• Journal of Gastric Cancer
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• v.22 no.1
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• pp.56-66
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• 2022

Purpose: Nutritional problems after gastrectomy affect continuation of postoperative chemotherapy. There have been no studies limited to total gastrectomy, which is particularly prone to nutritional problems. In this study, we aimed to investigate the factors that predict the continuation of postoperative chemotherapy. Materials and Methods: We included 101 patients who underwent curative total gastrectomy and postoperative chemotherapy at Hiroshima Memorial Hospital. The effects of 37 factors, including perioperative inflammatory, nutritional, and tumor status, on the persistence of postoperative chemotherapy were analyzed. Results: In univariate analysis of preoperative factors, age, carbohydrate antigen 19-9, platelet-to-neutrophil ratio, Onodera's prognostic nutritional index (PNI), controlling nutritional status score, and nutritional risk screening (NRS-2002) score were significantly associated with the duration of postoperative chemotherapy. In multivariate analysis of preoperative factors, age (≥74 years) was an independent factor for a shorter duration of postoperative chemotherapy (hazard ratio [HR], 5.24; 95% confidence interval [CI], 2.19-12.96; P<0.01). In univariate analysis of factors before postoperative chemotherapy, intraoperative blood loss, perioperative weight loss rate, postoperative performance status, PNI, albumin-to-bilirubin index, and NRS-2002 score were significantly associated with the duration of postoperative chemotherapy. In multivariate analysis of factors before postoperative therapy, age (≥74 years) (HR, 5.75; 95% CI, 1.90-19.49; P<0.01) and PNI (<39) (HR, 3.29; 95% CI, 1.26-8.56; P=0.02) were independent factors for a shorter duration of postoperative chemotherapy. Conclusions: Age and PNI are useful predictors of postoperative chemotherapy intolerance after total gastrectomy and may determine the treatment strategy and timing of chemotherapy initiation.

• The Journal of Internal Korean Medicine
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• v.45 no.1
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• pp.31-54
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• 2024

Objectives: This study assessed the effectiveness of Hwanggigyejiomul-tang for postoperative breast cancer-related lymphedema (BCRL) by a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: A search was conducted using keywords such as "breast cancer", "lymphedema", "edema", "Huangqi Guizhi Wuwu decoction", "Huangqi Guizhi Wuwu tang", and "Hwanggigyejiomul tang" in 10 databases (PubMed, Cochrane, ScienceDirect, CNKI, CiNii, RISS, KISS, ScienceON, OASIS, DBpia) on February 11, 2024. There were no limits on the publication period and language, and the quality of the studies was evaluated using Cochrane's risk of bias tool. A meta-analysis was performed based on the outcome measurements, such as total effective rate (TER), increase in shoulder joint mobility (flexion, extension, abduction, adduction), Fugl-Meyer assessment (FMA), and visual analog scale (VAS) using Review Manager Web. Results: Eleven RCTs were selected. The treatment group (Hwanggigyejiomul-tang-gagambang or hapbang with control group intervention) showed a more statistically significant effect compared with the control group (physical therapy or western medicine) in TER (upper limb circumference change), TER (upper limb edema grade change), increase in flexion angle, increase in extension angle, increase in adduction angle, FMA, and VAS. Conclusions: Hwanggigyejiomul-tang is effective in treating postoperative BCRL. However, because of the low quality of the included studies, more clinical studies are required to increase the possibility of clinical use.

