• Title/Summary/Keyword: Cancer risk assessment

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Role of endoscopy in patients with achalasia

  • So Young Han;Young Hoon Youn
    • Clinical Endoscopy
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    • v.56 no.5
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    • pp.537-545
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    • 2023
  • Achalasia is an esophageal motility disorder characterized by impaired lower esophageal sphincter relaxation and peristalsis of the esophageal body. With the increasing prevalence of achalasia, interest in the role of endoscopy in its diagnosis, treatment, and monitoring is also growing. The major diagnostic modalities for achalasia include high-resolution manometry, esophagogastroduodenoscopy, and barium esophagography. Endoscopic assessment is important for early diagnosis to rule out diseases that mimic achalasia symptoms, such as pseudo-achalasia, esophageal cancer, esophageal webs, and eosinophilic esophagitis. The major endoscopic characteristics suggestive of achalasia include a widened esophageal lumen and food residue in the esophagus. Once diagnosed, achalasia can be treated either endoscopically or surgically. The preference for endoscopic treatment is increasing owing to its minimal invasiveness. Botulinum toxins, pneumatic balloon dilation, and peroral endoscopic myotomy (POEM) are important endoscopic treatments. Previous studies have demonstrated excellent treatment outcomes for POEM, with >95% improvement in dysphagia, making POEM the mainstay treatment option for achalasia. Several studies have reported an increased risk of esophageal cancer in patients with achalasia. However, routine endoscopic surveillance remains controversial owing to the lack of sufficient data. Further studies on surveillance methods and duration are warranted to establish concordant guidelines for the endoscopic surveillance of achalasia.

Abiraterone for Treatment of Metastatic Castration-resistant Prostate Cancer: a Systematic Review and Meta-analysis

  • Zhou, Zhi-Rui;Liu, Shi-Xin;Zhang, Tian-Song;Xia, Jun;Li, Bo
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.3
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    • pp.1313-1320
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    • 2014
  • Introduction: Although most prostate cancers initially respond to castration with luteinizing hormonereleasing analogues or bilateral orchiectomy, progression eventually occurs. Based on the exciting results of several randomized controlled trials (RCTs), it seems that patients with metastatic castration-resistant prostate cancer (mCRPC) might benefit more from treatment withabiraterone. Therefore we conducted a systematic review to evaluate the efficacy and toxicity of abiraterone in the treatment of mCRPC. Methods: Literature was searched from Embase, PubMed, Web of Science, and Cochrane Library up to July, 2013. Quality of the study was evaluated according to the Cochrane's risk of bias of randomized controlled trial (RCT) tool, then the Grading of Recommendations Assessment, Development and Evaluation (GRADE) System was used to rate the level of evidence. Stata 12.0 was used for statistical analysis. Summary data from RCTs comparing abiraterone plus prednisone versus placebo plus prednisone for mCRPC were meta-analyzed. Pooled hazard ratios (HRs) for overall survival (OS), radiographic progression-free survival (RPFS) and time to PSA progression (TTPP); Pooled risk ratios (RR) for PSA response rate, objective response rate and adverse event were calculated. Results: Ten trials were included in the systematic review; Data of 2,283 patients (1,343 abiraterone; 940 placebo) from two phase 3 trials: COU-AA-301 and COU-AA-302 were meta-analyzed. Compared with placebo, abiraterone significantly prolonged OS (HR, 0.74; 95% confidence interval [CI], 0.66 to 0.84), RPFS (HR, 0.59; 95% CI, 0.48 to 0.74) and time to PSA progression (HR, 0.55; 95% CI, 0.43 to 0.70); it also significantly increased PSA response rate (RR, 3.63; 95% CI, 1.72 to 7.65) and objective response rate (RR, 3.05; 95% CI, 1.51 to 6.15). This meta-analysis suggested that the adverse events caused by abiraterone are acceptable and can be controlled. Conclutios: Abiraterone significantly prolonged OS, RPFS and time to progression patients with mCRPC, regardless of prior chemotherapy or whether chemotherapy-na$\ddot{i}$ve, and no unexpected toxicity was evident. Abiraterone can serve as a new standard therapy for mCRPC.

Effect of Dosage Level of Carcinogen and Clonorchis sinensis Infestation on Cholangiocellular Carcinoma Induction in Hamsters

  • Yoon, Byung-Il;Joo, Kyung-Whan;Lee, Joon-Sang;Lee, Jae-Hyun;Kim, Dae-Yong
    • Toxicological Research
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    • v.17
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    • pp.79-82
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    • 2001
  • The infection of liver flukes, Clonorchis sinensis (CS) and Opisthorchis viverrini (OV), has been known as a risk factor to induce cholangiocellular carcinoma (CCC) in human living in the endemic area, providing promoting effect on the liver initiated by chemical carcinogens. The present study evaluated the relationship between the dosage level of dimethylnitrosamine (DMN) and the infection load of CS in the neoplastic development by histopathological examination of the treated hamsters. To evaluate the effects of DMN, different doses of DMN ranging from 0 to 25 ppm were administered to hamsters with 20 CS metacercariea. For the risk assessment of the infection load, 0, 5, 15, 50 CS metacercariae were respectively infected with 12 ppm DMN. The mortality was closely related to the infection load rather than the concentration of DMN. The infection of CS clearly promoted the induction of CCC even at dose level of 6 ppm DMN. Only five metacercariae were enough to promote CCC induction at the concentration of 12 ppm DMN.

