• The Korean journal of internal medicine
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• 제33권6호
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• pp.1039-1049
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• 2018

The populations of Asian countries are expected to age rapidly in the near future, with a dramatic increase in the number of heart failure (HF) patients also anticipated. The need for palliative and end-of-life care for elderly patients with advanced HF is currently recognized in aging societies. However, palliative care and active treatment for HF are not mutually exclusive, and palliative care should be provided to reduce suffering occurring at any stage of symptomatic HF after the point of diagnosis. HF patients are at high risk of sudden cardiac death from the early stages of the disease onwards. The decision of whether to perform cardiopulmonary resuscitation in the event of an emergency is challenging, especially in elderly HF patients, because of the difficulty in accurately predicting the prognosis of the condition. Furthermore, advanced HF patients are often fitted with a device, and device deactivation at the end of life is a complicated process. Treatment strategies should thus be discussed by multi-disciplinary teams, including palliative experts, and should consider patient directives to address the problems discussed above. Open communication with the HF patient regarding the expected prognosis, course, and treatment options will serve to support the patient and aid in future planning.

• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.533-537
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• 2013

Background: Malignant melanoma is a cancer that demonstrates rapid progression and atypical clinically features with a poor prognosis. Aim: This study was performed to determine the clinical characteristics and treatment outcomes of patients with malignant melanoma in Turkey. Methods: The medical records of 98 patients between 2007-2012 at our centers were retrieved from the patient registry. Overall survival (OS) was calculated using the Kaplan-Meier method. Results: In our study, with the median follow-up of all patients with cutaneous MM of 46.3 months, the median OS rate of all cases was 43.6 months and 5-year OS was 48.6%. However, five-year OS rates of patients with localized disease (stage I-II) and node involvement (stage III) were 60.3% and 39.6%, respectively. The median OS of stage IV patients was 8.7 months and 1-year OS rate was 26.2%. We showed that advanced stage, male gender, and advanced age in all patients with MM were significant prognostic factors of OS. Conclusions: Compared with the results of current studies from Western countries, we found similar findings concerning demographical features, histological variables and survival analyses for our patients with cutaneous MM in Turkey.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.1745-1754
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• 2016

Background: The prime output of Hospital Based Cancer Registries is stage and treatment based survival to evaluate patient care, but because of challenges of obtaining follow-up details a separate study on Patterns of Care and Survival for selected sites was initiated under the National Cancer Registry Programme of India. The results of stage and treatment based survival for head and neck cancers by individual organ sites are presented. Materials and Methods: A standardized Patient Information Form recorded the details and entered on-line at www.hbccrindia.org to a central repository - National Centre for Disease Informatics and Research. Cases from 12 institutions diagnosed between 1 January 2006 and 31 December 2008 comprised the study subjects. The patterns of treatment were examined for 14053 and survival for 4773 patients from five institutions who reported at least 70% follow-up as of 31 December 2012. Results: Surgical treatment with radiation for cancer tongue and mouth showed five year cumulative survival (FCS) of 67.5% and 60.4% respectively for locally advanced stage. Chemo-radiation compared to radiation alone showed better survival benefit of around 15% in both oro and hypo-pharyngeal cancers and their FCS was 40.0%; Hazard Ratio (HR):1.5;CI=1.2-1.9) and 38.7%; (HR):1.7; CI=1.3-2.2). Conclusions: The awareness about the requirement of concurrent chemo-radiation in specifically cancers of the oro and hypopharynx has to be promoted in developing countries. The annual (2014) estimate number of new Head and Neck cancers with locally advanced disease in India is around 140,000 and 91,000 (65%) patients do not receive the benefit of optimal treatment with ensuing poorer survival.

• Asian Pacific Journal of Cancer Prevention
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• 제16권5호
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• pp.1747-1749
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• 2015

Background: Esophageal cancer is one of the major health concerns in Southeast Asian countries, including Thailand. However, only a limited number of studies have been reported from this region. This study was designed to evaluate the prevalence, clinical characteristics and survival rate of esophageal cancer in Thailand. Materials and Methods: Clinical information, histological features and endoscopic findings were collected from a tertiary care center in central region of Thailand between September 2011- November 2014 and reviewed. Results: A total of 64 esophageal cancer patients including 58 men and 6 women with mean age of 62.6 years were enrolled. Common presenting symptoms were dysphagia (74%), dyspepsia (10%) and hematemesis (8%). Mean duration of symptoms prior to diagnosis was 72 days. Esophageal stenosis with contact bleeding was the most common endoscopic finding (55.6%). The location of cancer was found in proximal (16%), middle (50%) and distal (34%) esophagus. Squamous cell carcinoma was far more common histology than adenocarcinoma (84.2% vs 10.5%). However, esophageal adenocarcinoma was significantly more common than squamous cell carcinoma in distal area of esophagus (100% vs 22.9%; p=0.0001, OR=1.6, 95%CI=1.1-2.2). Esophageal cancer stages 3 and 4 accounted for 35.2% and 59.3% respectively. Overall 2-year survival rate was 20% and only 16% in metastatic patients. Conclusions: Most esophageal cancer patients in Thailand have squamous cell carcinoma and nearly all present at advanced stage with a grave prognosis. Screening of high risk individuals and early detection might be important keys to improve the survival rate and treatment outcome in Thailand.

