• Journal of Korean Medical Science
• /
• v.33 no.43
• /
• pp.277.1-277.10
• /
• 2018

Background: To examine survival rates and renal function after partial nephrectomy (PN) and radical nephrectomy (RN) in patients with chronic kidney disease (CKD). Methods: We studied 4,332 patients who underwent PN or RN for pathological T1a-T2N0M0 renal cell carcinoma from 1988 to 2014. Patients were divided into two subgroups of CKD stage I-II and stage III. Kidney function, and survival outcomes were compared between groups. Results: We included 1,756 patients with CKD I-II and 276 patients with CKD III in the final pair-matched analysis. Kidney function was significantly better preserved in the PN than in the RN group among all patients. However, the beneficial effect of PN on kidney function gradually disappeared over time in CKD III patients. The 5-year overall survival (OS) rates after PN and RN differed in patients with CKD I-II disease (99.4% vs. 96.5%, respectively, P = 0.015). The 5-year OS rates after surgery were not affected by mode of nephrectomy in CKD III patients (97.8% vs. 93.5%, P = 0.103). The 5-year cancer-specific survival rates did not differ between treatment groups in all CKD stage. Cox hazard analysis showed that the operative method was a significant factor for OS in CKD I-II patients (hazard ratio [HR], 0.320; confidence interval [CI], 0.122-0.840; P = 0.021). However, PN was not beneficial in terms of OS in CKD III patients (HR, 0.395; CI, 0.086-1.172; P = 0.117). Conclusion: PN is associated with a higher OS rate and better kidney function in patients with preoperative CKD stage I and II, but not in those with CKD stage III.

• Journal of Korean Medical Science
• /
• v.33 no.51
• /
• pp.325.1-325.10
• /
• 2018

Background: To evaluate survival outcomes and prognostic factors for overall survival (OS) in patients with metastatic renal cell carcinoma (mRCC) who received sunitinib (SU) and pazopanib (PZ) as first-line therapy in real-world Korean clinical practice. Methods: Data of 554 patients with mRCC who received SU or PZ at eight institutions between 2012 and 2016 were retrospectively reviewed. Based on the targeted therapy, the patients were divided into SU (n = 293) or PZ (n = 261) groups, and the clinicopathological variables and survival rates of the two groups were compared. A multivariable Cox proportional hazard model was used to determine the prognostic factors for OS. Results: The median follow-up was 16.4 months (interquartile range, 8.3-31.3). Patients in the PZ group were older, and no significant difference was observed in the performance status (PS) between the two groups. In the SU group, the dose reduction rate was higher and the incidence of grade 3 toxicity was more frequent. The objective response rates were comparable between the two groups (SU, 32.1% vs. PZ, 36.4%). OS did not differ significantly between the two groups (SU, 36.5 months vs. PZ, 40.2 months; log-rank, P = 0.955). Body mass index, Eastern Cooperative Oncology Group PS > 2, synchronous metastasis, poor Heng risk criteria, and liver and bone metastases were associated with a shorter OS. Conclusion: Our real-world data of Korean patients with mRCC suggested that SU and PZ had similar efficacies as first-line therapy for mRCC. However, PZ was better tolerated than SU in Korean patients.

