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Statistical evaluation of factors influencing prognosis of gastric cancer patients: Predication of prognosis on patient clusters.

We found ten clusters of gastric cancer patients in Imanaga's group under a cancer research project organized by the Ministry of Health and Welfare, and evaluated the prediction of prognosis of those patients in each cluster by using the censored regression of postsurgical survival time on a "prognosic" factor which has been extracted from nine explanatory variables observed mainly at the time of surgery. Consequently, the ten clusters were interpreted and confirmed to be useful for prediction of the patient prognosis by comparison of the failure rates among those clusters and between treated (administration of chemotherapy) group and control group.

Adult

Prognosis of diabetics with diabetes onset before the age of thirty-one. II. Factors influencing the prognosis.

In 307 patients with diabetes mellitus, developed prior to 1933 and before age 31 it was demonstrated that: (1) frequent contact with a specialized diabetes clinic from an early stage of the disease; (2) a good quality of "metabolic control"; (3) a low insulin dose; (4) a body weight of 10% less than ideal; and (5) a mean blood pressure below 100 mm Hg, all had significantly beneficial effects upon the survival. It was also found that patients domiciled in Copenhagen had a significantly better prognosis than patients domiciled outside Copenhagen. Frequent contact with a diabetes centre was accompanied by an appreciable decrease in disabling late diabetic complications.

Age Factors

The prognosis of near-drowned children.

Thirty children were treated for near-drowning in the Children's Hospital, University of Helsinki during 1971--1976. The patients were divided into 3 groups according to the prognosis: group I included 13 children (43%) with a favourable prognosis, group II four children (13%) with a less favourable prognosis who developed severe sequelae, and group III 13 children with poor prognosis and in whom the subsequent outcome proved fatal. The surviving children underwent neurological, neurophysiological and psychological examination 6--58 months after the accident. The children in group I had slight neurological or psychological signs, some children presented a lowered intellectual functioning level. The children in group II were tetraplegic, unable to speak and had convulsions. The following factors were important in affecting prognosis: the longer the immersion time, the worse the prognosis. However, prognosis could still be favourable with an immersion-time of 11-20 min. Prognosis was bad if the first pH value was less than 7.00. The arterial oxygen pressure values measured during the treatment did not correlate with the prognosis but a low rectal temperature on admission was usually associated with a bad prognosis. The degree of EEG-disturbance had a prognostic value. However, the follow-up recording correlated better with the prognosis than the recordings during the first 24 hours, after which worsening of the EEG sometimes showed a progressive brain lesion.

Adolescent

Prognosis of the Lennox syndrome-long-term clinical and electroencephalographic follow-up study, especially with special reference to relationship with the West syndrome.

The long-term clinical and electroencephalographic follow-up studies were carried out for more than three years, up to 14 years in the longest, on 116 cases with Lennox syndrome. And the results of s-ystematic study on changing patterns and out come have been reported. The follow-up examination was performed also on West syndrome which is closely related with Lennox syndrome; especially the relationship between both syndromes regarding prognosis has been clarified. (1) According to the long-term follow-up on 116 cases with Lennox syndrome, there were 98 cases (84.5%) having mes (61.2%) and persisted as Lennox syndrome except for one case. (2) Generally speaking, the cases with age of onset before two years old showed unfavorable outcome. (3) There were 42 cases (36.2%), which were converted from West syndrome and showed markedly unfaborable prognosis in regard to intelligence as well as the remainging of seizure. (31 cases, 77.5%) (4) On thehand, in 23 idiopathic cases, which showed no developmental retardation before onset of seizure, had favorable outcome, and the remaining of seizure was observed in eight cases (34.8%). However, even in such cases, it was noticed that those displaying mental defect at the follow-up attained 14 cases (60.9%). That is to say, it was clarified that persistence of even minor seizures induced mental deterioration. (5) The cases with favorable prognosis showed usually a typical slow spike-and-wave pattern electroencephalographically, whereas those with poor prognosis showed mostly an asymmetric or disorganized slow spike-and-wave pattern. (6) In many cases displaying signs of brain atrophy with pneumoencephalograpm and accompanying overt neurological signs at the initial examination, prognosis is obviously poor. (7) From the follow-up examination on 94 cases with West syndrome for three to 15 years transformed into Lennox syndrome Among them, those cases with the remaining of seizure at the time of follow-up were 44 (46.8%) out 94 cases, of which 37 cases (83.8%) had remaining seizure as Lennox syndrome. (8) From the above results, it is emphasized that Lennox and West syndromes show close relationship with each other and that a study should be done on the interrelation between their prognosis.

