative patients with resectable NSCLC. For nonsquamous cell lung carcinomas, the presence of peritumoral B lymphocytes was strongly associated with improved survival, suggesting an important role for humoral mediated immunity.

Adult↗

Multivariate analysis of behavioral aging highlights some unexpected features of complex systems organization.

Ten different behavioral tests were performed on a population of young (n = 20) and aged (n = 20) Fischer 344 rats. The relationship structure among these tests was studied by principal component analysis applied both to the entire data set and separately to the two age groups. This analysis proved very useful in highlighting a global index of the rat "behavioral" age based on the entire test set. The analysis effected separately on the two age groups evidenced qualitative differences between them that were linked to the different meaning the same test would assume in rats of different ages. From an overall methodological viewpoint, this work indicates that the correlations among behavioral parameters appear to depend on the observational scale and that the spin-glass model represents an appropriate metaphor to approach the study of the correlations in biological systems.

Aging↗

Endometrial carcinoma: high dose-rate brachytherapy in combination with external irradiation; a multivariate analysis of relapses.

From June 1974 to June 1984, 347 women with endometrial carcinoma were referred to the radiotherapy department of the Catharina Hospital, Eindhoven, The Netherlands. Of this total number, 327 patients were considered eligible for analysis; 36 being referred for recurrences of previous surgically treated endometrial carcinoma, and 291 being referred for radiotherapy as part of the initial treatment. The 28% 5-year relapse-free survival (RFS) of the group of 36 patients demonstrated that endometrial carcinoma may behave as a radiosensitive tumour. The remaining 291 had all undergone surgery, except 10. Radiotherapy consisted of high dose-rate brachytherapy applied to the vaginal vault for pathological stage I tumours, well differentiated, and with superficial myometrial invasion. All other patients received external beam irradiation to a pelvic dose of 40 Gy in 4 weeks, followed by brachytherapy (4 fractions of 5 Gy each). The 5-year RFS for pathologically staged patients was: stage I (232 patients) 88%, stage II (27 patients) 68%, stage III and IV (22 patients) 50%. Treatment-related complications were minimal. In-field recurrences were rare: 5% locoregional, 2.2% both loco-regional and distant, versus 9.3% distant failures. Multivariate RFS analysis demonstrated age, stage and tumour differentiation as independent prognostic factors, tumour differentiation being the most important factor.

Adult↗

Relationship between prognostic factors of breast cancer and 99mTc-sestamibi uptake in patients who underwent scintimammography: Multivariate analysis of causes of false-negative results.

The complementary role of sestamibi scintimammography (SSM) in patients with breast cancer (BC) is well established. The aim of this study was to establish whether a relationship exists between sestamibi uptake, evaluated as a tumour-to-background ratio (TBR), and the main prognostic factors of BC. SSM with the measurement of TBR was performed preoperatively in 102 women (median age 57 years, range 32-81 years) who underwent curative surgery for primary BC. Final pathology showed 4 (3.9%) with pT1a, 17 (16.7%) with pT1b, 44 (43.1%) with pT1c and 37 (36.3%) with pT2 breast carcinomas. The overall sensitivity of SSM was 80.4%. An ANOVA showed significant (P<0.01) differences between the TBR of patients with G1 vs. G3 tumours, and between the TBR of those with G2 vs. G3 breast carcinomas. Moreover, there was a difference (P=0.021) between the TBR of patients (n=12, 11.8%) with CEA serum levels >10 ng/ml (2.031+/-0.420), and those with normal (n=90, 88.2%) CEA values (1.713+/-0.446), whilst no difference (P=NS) was found between patients (n=27, 26.5%) with CA 15-3 >30 U/ml (1.893+/-0.401) and those with normal (n=75, 73.5%) CA 15-3 values (1.699+/-0.462). There was a mild inverse correlation between TBR and both the oestrogen (R=0.25, P=0.011) and the progesterone receptor (R=0.23, P=0.02) rate. The logistic regression analysis showed that only size and CA 15-3 serum levels represent true independent parameters, but the function was able to predict only 11 out of 21 (52.4%) patients with false-negative SSM. TBR is independent of age and mainly correlates with the size of the tumour. There are no reliable preoperative prognostic factors that are really useful for improving SSM sensitivity in patients with small breast carcinomas.

Adult↗

Parenteral nutrition-related cholestasis in postsurgical neonates: multivariate analysis of risk factors.

The medical records of 74 neonates dependent on parenteral nutrition for at least 21 days after emergency abdominal surgery (performed between 1988 and 1992) were reviewed respectively. The role of enteral starvation, prematurity, composition and duration of parenteral nutrition, and sepsis in the evolution of parenteral nutrition-related cholestasis was evaluated by multiple regression analysis. The most important factors for cholestasis were low gestational age (median, 34 weeks), early exposure to parenteral nutrition, and sepsis. Episodes of sepsis were associated with a 30% increase in the bilirubin level. Enteral starvation and composition and the duration of parenteral nutrition solutions did not correlate significantly with the development of cholestasis. Prevention of sepsis should be the priority in minimising cholestasis in postsurgical neonates who are dependent on parenteral nutrition.