• Asian Pacific Journal of Cancer Prevention
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• 제15권21호
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• pp.9523-9527
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• 2014

The incidence of colorectal cancer (CRC) is increasing in many Asian countries and microRNAs have already been proven to be associated with tumorigenesis. Currently, microRNA-376a (miR-376a) expression and association with clinical factors in CRC remains unclear. In this study, real-time quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) was carried out on 53 matched pairs of CRC and adjacent normal mucosa to investigate the expression levels of miR-376a. According to the high or low expression of miR-376a, patients were divided into two groups. The relationship between miR-376a expression and clinicopathological factors of 53 patients was evaluated. Survival analysis of 53 CRC patients was performed with clinical follow-up information and survival curves were assessed by the Kaplan-Meier method. Immunohistochemistry (IHC) staining was performed on sections of paraffin-embedded tissue to investigate the vascular endothelial growth factor (VEGF) expression. MiR-376a showed low expression in cancer tissues compared to the adjacent normal tissues and altered high miR-376a expression tended to be positively correlated with advanced lymph node metastasis and shorter patient survival. VEGF IHC positivity was significantly more common in patients with high expression levels of miR-376a.Those results demonstrated that miR-376a may be a meaningful prognostic biomarker and potential therapeutic target in colorectal cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제13권7호
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• pp.3179-3185
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• 2012

Background: Most of the epidemiology studies on the effects of sun exposure and prostate cancer were conducted among the temperate countries of North America and Europe. Little is known about the influence on Asian populations. The purpose of current study was to evaluate any association of sun exposure with risk of prostate cancer in Chinese, Malays and Indians who reside in the tropics. Methods: The Singapore Prostate Cancer Study is a hospital-based case-control study of 240 prostate cancer incident cases and 268 controls conducted in Singapore between April 2007 and May 2009. Detailed information on outdoor activities in the sun, skin colour, sun sensitivity and other possible risk factors were collected in personal interviews. Cases were further classified by Gleason scores and TNM staging. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using unconditional logistic regression analysis, adjusted for age, ethnicity, education, family history of any cancers, BMI and skin colour. Results: We found that prostate cancer risk was increased in subjects with black/dark-brown eyes (OR 5.88, 95%CI 3.17-10.9), darker skin colour e.g. tan/dark brown/black (OR 7.62, 95%CI 3.41-17.0), frequent sunburn in lifetime (OR 4.30, 95%CI 1.7-11.2) and increased general sun exposure in adulthood per week (OR 2.03, 95%CI 1.09-3.81). The increased risk was consistent for high grade tumours and advanced stage prostate cancers. Conclusion: The findings from this study suggest that excessive sun exposure is a risk factor for prostate cancer in Asians.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3575-3581
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• 2016

Background: Cancer survival analysis is an essential indicator for effective early detection and improvements in cancer treatment. This study was undertaken to document colorectal cancer survival and associated prognostic factors in Malaysians. Materials and Methods: All data were retrieved from the National Cancer Patient Registry-Colorectal Cancer. Only cases with confirmed diagnosis through histology between the year 2008 and 2009 were included. Retrieved data include socio-demographic information, pathological features and treatment received. Survival curves were plotted using the Kaplan-Meier method. Univariate analysis of all variables was then made using the Log-rank test. All significant factors that influenced survival of patients were further analysed in a multivariate analysis using Cox' regression. Results: Total of 1,214 patients were included in the study. The overall 3- and 5-year survival rates were 59.1% and 48.7%, respectively. Patients with localized tumours had better prognosis compared to those with advanced stage cancer. In univariate analysis, staging at diagnosis (p<0.001), primary tumour size (p<0.001), involvement of lymph nodes (p<0.001) and treatment modalities (p=0.001) were found to be predictors of survival. None of the socio-demographic characteristics were found to exert any influence. In Cox regression analysis, staging at diagnosis (p<0.001), primary tumour size (p<0.001), involvement of lymph nodes (p<0.001) and treatment modalities (p<0.001) were determined as independent prognostic factors of survival after adjusted for age, gender and ethnicity. Conclusions: The overall survival rate for colorectal cancer patients in Malaysia is similar to those in other Asian countries, with staging at diagnosis, primary tumor size, involvement of lymph node and treatment modalities having significant effects. More efforts are needed to improve national survival rates in future.