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A Study on Water Quality Standard for the Protection of Human Health and Aquatic Life (인체의 위해성과 수생태계를 고려한 수질환경기준 설정에 관한 연구)

  • Lee, Jae-Hyun;Kim, Yoon-Shin
    • Journal of Korean Society on Water Environment
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    • v.23 no.6
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    • pp.985-992
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    • 2007
  • There are about 40,000 chemicals used in Korea and 300 new types of chemicals are added to the list every year, influencing quality of air, soil and water. Water quality standards that serve as the basis for water quality management have been proved inefficient and insufficient compared to those of advanced countries. This study aims to improve the existing water quality standards. Most importantly, the water quality standards need to take into account not only protection of human health but also aquatic resources. To that end, water quality criteria need to be set by monitoring each watershed every year and conducting risk assessment. Criteria for human health are set at $10^{-6}$ cancer risk level, and for aquatic life at conservative level, adopting the methodology of the U.S. and Australia, respectively. After carrying out technical and economic feasibility studies, more conservative criteria will be used to decide final water quality standards. The development of this system to establish integrated water quality standards for both human health and aquatic resources protection is urgently needed.

Optimization method for offsite consequence analysis by efficient plume segmentation

  • Seunghwan Kim;Sung-yeop Kim
    • Nuclear Engineering and Technology
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    • v.56 no.9
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    • pp.3851-3863
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    • 2024
  • The speed of offsite consequence analysis is highly important due to the extensive calculations required to handle all the scenarios for a single-unit or multi-unit Level 3 PSA (probabilistic safety assessment). To perform an offsite consequence analysis as part of Level 3 PSA, various input parameters are considered, amongst which certain parameters, such as plume segments, spatial grids, and particle size distributions, have flexible input formats. This study describes the development of an effective optimization method to reduce the analysis time as much as possible while maintaining the accuracy of the offsite consequence analysis results. The effect of plume segmentation on offsite consequence analysis was investigated by observing deviations in analysis results and changes in the required analysis times following changes in plume release. Then a plume segmentation optimization method based on the cumulative release fraction slope was developed to intensively analyze the sections with rapid release and to simplify the analysis for the sections with nonsignificant release. As a result of applying this method, the analysis time was reduced by about 54.5 % compared to the base case, while the resulting health effects showed very small deviations of 0.03 % and 1.77 % for early fatality risk and cancer fatality risk, respectively.

Assessment of Operative Risks of Pneumonectomy (전폐절제술에 있어서 수술 위험인자의 평가)

  • Jeong, Gyeong-Yeong;Kim, Gil-Dong
    • Journal of Chest Surgery
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    • v.28 no.5
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    • pp.464-470
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    • 1995
  • From Jan 1988 to Dec 1993, 196 consecutive patients with various pulmonary diseases underwent pneumonectomy. Mean age was 54.0 years[range:7-74 . The underlying diseases were lung cancer[154 cases , destroyed lung[29 cases with pulmonary tuberculosis or empyema thoracis and others[13 cases . The overall mortality and complication rate were 5.6% and 14.8%. In the groups of more than and less than 60 years of age, there was significant differences in mortality rate[P=0.004 . In the group of pneumonectomy and pleuropneumonectomy, there was no significant differences in mortality[P=0.164 and complication rate[P=0.052 . In the group of normal and abnormal EKG, there was no significant differences in mortality[P=0.560 and complication rate[P=0.693 . In the preoperative FEV1, preoperative FVC and predicted postoperative FEV1, prognostic cut-off points were 1800cc, 2600cc and 1300cc, and at points, positive predicted value were 12.3%, 10.5%.and 7.7% and negative predicted value were 97.8%, 98.3% and 96.2% respectively. The preoperative FEV1 is the most reliable indicator in assessment of prognosis of pneumonectomy.

