• YAKHAK HOEJI
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• v.59 no.6
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• pp.245-250
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• 2015

Middle East respiratory syndrome - coronavirus infection has posed substantial threat to public health with extremely high mortality rate in 2015. Although there are no approved novel medications for coronavirus, several antiviral agents such as ribavirin and interferon have been tried to MERS patients according to the in-vitro inhibitory effect, therapeutic effect on the animal model and experience from the severe acute respiratory syndrome - coronavirus infection. The aim of this study is to evaluate the clinical evidence of the antiviral treatment for MERS-CoV infection. After systematically searching the medical literature databases, I found five studies described the clinical efficacy of antiviral treatment on MERS patients. All of them were about the combination therapy of ribavirin and interferon (IFN). Two of them were retrospective cohort studies with quality of evidence (QOE) II and the others were observational study and case reports with QOE III. As a result of critical appraisal, it is concluded that none of those studies represented confirmatory clinical evidence of the efficacy of ribavirin and interferon combination therapy on MERS patients. Although Omrani et al. represented that ribavirin and IFN treatment had significantly improved survival at 14 days, it was not enough time to conclude the effect.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.1373-1377
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• 2016

Background: We vigorously reviewed patients' operation record who had adhesion of the Denonvilliers' fascia and found out most of these patients had prostatic bleeding after prostatic gland biopsies. We examined the magnitude of prostatic bleeding and frequency after biopsies and the relationship with oncological outcomes. Materials and Methods: A total of 285 patients were selected for the final analyses. Inclusion criteria were as follows: receiving MRI three weeks after biopsiesand laparoscopic radical prostatectomy within 300 days after biopsy. We divided the patients into two groups with (group A) or without (group B) prostatic bleeding. We examined the magnitude of prostatic bleeding after biopsies and the relationship with operation time (OT), positive surgical margin (PSM), biochemical recurrence (BCR) and other factors. Furthermore, we created a logistic-regression model to derive a propensity score for prostatic bleeding after biopsies, which included all patient and hospital characteristics as well as selected interaction terms, and we examined the relationship with PSM and BCR. Results: In all patients, the OT in the group B was shorter than the group A (p < 0.001). Prostatic bleeding was associated with PSM (p=0.000) and BCR (p=0.036). In this propensity-matched cohort, 11 of 116 patients in the group B had PSM as compared with 36 of 116 patients from group A (match-adjusted odds ratio, 4.30; 95%CI confidence interval, 2.06 to 8.96; P=0.000). In addition, eight of 116 patients in group B encountered BCR, as compared with 18 of 116 patients in group A (match-adjusted odds ratio, 2.48; 95%CI, 1.03 to 5.96; P=0.042). Kaplan-Meier analysis in the propensity matching cohort showed a significant biochemical recurrence-free survival advantage for being free of prostate bleeding after biopsies. Conclusions: Our findings in the present cohort should help equip surgeons to pay attention to careful excision especially for those who experienced deferred prostatic bleeding.

• Korean Journal of Radiology
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• v.22 no.12
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• pp.1985-1995
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• 2021

Objective: Although the liver-to-spleen volume ratio (LSVR) based on CT reflects portal hypertension, its prognostic role in cirrhotic patients has not been proven. We evaluated the utility of LSVR, automatically measured from CT images using a deep learning algorithm, as a predictor of hepatic decompensation and transplantation-free survival in patients with hepatitis B viral (HBV)-compensated cirrhosis. Materials and Methods: A deep learning algorithm was used to measure the LSVR in a cohort of 1027 consecutive patients (mean age, 50.5 years; 675 male and 352 female) with HBV-compensated cirrhosis who underwent liver CT (2007-2010). Associations of LSVR with hepatic decompensation and transplantation-free survival were evaluated using multivariable Cox proportional hazards and competing risk analyses, accounting for either the Child-Pugh score (CPS) or Model for End Stage Liver Disease (MELD) score and other variables. The risk of the liver-related events was estimated using Kaplan-Meier analysis and the Aalen-Johansen estimator. Results: After adjustment for either CPS or MELD and other variables, LSVR was identified as a significant independent predictor of hepatic decompensation (hazard ratio for LSVR increase by 1, 0.71 and 0.68 for CPS and MELD models, respectively; p < 0.001) and transplantation-free survival (hazard ratio for LSVR increase by 1, 0.8 and 0.77, respectively; p < 0.001). Patients with an LSVR of < 2.9 (n = 381) had significantly higher 3-year risks of hepatic decompensation (16.7% vs. 2.5%, p < 0.001) and liver-related death or transplantation (10.0% vs. 1.1%, p < 0.001) than those with an LSVR ≥ 2.9 (n = 646). When patients were stratified according to CPS (Child-Pugh A vs. B-C) and MELD (< 10 vs. ≥ 10), an LSVR of < 2.9 was still associated with a higher risk of liver-related events than an LSVR of ≥ 2.9 for all Child-Pugh (p ≤ 0.045) and MELD (p ≤ 0.009) stratifications. Conclusion: The LSVR measured on CT can predict hepatic decompensation and transplantation-free survival in patients with HBV-compensated cirrhosis.