• Health Policy and Management
• /
• v.31 no.4
• /
• pp.462-471
• /
• 2021

Background: The purpose of this study was to identify the association between participation in social activities and mortality rates for those aged 45 aged and older in Korea. Methods: In this study, the 1st to 6th Korea Longitude Study of Aging was used to analyze 10,217 people excluding missing values among middle and old age groups aged 45 or older. The scope of social activities was classified into "religious gatherings," "religious gatherings," "leisure/cultural/sports-related organizations," and "clubs/hometowns/religious associations," and analyzed using a chi-square test and Cox proportional risk model. Results: In the case of non-participating groups in religious activities, the mortality rate was 1.24 times higher (hazard ratio [HR], 1.24; p=0.000) than those of the participating group. The non-participating group of social gatherings had a 1.27 times higher mortality rate (HR, 1.27; p<0.0001) than the participating group. In addition, the mortality rate of non-participating groups related to leisure/cultural/sports was 1.79 times higher (HR, 1.79; p=0.000). The mortality rate of the group that did not participate in the alumni association/festival/folklore society was 1.51 times higher than that of the participating group (HR, 1.51; p<0.0001). As a result of correcting the control variable to analyze the relationship between the number of participants in social activities and the mortality rate, the mortality rate of the group participating in one or less social activities was 2.26 times higher (HR, 2.26; p<0.0001) compared to the four or more social activity participating groups, and the mortality rate of the 1-3 social activities was 1.64 times higher (HR, 1.64; p<0.0001). Conclusion: As a result of the study, it was found that participation in social activities of the middle-aged and elderly groups was effective in reducing mortality, and in particular, it was found that there was a strong relationship with mortality in less than one social activity group. Therefore, it is intended to provide an academic basis for lowering the mortality rate of the group in line with the continuous improvement of domestic social activity participation conditions, and through this, this study can be expected to serve as a policy and institutional basis for lowering the mortality rate of the group.

• Journal of vocational education research
• /
• v.35 no.6
• /
• pp.39-63
• /
• 2016

The purpose of this study was to identify the factors affecting the actual employment rate and job retention rate after completion of the training program the unemployed. Survival analysis was conducted by utilizing employment insurance status and subscription data over two years of 840 patients who finally completed a training course from 889 patients in response to survey about the training service quality in 2012. The finding of the study were as follows. First, the highest employment rate (36.8%) after the completion time was within three months, a period more than 50% of the trainees were employed within six months. While employment continued to occur even with the lapse of one year and two years after the completion point, the employment rate over time was found to decrease gradually. Second, the factors affecting employment rate after completing training, appeared teaching competency(-) among training service quality and potential employability(+), which low awareness of teaching capacity and high awareness potential employability increased the possibility of their employment. Third, the highest periods (each 22.0%, 22.3%) of employment loss rate were within three months and within three to six months, and more than 50% of the trainees have lost their unemployment insurance were less than 8.8 months. Fourth, the factors affecting job retention rates after employment, appeared relationship between teachers and students(+), a fellow student relationships(+) among training service quality and training satisfaction(+), which high awareness of teacher-student relationships, fellow student relationships and training satisfaction increased the possibility of their maintaining employment.

• Korean Journal of Social Welfare Studies
• /
• v.48 no.4
• /
• pp.221-249
• /
• 2017

This study aims to investigate determinants that affect job retention of injured workers depending upon types of return to work in order to suggest define the intervention priority for those who returned to original works and for those who did not. After constructing explaining variables based on literature reviews, determinants were verified analyzing 1,292 people using Panel Study of Worker's Compensation Insurance(PSWCI) data. The job retention period turned out to be 46.6 months for those who returned to original work and 34.2 month for those who returned to new works. Injured workers who return to new works tend to have more unemployment experiences. As a result of Cox proportional regression analysis, the longer it takes to return to work, the longer both groups tend to retain after the accident. Age, recuperation period, health status, psycho-social rehabilitation, education and occupational training also affect on job retention probability for those who return to new work. Based upon the analyzed result, setting up an adequate duration for return-to-work, intervention for injured workers who experienced vulnerable working condition before the accident and continuous case management after return-to-work are suggested.

• Journal of Microbiology and Biotechnology
• /
• v.31 no.11
• /
• pp.1501-1507
• /
• 2021