• Korean Journal of Radiology
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• v.21 no.9
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• pp.1027-1035
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• 2020

Objective: To assess the appropriate follow-up interval, and rate and timepoint of cancer detection in women with Breast Imaging Reporting and Data System (BI-RADS) 3 lesions on screening ultrasonography (US) according to the type of institution. Materials and Methods: A total of 1451 asymptomatic women who had negative or benign findings on screening mammogram, BI-RADS 3 assessment on screening US, and at least 6 months of follow-up were included. The median follow-up interval was 30.8 months (range, 6.8-52.9 months). The cancer detection rate, cancer detection timepoint, risk factors, and clinicopathological characteristics were compared between the screening and tertiary centers. Nominal variables were compared using the chi-square or Fisher's exact test and continuous variables were compared using the independent t test or Mann-Whitney U test. Results: In 1451 women, 19 cancers (1.3%) were detected; two (0.1%) were diagnosed at 6 months and 17 (1.2%) were diagnosed after 12.3 months. The malignancy rates were both 1.3% in the screening (9 of 699) and tertiary (10 of 752) centers. In the screening center, all nine cancers were invasive cancers and diagnosed after 12.3 months. In the tertiary center, two were ductal carcinomas in situ and eight were invasive cancers. Two of the invasive cancers were diagnosed at 6 months and the remaining eight cancers newly developed after 13.1 months. Conclusion: One-year follow-up rather than 6-month follow-up may be suitable for BI-RADS 3 lesions on screening US found in screening centers. However, more caution is needed regarding similar findings in tertiary centers where 6-month follow-up may be more appropriate.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.19 no.3
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• pp.171-181
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• 2009

This study was carried out to evaluate a musculoskeletal symptom and the work posture of the nurses in an operating room who have worked in the present department for more than one year. The job analysis of operating room nurses for ergonomic work posture analysis is divided into 14 tasks. On the basis of that, a survey research and ergonomic work posture analysis are also carried out. Among 41 operating room nurses of a cancer center in Kyonggi province who responded to the self-administered questionnaire, 20 nurses were observed and videorecorded to apply Rapid Entire Body Assessment(REBA) to ergonomic work posture analysis from April 16, 2007 to May 18, 2007. The results of analysis are as follows. The prevalence rate of musculoskeletal symptoms was 75.6% and its prevalence rates by part of the body are these followings; lower back and leg/foot 43.9%, shoulder 36.6%, neck 34.1%, hand/wrist/ finger 22.0%, arm/elbow 14.6%. In accordance with the results of ergonomic work posture analysis, 4 tasks that have a REBA score of 8 have high-risk levels and require an immediate management. It shows there is a significant correlation with overall musculoskeletal symptoms and objective workloads that are estimated by REBA. In conclusion, the work conditions of operating room nurses should be improved. It is also necessary that inappropriate work postures and ergonomic work conditions are improved to prevent musculoskeletal disorders of operating room nurses.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.3045-3050
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• 2013

Purpose: Hepatic resection is arguably the preferred treatment for huge hepatocellular carcinoma (H-HCC). Estimating the remnant liver volume is therefore essential. This study aimed to evaluate the feasibility of using computer-assisted volumetric analysis for this purpose. Methods: The study involved 40 patients with H-HCC. Laboratory examinations were conducted, and a contrast CT-scan revealed that 30 cases out of the participating 40 had single-lesion tumors. The remaining 10 had less than three satellite tumors. With the consensus of the team, two physicians conducted computer-assisted 3D segmentation of the liver, tumor, and vessels in each case. Volume was automatically computed from each segmented/labeled anatomical field. To estimate the resection volume, virtual lobectomy was applied to the main tumor. A margin greater than 1 cm was applied to the satellite tumors. Resectability was predicted by computing a ratio of functional liver resection (R) as (Vresected-Vtumor)/(Vtotal-Vtumor) x 100%, applying a threshold of 50% and 60% for cirrhotic and non-cirrhotic cases, respectively. This estimation was then compared with surgical findings. Results: Out of the 22 patients who had undergone hepatectomies, only one had an R that exceeded the threshold. Among the remaining 18 patients with non-resectable H-HCC, 12 had Rs that exceeded the specified ratio and the remaining 6 had Rs that were < 50%. Four of the patients who had Rs less than 50% underwent incomplete surgery due to operative findings of more extensive satellite tumors, vascular invasion, or metastasis. The other two cases did not undergo surgery because of the high risk involved in removing the tumor. Overall, the ratio of functional liver resection for estimating resectability correlated well with the other surgical findings. Conclusion: Efficient pre-operative resectability assessment of H-HCC using computer-assisted volumetric analysis is feasible.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.sup3
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• pp.53-57
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• 2016