• Annals of Occupational and Environmental Medicine
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• v.34
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• pp.40.1-40.9
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• 2022

Background: According to the occupational accident status analysis in 2020, of 1,180 occupational deaths, 463 were caused by cardiovascular disease (CVD). Workers should be assessed for CVD risk at regular intervals to prevent work-related CVD in accordance with the rules on occupational safety and health standards. However, no previous study has addressed risk and mortality. Therefore, this longitudinal study was conducted to evaluate the relationship between 10-year cardiovascular risk of the general health checkup and mortality. Methods: The study included 545,859 participants who visited Kangbuk Samsung Total Healthcare Centers from January 1, 2002, to December 31, 2017. We performed 10-year cardiovascular risk assessment for the participants and the risk was divided into 4 groups (low, moderate, high, and very high). The study used death data from the Korea National Statistical Office for survival status as an outcome variable by December 31, 2019, and the cause of death based on the International Classification of Diseases, 10^th Revision (ICD-10) was identified. Statistical analysis was performed using Cox proportional hazards regression analysis, and the sum of the periods from the first visit to the date of death or December 31, 2019, was used as a time scale. We also performed a stratified analysis for age at baseline and sex. Results: During 5,253,627.9 person-years, 4,738 overall deaths and 654 cardiovascular deaths occurred. When the low-risk group was set as a reference, in the multivariable-adjusted model, the hazard ratios (HRs) (95% confidence interval [CI]) for overall mortality were 3.36 (2.87-3.95) in the moderate-risk group, 11.08 (9.27-13.25) in the high-risk group, and 21.20 (17.42-25.79) in the very-high-risk group, all of which were statistically significant. In cardiovascular deaths, the difference according to the risk classification was more pronounced. The HRs (95% CI) were 8.57 (4.95-14.83), 38.95 (21.77-69.69), and 78.81 (42.62-145.71) in each group. As a result of a subgroup analysis by age and sex, the HRs of all-cause mortality and cardiovascular mortality tended to be higher in the high-risk group. Conclusions: This large-scale longitudinal study confirmed that the risk of death increases with the 10-year cardiovascular risk of general health checkup.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.13
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• pp.5537-5540
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• 2015

Purpose: To research the association between pre-treatment elevated platelet count and clinicopathologic characteristics in breast cancer (BC), as well as explore the relationship between pre-treatment elevated platelet count and HER2 status and prognosis of BC patients. Materials and Methods: A retrospective cohort of BC patients who were newly diagnosed or treated by surgery only and had pathological detection results and platelet values in the Department of Oncology, the First Affiliated Hospital of Liaoning Medical College were enrolled from 1/1/2008 until 31/12/2009, and followed up until 31/12/2014. Age, thrombocyte parameters before chemotherapy and/or radiotherapy, immunohistochemical (IHM) indexes, and regional lymph node (LN) involvement and progression-free survival (PFS) were recorded. Results: A total of 447 eligible subjects were included in this research. As we analyzed, for HER2, positive and negative, the incidence rates of elevated platelet count were 25.8% and 14.7% (P<0.05). In the Cox proportional hazards model both variables were independent risk factors for BC (for HER2, OR, 0.592, 95% confidence interval, CI, 0.355 to 0.985, P=0.044;f or PLT, OR, 0.998, 95% CI, 0.996 to 1.000, P=0.042). For ER, PR, Ki67 and LN involvement, the differences were not statistically significant (P>0.05). Conclusions: In this research, pre-treatment elevated level of platelet count demostrated a significantrelationship with HER2 amplification/overexpression, and both variables significantly influenced the prognosis of BC. However, elevated platelet count did not exhibit any association with ER, PR, Ki67 and LN involvement.

• Korean Journal of Radiology
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• v.22 no.2
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• pp.233-242
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• 2021