Adolescent

Comparison of the prognosis of hypertension associated with chronic glomerulonephritis with that of essential hypertension.

The difference of the prognosis between essential and renal hypertension (chronic glomerulonephritis) was examined by compairing the survival rate of the patients, and the effect of lability of blood pressure and the effect of the response to hypotensive drugs on the prognosis of the two types of hypertension was observed. The prognosis of renal hypertensives was remarkedly worse when it was compaired with the prognosis of essential hypertensives. More then 80% of the latter was still alive after ten years, while the mortality rate of the former after 5 years was only 20%. Each factor of severity (diastolic pressure, optic fundi, cardiac, cerebrovascular and renal complication) in non severe patients (group O-II) did not differently affect the survival rate of both hypertensives. Diverse prognosis was observed in severe patients (group III-IV), depending on each factor of severity. In renal hypertension the survival rate was extremely low when the patients had high diastolic pressure, severe cardiac and cerebrovascular complication. It was not so low in the patients with severe ophthalmoscopic change. The prognosis of essential hypertension was poor in the order of severe cerebrovascular complication, renal complication and cardiac complication. The survival rate of the patients with high diastolic pressure or severe ophthalmoscopic change was considerably high. The patients with both renal and essential hypertension showed greater survival rate when the blood pressure was much more reduced by bed rest or antihypertensive drugs during the first hospitalization.

Blood Pressure

[Malignant reticuloendothelioses. Clinical variations influencing prognosis].

The relationship of age, sex, clinical findings and prognosis was studied among 30 children with malignant reticuloendotheliosis. A male predominance was found, but it was not possible to make any prognostic correlation regarding this parameter. A definitive worse prognosis was found in the early ages, thus 88% of less than 12 months-old children died. Although the visceral involvement degree signifies a poor prognosis, it was found that nevertheless, a solitary osteolytic lesion is in the accordance with good prognosis; all patients who did not have bone lesions died in less than three years. It is the first part of our purpose to enact the usefulness of the clinical findings toward a more precise prognosis in the malignant reticuloengotheliosis. Later on, we will report the possibility to obtain a numerical data from the clinical findings in order to establish an accurate prognosis.

Age Factors

[Initial EEG findings and the prognosis of epilepsy with generalized convulsive seizures].

Correlation between the initial EEG's and the prognosis of generalized convulsive seizures without other seizures was investigated. The subjects of this study was 437 epileptics with the period of the follow-up over 3 years. They were devided into 2 groups from view point of prognosis: "good prognosis" group, in which their seizures were completely controlled, the "poor prognosis", not well controlled. Most of the EEG findings appear to be not of value in predicting the prognosis. Exceptionally, however, the localized seizure discharged in the areas of T3,4, C3, 4 and P3,4 and 14--6 Hz positive spikes related closely to good prognosis, in the group of 7 to 12 years of the age.

Adolescent

A long-term prognosis for the fixed saddle-bridge. A study of 100 constructions.