Colorectal cancer is one of the most common cancers. Due to demographic changes, it is predicted that the incidence of this cancer will increase. Variations of its incidence rate among geographical areas are due to various contributing factors. Since there have been a lack of studies on this topic in our country, the present assessment of spatial patterns of colorectal cancer incidence in Iran was performed. In this ecological study, the new cases of colon cancer were extracted from Cancer Registry Center report of the Health Deputy of Iran in 2009. The reported incidences of the disease were standardized on the basis of the World Health Organization population and the direct method. Then the data were inserted into the GIS software, and finally, using the analysis of hot spots (Getis-Ord Gi) high-risk areas were drawn. Provinces that are higher or lower than the national average (1.9 SD) were considered hot spots or cold spots, significant at the level of 0.05. A total of 6,210 cases of colorectal cancer were registered in Iran in 2009, of which 3,727 were in men and 2,783 in women (age-standardized rates of 11.3 and 10.9 per 100,000 population, respectively). The results showed that in central and northern Iran including Isfahan, Qom, Tehran, Qazvin and Mazandaran significant hot spots in men were present (p <0.05). In women also we have high incidence in northern and central states: Mazandaran province (p<0.01) and the province of Tehran (p<0.05) had higher incidences than the national average and were apparent as significant hot spots. Analysis of the spatial distribution of colorectal cancer showed significant differences between different areas pointing to the necessity for further epidemiological studies into the etiology and early detection.

• Toxicological Research
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• v.34 no.4
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• pp.291-296
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• 2018

Chemical carcinogenesis is a multistep process. Genotoxic carcinogens, which are DNA-reactive, induce DNA adduct formation and genetic alterations in target cells, thereby generating mutated cells (initiation). Subsequently, preneoplastic lesions appear through clonal proliferation of the mutated cells and transform into tumors (promotion and progression). Many factors may influence these processes in a dose-dependent manner. Therefore, quantitative analysis plays an important role in studies on the carcinogenic threshold of genotoxic carcinogens. Herein, we present data on the relationship between key carcinogenic events and their deriving point of departure (PoD). Their PoDs were also compared to those of the carcinogenesis pathway. In an experiment, the liver of rats exposed to 2-amino-3,8-dimethylimidazo-(4,5-f)quinoxaline (MeIQx) was examined to determine the formation of MeIQx-DNA adducts, generation of mutations at LacI transgene, and induction of preneoplastic glutathione S-transferase placental form (GST-P)-positive foci and tumors (benign and malignant). The PoDs of the above key events in the carcinogenicity of MeIQx were increased as the carcinogenesis advanced; however, these PoDs were lower than those of tumor induction. Thus, the order of key events during tumor induction in the liver was as follows: formation of DNA adducts ${\ll}$ Mutations ${\ll}$ GST-positive foci (preneoplasia) ${\ll}$ Tumor (adenoma and carcinoma). We also obtained similar data on the genotoxic and carcinogenic PoDs of other hepatocarcinogens, such as 2-amino-3,8-dimethylimidazo(4,5-f)quinoline. These results contribute to elucidating the existence of a genotoxic and carcinogenic threshold.