Objective: To evaluate the association of MRI features with the major genomic profiles and prognosis of World Health Organization grade III (G3) gliomas compared with those of glioblastomas (GBMs). Materials and Methods: We enrolled 76 G3 glioma and 155 GBM patients with pathologically confirmed disease who had pretreatment brain MRI and major genetic information of tumors. Qualitative and quantitative imaging features, including volumetrics and histogram parameters, such as normalized cerebral blood volume (nCBV), cerebral blood flow (nCBF), and apparent diffusion coefficient (nADC) were evaluated. The G3 gliomas were divided into three groups for the analysis: with this isocitrate dehydrogenase (IDH)-mutation, IDH mutation and a chromosome arm 1p/19q-codeleted (IDHmut1p/19qdel), IDH mutation, 1p/19q-nondeleted (IDHmut1p/19qnondel), and IDH wildtype (IDHwt). A prediction model for the genetic profiles of G3 gliomas was developed and validated on a separate cohort. Both the quantitative and qualitative imaging parameters and progression-free survival (PFS) of G3 gliomas were compared and survival analysis was performed. Moreover, the imaging parameters and PFS between IDHwt G3 gliomas and GBMs were compared. Results: IDHmut G3 gliomas showed a larger volume (p = 0.017), lower nCBF (p = 0.048), and higher nADC (p = 0.007) than IDHwt. Between the IDHmut tumors, IDHmut1p/19qdel G3 gliomas had higher nCBV (p = 0.024) and lower nADC (p = 0.002) than IDHmut1p/19qnondel G3 gliomas. Moreover, IDHmut1p/19qdel tumors had the best prognosis and IDHwt tumors had the worst prognosis among G3 gliomas (p < 0.001). PFS was significantly associated with the 95th percentile values of nCBV and nCBF in G3 gliomas. There was no significant difference in neither PFS nor imaging features between IDHwt G3 gliomas and IDHwt GBMs. Conclusion: We found significant differences in MRI features, including volumetrics, CBV, and ADC, in G3 gliomas, according to IDH mutation and 1p/19q codeletion status, which can be utilized for the prediction of genomic profiles and the prognosis of G3 glioma patients. The MRI signatures and prognosis of IDHwt G3 gliomas tend to follow those of IDHwt GBMs.

• Korean Journal of Social Welfare
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• v.68 no.2
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• pp.107-130
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• 2016

This study is aimed at the exploratory research on the influence of the obligation of extension of the retirement age on the baby boom generation. The basic question of this study is about which of the baby boom generation can get how much benefit according as the extension of the retirement age becomes compulsory. The extension of the retirement age is the system that can be applied to regular full-time workers. Accordingly, this study is intending to analyze the characteristics of the workers having a high likelihood for benefits from extension of the retirement age by tracing the economic activity state and labor history of the baby boomers. For this purpose, this study looked into the change of the economic activity state by age cohort of the male baby boomers based on the data for the Korea Labor Panel's 4th(2001) & 17th(2014)year. Using Survival analysis, this study also analyzed who will continue to remain as a regular full-time wage earner. As the result of the analysis, it was found that the more the cohort ages of baby boomers increased, the smaller the probability of remaining as a regular full-time wage earner, and the group who can get benefits from extension of the retirement age was predicted to account for only 11.4% level among the baby boomers. In addition, the result showed that there was a high likelihood of getting more benefits from extension of the retirement age when the baby boomers worked for the government-invested institution, corporate bodies, and government organizations rather than working for private enterprises. Thus, it can be safely said that there might appear a generational conflict due to extension of the retirement age in that such jobs coincide with the ones favored by the rising generation.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.4
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• pp.1811-1815
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• 2014

Background: In clinical trials with no upper age limit, the proportion of older patients is usually small, probably reflecting the more conservative approach adopted by clinicians when treating the elderly. An exploratory analysis of elderly patients in the RECORD-1 Trial showed that patients ${\geq}$ 65 y.o. had superior median PFS than overall RECORD-1 population (5.4 months and 4.9 months, respectively). We investigated the efficacy, relative benefit and safety of Everolimus (EVE) as sequential therapy after failure of VEGFr-TKI therapy for older patients with metastatic renal cell cancer (mRCC), in daily practice. Materials and Methods: 172 consecutive IRB approved patients with mRCC (median age 65, M:F 135/37, 78% clear cell) who received salvage EVE at 39 tertiary institutions between October 2009 and August 2011 were included in this analysis. Some 31% had progressed on sunitinib, 22% on sorafenib, 1% on axitinib, 41% on sequential therapy, and 5% had received other therapy. Patients with brain metastases were not included and 95% of the patients had a ECOG (Eastern Cooperative Oncology Group) performance status (PS) of 0 or 1. Previous radiotherapy was an exclusion criterion, but prior chemotherapy was permitted. Adequate organ function and hematologic parameters were mandatory. EVE administration was approved by the institutional review board at each participating institution and signed informed consent was obtained from all patients. Results: Median time of the whole cohort to last follow-up was 3.5 months (range 0.4-15.2 months). Forty four percent were continuing to take EVE at last followup. There were 86 (50%) patients ${\geq}$ 65 y.o. and 86 (50%) <65 y.o. The percentage of patients who showed PR/SD was higher in the older group than in the younger one (5.9%/61.2% vs 1.2%/46.5%, respectively). Median survival of older patients was also significantly longer (3.5 +/- 0.31 vs 3.1 +/- 0.34, hazard ratio=0.45, CI; 0.255-0.802). Analysis using Cox regression model adjusted for gender, PS, number of metastases, site of metastases, histology, smoking history and age detected an association between age and PFS (p=0.011). The frequency of adverse events in elderly patients treated with EVE was no greater than that in younger patients, although such toxicity may have had a greater impact on their quality of life. Conclusions: Older patients should not generally be excluded from accepted therapies (mTOR inhibitors after failure of VEGFr-TKI therapy) for mRCC.