Abdomen↗

Natural history of small untreated hepatocellular carcinoma in cirrhosis: a multivariate analysis of prognostic factors of tumor growth rate and patient survival.

We analyzed the growth pattern of tumor masses and the survival of 39 asymptomatic Italian patients with a total of 59 small (less than or equal to 5 cm in diameter) hepatocellular carcinomas arising from cirrhosis. The total length of the observation period ranged from 90 to 962 days, with an average of 364 +/- 229 (mean +/- S.D.). Doubling time ranged from 27.2 to 605.6 days (mean +/- S.D., 204.2 +/- 135; median = 171.6 days). Three different growth patterns were recognized: (a) tumors with no or very slow initial growth pattern (doubling time greater than 200 days), 10 cases (37%); (b) tumors with declining growth rate over time, 9 cases (33.4%); and (c) tumors with almost constant growth rate, 8 cases (29.6%). Using the stepwise discriminant analysis, we found a score based on albumin, alcohol intake, number of nodules, echo pattern and histological type that allowed a correct prediction of short doubling time (less than or equal to 150 days) in 55.6%, medium doubling time (151 to 300 days) in 60% and long doubling time (greater than 300 days) in 100% of cases. The estimated survival rate of the 39 patients, calculated by the Kaplan-Meier method was 81% at 1 yr, 55.7% at 2 yr and 21% at 3 yr. Stepwise discriminant analysis showed that a score based on sex, HBsAg status, alcohol consumption, ascites, gamma-glutamyltranspeptidase, prothrombin time, Child-Pugh class and all the sonographical parameters could predict 2-yr survival in 100% of cases. We conclude that great variability of growth patterns exists among and within small hepatocellular carcinomas. Prediction of subsequent growth rate is unreliable in most cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Alcohol Drinking↗

Gastric acid secretion in relation to personality, affect and coping ability in duodenal ulcer patients. A multivariate analysis. Hvidovre Ulcer Project Group.

The role of personality, mood state (affect) and coping ability (ego strength) on basal and stimulated gastric acid secretion were assessed in 56 duodenal ulcer patients using the Minnesota, Multiphasic Personality Inventory. The patients had high scores on most MMPI scales, but basal acid output was related significantly only to the hypochondriasis scale and the validity scale L. Peak acid output was related significantly only to the validity scale L. Both basal and peak acid output were related significantly, but positively to coping ability. No relations were found to mood state. The personality disorders found in peptic ulcer patients may evidently be consequences of the disease rather than causal factors.

Adaptation, Psychological↗

A multivariate analysis of mental hospital recidivism.

This study identifies health problems, instrumental activities of daily living, employment status, and number of previous admissions as significant factors of recidivism to a mental health residential facility. The study, conducted over a 5-year period, includes measures on 32 predictor variables collected either on admission, on discharge, or 12-15 months following discharge or on readmission. The study's results are interpreted in light of current changes in the mental health service delivery system including the interactive role of physical and mental illnesses, expanding access to community-based generic services, focusing on functional skills and their development or remediation, and the changing criteria for measuring mental health effectiveness.

Catchment Area, Health↗

A multivariate analysis of otological, surgical and patient-related factors in determining success in myringoplasty.

OBJECTIVES: The aim of this study was to evaluate the effects of smoking and other prognostic factors on long-term surgical outcome and hearing results in myringoplasty. DESIGN: Retrospective cohort. SETTING: Tertiary medical centre. PARTICIPANTS: Eighty myringoplasty operations were analysed retrospectively from the charts of 74 patients who underwent myringoplasty between January 2000 and November 2002 at the First ENT Clinic of Ataturk Training and Research Hospital, using the chi-squared test, Fisher's exact test, t-test and multiple logistic regression statistical analysis. MAIN OUTCOME MEASURES: The effects of prognostic factors and smoking on myringoplasty were investigated by variables noted from patients' files such as smoking status, operation type, duration of dry period of the diseased ear, peroperative otorrhoea, status of the opposite ear, presence of perforation at admission, place of perforation, size of perforation, status of middle ear mucosa, presence of cholesteatoma and tympanosclerosis, ossicular status, previous and related surgery, experience of the surgeon, presence of anterior overhang, presence of valsalva manoeuvre, postoperative antiobiotic cover and income per day. RESULTS: The overall take rate of the myringoplasty graft was 71%. Based on the univariate analysis, smoking status of the patients (P = 0.008), status of the opposite ear (P = 0.01), size of perforation (P = 0.009) and the experience of the surgeon (P = 0.002) were found to be statistically significant (P < 0.01) prognostic factors influencing the success rate of the operations. Multiple logistic regression analysis was subsequently carried out on these prognostic factors and yielded the following classification (95% CI): senior surgeon (OR = 14.3), non-smoking patient (OR = 11.4), longer duration of dry period of the diseased ear (OR = 5.3), normal opposite ear (OR = 5.0) and small perforation (OR = 4.8). CONCLUSIONS: A non-smoking patient, a longer dry ear, a healthy opposite ear, a relatively smaller perforation and a senior surgeon were found to be significant prognostic factors positively influencing the success rate of myringoplasty.