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Associated Factors of Impaired Fasting Glucose in Some Korean Rural Adults (농촌지역 주민의 공복혈당장애와 관련요인)

  • Yun, Hye-Eun;Han, Mi-Ah;Kim, Ki-Soon;Park, Jong;Kang, Myeng-Guen;Ryu, So-Yeon
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.4
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    • pp.309-318
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    • 2010
  • Objective: This study was performed to investigate the prevalence of impaired fasting glucose (IFG) and its related characteristics among healthy adults in some Korean rural areas. Methods: We conducted a cross-sectional study using the data from 1352 adults who were over the age 40 and under the age 70 and who were free of diabetes mellitus (DM), cardiovascular diseases and other diseases and who participated in a survey conducted as part of the Korean Rural Genomic Cohort Study. IFG was defined as a serum fasting glucose level between 100 and 125 mg/dL. Results: The prevalence of IFG was 20.4% in men, 15.5% in women and 12.7% overall. Multivariate logistic regression analysis demonstrated that the independent risk factors for IFG were male gender, having a family history of DM, the quartiles of gamma glutamyltransferase and high sensitive C-reactive protein and the waist circumference. The homeostatis model assessment for insulin resistance was very strongly associated with IFG. The prevalence of metabolic syndrome (MS) and MS components was higher in the subjects with IFG then in those with normal fasting glucose (NFG). Conclusions: The result of study could supply evidence to find the high risk population and to determine a strategy for treating IFG. Further research is needed to explain the causal relationship and mechanisms of IFG.

Radiometric examination of fertilizers and assessment of their health hazards, commonly used in Pakistan

  • Hannan Younis;Sumbilah Shafique;Zahida Ehsan;Aleena Ishfaq;Khurram Mehboob;Muhammad Ajaz;Abdullah Hidayat;Wazir Muhammad
    • Nuclear Engineering and Technology
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    • v.55 no.7
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    • pp.2447-2453
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    • 2023
  • The radioactivity concentrations of Naturally Occurring Radioactive Materials (NORM) i.e., 226Ra, 232Th, and 4K in various chemical fertilizers being used in the agricultural soil of Pakistan were determined utilizing gamma spectrometry by employing a High Purity Germanium (HPGe) detector. The radioactivity concentrations of 226Ra, 232Th, and 4K extended from 2.58 ± 0.8-265.7 ± 8.8 Bq kg-1, 1.53 ± 0.14-76.6 ± 1.07 Bq kg-1 and 36.5 ± 1.34-15606.7 ± 30.2 Bq kg-1 respectively. The radiological hazard parameters such as internal and external indices and annual effective dose rates were calculated, while excessive lifetime cancer risk factors for the indoor and outdoor areas were found in the range from 0.3×10-3 to 10.723×10-3 and 0.03×10-3 to 2.7948×10-3 of most fertilizers, however, some values were slightly higher than the UNSCEAR (The United Nations Scientific Committee on the Effects of Atomic Radiation) recommended values for potash-containing fertilizers such as MOP (Muriate of Potash).

Health-related Quality of Life After Treatment for Malignant Bone Tumors: A Follow-up Study in China

  • Sun, Yong-Jian;Hu, Yan-Jun;Jin, Dan;Li, Jian-Wei;Yu, Bin
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3099-3102
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    • 2012
  • Aim: We conducted the present study to assess health-related quality of life (HRQoL) among bone cancer patients after surgical treatment in one large teaching hospitals in China, and assess the risk factors for improving the physical or mental HRQoL. Methods: 344 eligible adult patients who were admitted to the hospital with malignant bone tumors during the period of Jun. 2008 to Dec. 2011, and a reference group with 361 health cases was recruited in the same hospital during the same period. All 344 patients were followed up for one year. The HRQoL before treatment and after one year was evaluated with the Medical Outcome Short Form 36 (SF-36). Results: All 8 domains of HRQoL had the lowest scores greatly improved over the first year after discharge. However, the patients still had significantly lower scores in every domain than the reference group one year after discharge. Age and type of surgery were associated with HRQoL in the mental domain. Conclusion: The HRQoL of patients with malignant bone tumors greatly improved one year after the treatment. This study also highlighted the utility of HRQoL assessment for prognostic evaluation of patients after surgical treatment for bone cancer.

Deep Learning in Radiation Oncology

  • Cheon, Wonjoong;Kim, Haksoo;Kim, Jinsung
    • Progress in Medical Physics
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    • v.31 no.3
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    • pp.111-123
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    • 2020
  • Deep learning (DL) is a subset of machine learning and artificial intelligence that has a deep neural network with a structure similar to the human neural system and has been trained using big data. DL narrows the gap between data acquisition and meaningful interpretation without explicit programming. It has so far outperformed most classification and regression methods and can automatically learn data representations for specific tasks. The application areas of DL in radiation oncology include classification, semantic segmentation, object detection, image translation and generation, and image captioning. This article tries to understand what is the potential role of DL and what can be more achieved by utilizing it in radiation oncology. With the advances in DL, various studies contributing to the development of radiation oncology were investigated comprehensively. In this article, the radiation treatment process was divided into six consecutive stages as follows: patient assessment, simulation, target and organs-at-risk segmentation, treatment planning, quality assurance, and beam delivery in terms of workflow. Studies using DL were classified and organized according to each radiation treatment process. State-of-the-art studies were identified, and the clinical utilities of those researches were examined. The DL model could provide faster and more accurate solutions to problems faced by oncologists. While the effect of a data-driven approach on improving the quality of care for cancer patients is evidently clear, implementing these methods will require cultural changes at both the professional and institutional levels. We believe this paper will serve as a guide for both clinicians and medical physicists on issues that need to be addressed in time.