Lagerstroemia ovalifolia Teijsm. & Binn. (LO) (crape myrtle) has reportedly been used as traditional herbal medicine (THM) in Java, Indonesia. Our previous study revealed that the LO leaf extract (LOLE) exerted anti-inflammatory effects on lipopolysaccharide (LPS)-stimulated RAW264.7 macrophages. Based on this finding, the current study aimed to evaluate the protective effects of LOLE in a mouse model of LPS-induced acute lung injury (ALI). The results showed that treatment with LPS enhanced the inflammatory cell influx into the lungs and increased the number of macrophages and the secretion of the inflammatory cytokines in the bronchoalveolar lavage fluid (BALF) of mice. However, these effects were notably abrogated with LOLE pretreatment. Furthermore, the increase of inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2) and monocyte chemoattractant protein-1 (MCP-1) expression in the lung tissues of mice with ALI was also reversed by LOLE. In addition, LOLE significantly suppressed the LPS-induced activation of the MAPK/NF-κB signaling pathway and led to heme oxygenase-1 (HO-1) induction in the lungs. Additionally, in vitro experiments showed that LOLE enhanced the expression of HO-1 in RAW264.7 macrophages. The aforementioned findings collectively indicate that LOLE exerts an ameliorative effect on inflammatory response in the airway of ALI mice.

• The Korea Journal of Herbology
• /
• v.34 no.4
• /
• pp.27-35
• /
• 2019

Objectives : Osteoarthritis is characterized by degeneration of articular cartilage, which is characterized by chronic pain, stiffness and decrease range of motion. The present study was designed to compare the therapeutic effect of Dioscoreae Rhizoma water extract (DRW) and Dioscoreae Rhizoma 30% ethanol extract (DRE) on the monosodium iodoacetate (MIA)-induced osteoarthritis rats. Methods : Osteoarthritis was induced by injection of MIA ($50{\mu}{\ell}$ with $80mg/m{\ell}$) into the knee joint cavity of rats. After adaptation period for seven days, rats were divided by 5 groups (n=10/group): normal group, control group, positive control (indomethacin 5 mg/kg), DRW 200 mg/kg treated group, DRE 200 mg/kg treated group (n=10/group). The hind paw weight distribution was measured with the changes of reactive oxygen species (ROS), peroxynitrite ($ONOO^-$) in articulation tissue. Also, the cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS), tumor necrosis factoralpha ($TNF{\alpha}$), interleukin-6 (IL-6), matrix metalloproteinase-1 (MMP-1), and tissue inhibitor of metalloproteinases-1 (TIMP-1) were investigated by western blot analysis. Results : The administration of DRW and DRE significantly decreased the hind paw weight distribution. The ROS and $ONOO^-$ levels of cartilaginous tissue were significantly decreased in DRW and DRE compared to control group. The results showed that DRE decreased inflammatory cytokines such as iNOS and $TNF{\alpha}$. Also DRE decreased MMP-1 and increased TIMP-1. Conclusions : Based on the above results, Dioscoreae Rhizoma extract seems to have the therapeutic effect on osteoarthritis via suppression of inflammation.

• Journal of Chest Surgery
• /
• v.55 no.2
• /
• pp.143-150
• /
• 2022

Background: The effectiveness of extracorporeal membrane oxygenation (ECMO) for patients with refractory cardiogenic shock or cardiac arrest is being established, and serum lactate is well known as a biomarker of end-organ perfusion. We evaluated the efficacy of pre-ECMO lactate for predicting 6-month survival in patients with acute coronary syndrome (ACS) undergoing ECMO. Methods: We reviewed the medical records of 148 patients who underwent veno-arterial (VA) ECMO for ACS between January 2015 and June 2020. These patients were divided into survivors and non-survivors based on 6-month survival. All clinical data before and during ECMO were compared between the 2 groups. Results: Patients' mean age was 66.0±10.5 years, and 116 (78.4%) were men. The total survival rate was 45.9% (n=68). Cox regression analysis showed that the pre-ECMO lactate level was an independent predictor of 6-month mortality (hazard ratio, 1.210; 95% confidence interval [CI], 1.064-1.376; p=0.004). The area under the receiver operating characteristic curve of pre-ECMO lactate was 0.64 (95% CI, 0.56-0.72; p=0.002; cut-off value=9.8 mmol/L). Kaplan-Meier survival analysis showed that the cumulative survival rate at 6 months was significantly higher among patients with a pre-ECMO lactate level of 9.8 mmol/L or less than among those with a level exceeding 9.8 mmol/L (57.3% vs. 31.8%, p=0.0008). Conclusion: A pre-ECMO lactate of 9.8 mmol/L or less may predict a favorable outcome at 6 months in ACS patients undergoing VA-ECMO. Further research aiming to improve the accuracy of predictions of reversibility in patients with high pre-ECMO lactate levels is essential.