• Journal of the Korean Dietetic Association
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• v.20 no.4
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• pp.285-295
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• 2014

The purpose of this study was to examine changes in nutrient intake in patients at nutritional risk. We included 106 malnourished patients who were admitted to Severance Hospital from March to September 2014. The average age was $59.0{\pm}11.6$ years old and 59 patients were male (59.7%). The majority of diagnosis was cancer (94.3%). We evaluated patients' nutritional status by scored patient-generated subjective global assessment (PG-SGA), anthropometric measurement (height, weight, body composition by Bioelectrical impedance analysis), hand grip strength, biochemical and dietary assessment. The patients' daily intakes of energy and protein ($1,019.5{\pm}706.4kcal$, $40.4{\pm}27.7g$) during hospitalization were significantly lower than their usual intakes ($1,382.0{\pm}499.8kcal$, $54.4{\pm}25.1g$, P<0.001). Serum levels of albumin, cholesterol, and total lymphocytes were significantly reduced during hospital stay. The negatively influencing factors for reduced dietary intake were anorexia (42.5%), abdominal distention (14.2%), pain (13.2%), and others. The results of this study could be used to establish baseline data for developing new strategies for nutritional intervention in malnourished patients.

• Journal of Environmental Health Sciences
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• v.40 no.3
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• pp.178-186
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• 2014

Background: This study was conducted to assess health risks in regard to exposure by children to volatile organic compounds (VOCs) in children's products. Methods: Ten VOCs were measured by head-space gas chromatography in children's products, including toys, oil pastels, sign pens, furniture, ball pools, and playmats. We estimated the average daily dose (ADD) via inhalation during the use of these children's products and calculated hazard quotient (HQ) by dividing ADD by reference dose of VOCs. Results: Among the measured VOCs, five compounds were identified in children's products: benzene, ethylbenzene, styrene, toluene, and xylene. The detection rates of VOCs in toys, ball pools, furniture, playmats, sign pens, and oil pastels were 85%, 100%, 100%, 30%, 100%, and 60%, respectively. The maximum levels of VOCs were 0.18 mg benzene/kg in toys, 5.92 mg toluene/kg in playmats, 10.37 mg ethylbenzene/kg in ball pools, 24.85 mg xylene/kg in toys, and 118.29 mg styrene/kg in ball pools. From exposure levels of VOCs in the children's products HQs were calculated within a range of $5.71{\times}10^{-10}$ to $4.77{\times}10^{-4}$. The HQ of xylene was the highest for children aged 0-6 playing on the playmats. However, the HQ via inhalation exposure to VOCs in individual products did not exceed 1.00. Conclusion: Based on the results, it was concluded that the use of these children's products do not pose health risks to children.

• Journal of Environmental Health Sciences
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• v.49 no.4
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• pp.218-227
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• 2023

Background: Since 2019, the Ministry of Environment has implemented a seasonal fine dust management system from December to March, targeting high PM_2.5 levels with the aim of reducing PM_2.5 concentrations and protecting public health. The focus of improving the seasonal management system lies in the atmospheric PM_2.5 levels. Considering the primary goal of protecting public health, it is necessary to analyze the policy effects from an exposure perspective rather than a concentration-based approach. Objectives: This study aims to quantitatively assess the improvement of indoor PM_2.5 levels and the health impacts of the seasonal management system by comparing the periods before and during its implementation in residential environments. Methods: PM_2.5 concentrations within residential environments in a metropolitan area were measured using an optical particle counter (IAQ-C7, K-weather, Ltd, Korea) at one-minute intervals during the pre-implementation period (November 21~25, 2022) and during the implementation period (December 19~23, 2022). Based on the measured PM_2.5 concentrations, a quantitative evaluation of cancer and mortality risks was conducted according to age and gender. Results: The results of comparing indoor and outdoor PM_2.5 concentrations before and during the implementation of the seasonal management system showed a decrease of approximately 56.6% and 47.9%, respectively. Health risk assessments revealed that both the safety-limit-based and safety-target-based Hazard Quotients (HQ) exceeded the threshold of 0.1 for children under 19 years of age, both before and after the implementation. The mortality risk decreased by approximately 47.9% after the implementation, with children aged 0-9 showing the highest mortality risk at 0.9%. Conclusions: The findings of this study confirmed the positive health impacts of the seasonal management system across all age groups, particularly children under 19 who are more vulnerable to fine dust exposure.