Adolescent↗

Is early ischemic lesion volume on diffusion-weighted imaging an independent predictor of stroke outcome? A multivariable analysis.

BACKGROUND AND PURPOSE: The heterogeneity of stroke makes outcome prediction difficult. Neuroimaging parameters may improve the predictive value of clinical measures such as the National Institutes of Health Stroke Scale (NIHSS). We investigated whether the volume of early ischemic brain lesions assessed with diffusion-weighted imaging (DWI) was an independent predictor of functional outcome. METHODS: We retrospectively selected patients with nonlacunar ischemic stroke in the anterior circulation from 4 prospective Stanford Stroke Center studies evaluating early MRI. The baseline NIHSS score and ischemic stroke risk factors were assessed. A DWI MRI was performed within 48 hours of symptom onset. Clinical characteristics and early lesion volume on DWI were compared between patients with an independent outcome (Barthel Index score >/=85) and a dependent outcome (Barthel Index score <85) at 1 month. A logistic regression model was performed with factors that were significantly different between the 2 groups in univariate analysis. RESULTS: Sixty-three patients fulfilled the entry criteria. One month after symptom onset, 24 patients had a Barthel Index score <85 and 39 had a Barthel Index score >/=85. In univariate analysis, patients with independent outcome were younger, had lower baseline NIHSS scores, and had smaller lesion volumes on DWI. In a logistic regression model, DWI volume was an independent predictor of outcome, together with age and NIHSS score, after correction for imbalances in the delay between symptom onset and MRI. CONCLUSIONS: DWI lesion volume measured within 48 hours of symptom onset is an independent risk factor for functional independence. This finding could have implications for the design of acute stroke trials.

Adult↗

[On factors related to the width of anterior chamber angle--multivariate analysis of biometrically determined values].

Primary angle-closure glaucoma (PACG) is associated with certain biometric ocular features such as shallow anterior chamber, axial hyperopia, increased thickness of the lens and small corneal diameter. The vast majority of previous studies on PAGG has shown that females are affected more frequently than males. In an attempt to study the relationship between the angle width and ocular dimensions, we carried out gonioscopic examination and biometric measurements (corneal diameter, corneal radius, anterior chamber depth, lens thickness, relative lens position and axial length) in 1,169 eyes of 585 adult subjects who participated in the glaucoma screening in Gifu Prefecture. It was found that the angle width significantly correlated with each biometric value. The coefficient of determination calculated by multiple regression analysis was 0.41, suggesting that factors other than these are involved in determining the angle width. When the angle width of females was compared to that of males with identical refractive errors and biometric values, the angle width of females was significantly narrower than that of males. Hence, the difference in ocular dimensions does not adequately explain the higher incidence of narrow angle in females. Increased asymmetry of angle width between a pair of eyes with aging appeared to be related to asymmetry of lens thickness, anterior chamber depth and lens position.

Adult↗

Sodium dodecyl sulphate-polyacrylamide gel electrophoresis of proteins in dry-cured hams: data registration and multivariate analysis across multiple gels.

This study investigates whether dry-cured hams from two European countries can be distinguished using SDS-PAGE. Thirty-seven commercial hams (19 Spanish, 18 French) were used in the study. Four protein fractions were extracted from each sample, with sufficient material prepared to allow each fraction to be analysed in triplicate lanes. The complete extraction process was carried out in duplicate. The 24 specimens originating from each ham sample were randomly allocated to different lane positions and gels, as were at least two reference lanes (for reference proteins). In total, 118 gels were prepared. Mathematical routines were developed using a matrix language to process the gel image files. Procedures were written to carry out 'within-gel' image correction, lane extraction and normalization, 'between-gel' data registration and linear discriminant analysis (LDA) of each fraction's data to establish whether the provenance could be systematically distinguished. The between-gel registration was carried out using a genetic algorithm (GA). Feature selection was also performed using a GA, to pass subsets of features to the LDA routine. Cross-validated classification success rates were 84, 91, 81 and 85%, respectively, for the four fractions. We conclude that SDS-PAGE can be conducted in a sufficiently quantitative manner and can potentially verify the provenance of regional speciality dry-cured hams.

Electrophoresis, Polyacrylamide Gel↗