• Korean Journal of Radiology
• /
• v.22 no.2
• /
• pp.159-167
• /
• 2021

Objective: The aim of this study was to compare the survival rates of Korean females aged 40 to 49 years with breast cancer detected by supplemental screening ultrasound (US) or screening mammography alone. Materials and Methods: This single-institution retrospective study included 240 patients with breast cancer (mean age, 45.1 ± 2.8 years) detected by US or mammography who had undergone breast surgery between 2003 and 2008. Medical records were reviewed for clinicopathologic characteristics and detection methods. Disease-free survival (DFS) and overall survival (OS) were compared between patients with breast cancer in the US and mammography groups using the log-rank test. Multivariable cox regression analysis was used to identify independent variables associated with DFS and OS. Results: Among the 240 cases of breast cancer, 43 were detected by supplemental screening US and 197 by screening mammography (mean follow-up: 7.4 years, 93.3% with dense breasts). There were 19 recurrences and 16 deaths, all occurring in the mammography group. While the US group did not differ from the mammography group in tumor stage, the patients in this group were more likely to undergo breast-conserving surgery and radiation therapy than the mammography group. The US group also showed better DFS (p = 0.016); however, OS did not differ between the two groups (p = 0.058). In the multivariable analysis, the US group showed a lower risk of recurrence (hazard ratio, 0.097; 95% confidence interval, 0.001-0.705) compared to the mammography group. Conclusion: Our study found that Korean females aged 40-49 years with US-detected breast cancer showed better DFS than those with mammography-detected breast cancer. However, there were no statistically significant differences in OS.

• Korean Journal of Radiology
• /
• v.24 no.4
• /
• pp.338-348
• /
• 2023

Objective: Patients with a history of ischemic stroke are at risk for a second ischemic stroke. This study aimed to investigate the relationship between carotid plaque enhancement on perfluorobutane microbubble contrast-enhanced ultrasonography (CEUS) and future recurrent stroke, and to determine whether plaque enhancement can contribute to risk assessment for recurrent stroke compared with the Essen Stroke Risk Score (ESRS). Materials and Methods: This prospective study screened 151 patients with recent ischemic stroke and carotid atherosclerotic plaques at our hospital between August 2020 and December 2020. A total of 149 eligible patients underwent carotid CEUS, and 130 patients who were followed up for 15-27 months or until stroke recurrence were analyzed. Plaque enhancement on CEUS was investigated as a possible risk factor for stroke recurrence and as a possible adjunct to ESRS. Results: During follow-up, 25 patients (19.2%) experienced recurrent stroke. Patients with plaque enhancement on CEUS had an increased risk of stroke recurrence events (22/73, 30.1%) compared to those without plaque enhancement (3/57, 5.3%), with an adjusted hazard ratio (HR) of 38.264 (95% confidence interval [CI]:14.975-97.767; P < 0.001) according to a multivariable Cox proportional hazards model analysis, indicating that the presence of carotid plaque enhancement was a significant independent predictor of recurrent stroke. When plaque enhancement was added to the ESRS, the HR for stroke recurrence in the high-risk group compared to that in the low-risk group (2.188; 95% CI, 0.025-3.388) was greater than that of the ESRS alone (1.706; 95% CI, 0.810-9.014). A net of 32.0% of the recurrence group was reclassified upward appropriately by the addition of plaque enhancement to the ESRS. Conclusion: Carotid plaque enhancement was a significant and independent predictor of stroke recurrence in patients with ischemic stroke. Furthermore, the addition of plaque enhancement improved the risk stratification capability of the ESRS.