This report constitutes a long-term study of 100 saddle-bridges applied by the author during the years 1958-1973. The aim of the investigation has been to assess the prognosis for this form of therapy. The probability that a saddle-bridge will still be functioning completely, without repair, after 5 years is 93%, and after 10 years (as also after 12 years) 83%. Only 12% of the appliances had been removed 12 years after the application. The risk of defects is about the same during the first 5-year period after the application as it is during the second and the third 5-year periods. A comparison between saddle-bridges applied before and after 1965 shows no demonstrable difference as regards the 5-year prognosis in spite of modifications with respect to range of indication and therapy. The causes of the defects have been divided into biological and technical. During the first 5-year period technical defects appear to be in the majority, whereas during the later stages, biological defects predominate. Background factors such as sex, the age of the patient, length of saddle, localization in the jaw do not prove to have any appreciable importance for the prognosis. There is, on the other hand, a significantly better prognosis when the opposing jaw is furnished with the patient's own teeth and/or fixed bridges than with a removable denture. The author points out that from the result of the study, the saddle-bridge has such a good long-term prognosis that its range of application for fixed constructions should be considerably extended.

Adult

Integrated bioinformatics analysis and experimental validation reveal the relationship between ALOX5AP and the prognosis and immune microenvironment in glioma.

BACKGROUND: Treatment of gliomas, the most prevalent primary malignant neoplasm of the central nervous system, is challenging. Arachidonate 5-lipoxygenase activating protein (ALOX5AP) is crucial for converting arachidonic acid into leukotrienes and is associated with poor prognosis in multiple cancers. Nevertheless, its relationship with the prognosis and the immune microenvironment of gliomas remains incompletely understood. METHODS: The differential expression of ALOX5AP was evaluated based on public Databases. Kaplan-Meier, multivariate Cox proportional hazards regression analysis, time-dependent receiver operating characteristic, and nomogram were used to estimate the prognostic value of ALOX5AP. The relationship between ALOX5AP and immune infiltration was calculated using ESTIMATE and CIBERSORT algorithms. Relationships between ALOX5AP and human leukocyte antigen molecules, immune checkpoints, tumor mutation burden, TIDE score, and immunophenoscore were calculated to evaluate glioma immunotherapy response. Single gene GSEA and co-expression network-based GO and KEGG enrichment analysis were performed to explore the potential function of ALOX5AP. ALOX5AP expression was verified using multiplex immunofluorescence staining and its prognostic effects were confirmed using a glioma tissue microarray. RESULT: ALOX5AP was highly expressed in gliomas, and the expression level was related to World Health Organization (WHO) grade, age, sex, IDH mutation status, 1p19q co-deletion status, MGMTp methylation status, and poor prognosis. Single-cell RNA sequencing showed that ALOX5AP was expressed in macrophages, monocytes, and T cells but not in tumor cells. ALOX5AP expression positively correlated with M2 macrophage infiltration and poor immunotherapy response. Immunofluorescence staining demonstrated that ALOX5AP was upregulated in WHO higher-grade gliomas, localizing to M2 macrophages. Glioma tissue microarray confirmed the adverse effect of ALOX5AP in the prognosis of glioma. CONCLUSION: ALOX5AP is highly expressed in M2 macrophages and may act as a potential biomarker for predicting prognosis and immunotherapy response in patients with glioma.

Humans

Bell's palsy-beneficial effect of treatment with adrenocorticotrophic hormone (ACTH) in patients with a poor prognosis.

In 111 patients with idiopathic peripheral facial paralysis (Bell's palsy) the prognosis was established during the first days of the disease, using sialometry and the stapedius reflex test in 102 patients. A poor prognosis was indicated in 36 patients. Treatment with adrenocorticotrophic hormone (ACTH) was commenced within 10 days (in the majority within 5 days) of the onset of the paresis in 31 of those patients with a poor prognosis. The recovery rate in the ACTH-treated group was superior compared with the untreated control group of patients with a poor prognosis. The difference is statistically significant. Those patients with a good prognosis were not treated but merely followed up. Some factors which could influence the result of the treatment are considered.

Adrenocorticotropic Hormone