• 한국산학기술학회논문지
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• 제21권9호
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• pp.509-517
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• 2020

이 연구는 중국인이 세계화로 편입되는 상황에서 나타나는 이민자, 유학생, 여행자의 네트워크 분석을 통해 중국 세계화 현황을 살펴보는 것을 목적으로 한다. 글로벌 네트워크에서 중국 이민자, 유학생, 여행자의 연관성을 제시하였다. 분석 방법은 UN의 이민자 데이터와 UNESCO의 유학생 데이터, 중국문화여행부의 여행자 데이터를 이용하여 중국 세계화의 관점에서 네트워크 및 QAP분석을 이용하였다. 분석결과 첫째, 이민이나 유학은 선진국으로 향하는 경향이 강했고, 여행은 아시아 지역에 대한 선호도가 높은 것으로 나타났다. 국가별로 태국은 여행자 네트워크에서, 미국은 이민자와 유학생 네트워크의 주요 목적지로 나타났다. 둘째, QAP 기반 통계적 상관관계 분석결과 중국 이민자들과 유학생들로 구성된 매트릭스 간 상관관계가 유의미한 것으로 나타났다. MR-QAP 분석을 통해 유학생과 이민자 네트워크가 높은 결정계수를 보여 두 변수 간 인과관계가 높은 것으로 나타났다. 이 분석을 통해 중국의 세계화에 따른 기회와 문제점을 검토하고 각국별 정책적 대책을 마련할 수 있는 실증적 근거를 제시하였다. 후속 연구에서는 중국 유학생과 중국 이민자의 국가 선택 요인, 중국의 세계화가 다른 나라들에 미치는 경제적, 사회적, 문화적 영향을 다각도로 분석하여 이 연구의 제한점을 보완할 것이다.

• Strategy21
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• 통권30호
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• pp.143-176
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• 2012

We are witnessing the growing maritime tension on the East Asian sea these days. Each naval powers in the region are competing each other to acquire more advanced naval capabilities. Based upon the rapid economic development, China is actively beefing up its naval capabilities and expand its boundary of naval activities all over the East Asian region. Chinese Navy already unveiled its expansive naval strategy replacing the traditional concept of 'Near-Sea Defense' with the new concept of 'Far-Sea Defense' strategy. In response to potential rival's naval build up, the U.S. is redeploying its naval forces focusing on the Asia-Pacific region. The U.S. enhances its joint naval exercises with the countries in the region, such as Japan, India, Australia and so on. In addition, Washington is devising new naval strategy under the concept of 'Air-Sea Battle' to deter Peking's so-called 'Anti-Access/ Area Denial(A2AD)' strategy. As a close ally of the U.S., Japan also disclosed its clear intention to strengthen the Maritime Self Defense Force(MSDF)'s capabilities by introducing the new concept of 'Dynamic Defense Force' in 2011. Under the new concept, JMSDF is pursuing the additional acquisition of submarines, quasi-aircraft carriers, Aegis-equipped destroyers, etc. Under the new president's strong leadership, Russia is also invigorating the naval build-up. Especially, Russia is fortifying the Pacific Fleet's naval assets by deploying new-type of naval ships such as the Mistral which was imported from France. In the midst of competitive naval build-up among the major naval powers in the region, we are observing the growing maritime conflicts on the East China Sea as well as South China Sea. Those naval conflicts can pose severe threats to our national interests. Maritime conflicts on the East or South China Sea can imperil our sea lanes which will be indispensible for national economic development. Neighboring countries' maritime conflicts also will cast an uncertainty on the path to mobilize international cooperation to resolve the North Korean issues. We should contribute to ease the maritime tension in the region by various ways. First, we should actively galvanize the bilateral maritime dialogue among the major naval powers in the region. Second, we also should take the lead to form a multilateral maritime cooperation mechanism in the region. Above all, we should set the aim to be a peaceful maritime power who can contribute to a building of stable maritime order in the region with a considerable naval power.

• 농업과학연구
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• 제48권3호
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• pp.433-446
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• 2021

In this study, the future flood inundation changes under a climate change were simulated in the Tonle Sap basin in Cambodia, one of the countries with high vulnerability to climate change. For the flood inundation simulation using the rainfall-runoff-inundation (RRI) model, globally available geological data (digital elevation model [DEM]; hydrological data and maps based on Shuttle elevation derivatives [HydroSHED]; land cover: Global land cover facility-moderate resolution imaging spectroradiometer [GLCF-MODIS]), rainfall data (Asian precipitation-highly-resolved observational data integration towards evaluation [APHRODITE]), climate change scenario (HadGEM3-RA), and observational water level (Kratie, Koh Khel, Neak Luong st.) were constructed. The future runoff from the Kratie station, the upper boundary condition of the RRI model, was constructed to be predicted using the long short-term memory (LSTM) model. Based on the results predicted by the LSTM model, a total of 4 cases were selected (representative concentration pathway [RCP] 4.5: 2035, 2075; RCP 8.5: 2051, 2072) with the largest annual average runoff by period and scenario. The results of the analysis of the future flood inundation in the Tonle Sap basin were compared with the results of previous studies. Unlike in the past, when the change in the depth of inundation changed to a range of about 1 to 10 meters during the 1997 - 2005 period, it occurred in a range of about 5 to 9 meters during the future period. The results show that in the future RCP 4.5 and 8.5 scenarios, the variability of discharge is reduced compared to the past and that climate change could change the runoff patterns of the Tonle Sap basin.