• Asian Pacific Journal of Cancer Prevention
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• 제16권13호
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• pp.5289-5296
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• 2015

Background: Despite the decreased incidence, gastric cancer is still a frequent cause of cancer related death. The 1st line 2 or 3 drugs regimen is still a debatable issue. HER2 targeted therapy has emerged as the standard of care, but it is unavailable in the Brazilian Public Health System. The end-point of this trial was overall survival (OS) in patients with metastatic gastric cancer treated in a public university hospital in Brazil. The secondary end-points were efficacy and safety of regimens with 2 (F+P) or 3 (EOX) drugs to develop an institutional guideline to facilitate optimal treatments. Materials and Methods: In this retrospective study, 1st line regimens were evaluated for OS and PFS stratified by age and ECOG using Cox regression. Results: 47 patients were treated over the last 3 years. In 1st line, 29 were treated with F+P (mean 59.3 years, 34.5% ECOG 2 and a mean of 5.69 cycles) and 16 with EOX (mean 47 years, 18.8% ECOG 2 and a mean of 5.44 cycles). The median OS was 13.8 months (95%CI 10.7-16.9). Response was evaluated in 40 cases and was 64.3% for EOX and 37.5% for F+P (p=0.25). The median PFS was 9.5 months for EOX and 5.6 months for F+P (HR 0.85, 95%CI 0.41-1.74). However, among patients with ECOG 2 mPFS was 3.70 vs 5.40 months, respectively (p=0.86). Regimens showed similar manageable adverse events. A total of 34 patients suffered progression and 14 received $2^{nd}$ line therapy. Diffuse histology (HR 1.89, 95%CI 1.22-2.88), achieving 2nd line (HR: 0.25, 95%CI 0.11-0.58) and treatment response (HR 0.23, 95%CI 0.12-0.47) were OS prognostic factors. Conclusions: Patients treated in our hospital had outcomes compatible with the literature. The regimen choice should be related to patient features. Second line treatment should be considered.

• Asian Pacific Journal of Cancer Prevention
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• 제15권20호
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• pp.8871-8876
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• 2014

Background: Postoperative chemoradiotherapy (CRT) of gastric carcinoma improves survival among high-risk patients. This study was undertaken to analyse long-term survival probability and the impact of certain covariates on the survival outcome in affected individuals. Materials and Methods: Between January 2000 and December 2005, 244 patients with gastric cancer underwent adjuvant radiotherapy (RT) in our institution. Data were retrieved retrospectively from patient files and analysed with SPSS version 21.0. Results: A total of 244 cases, with a male to female ratio of 2.2:1, were enrolled in the study. The median age of the patients was 52 years (range, 20-78 years). Surgical margin status was positive or close in 72 (33%) out of 220 patients. Postoperative adjuvant RT dose was 46 Gy. Median follow-up was 99 months (range, 79-132 months) and 23 months (range, 2-155 months) for surviving patients and all patients, respectively. Actuarial overall survival (OS) probability for 1-, 3-, 5- and 10-year was 79%, 37%, 24% and 16%, respectively. Actuarial progression free survival (PFS) probability was 69%, 34%, 23% and 16% in the same consecutive order. AJCC Stage I-II disease, subtotal gastrectomy and adjuvant CRT were significantly associated with improved OS and PFS in multivariate analyses. Surgical margin status or lymph node dissection type were not prognostic for survival. Conclusions: Postoperative CRT should be considered for all patients with high risk of recurrence after gastrectomy. Beside well-known prognostic factors such as stage, lymph node status and concurrent chemotherapy, the type of gastrectomy was an important prognostic factor in our series. With our findings we add to the discussion on the definition of required surgical margin for subtotal gastrectomy. We consider that our observations in gastric cancer patients in our clinic can be useful in the future randomised trials to point the way to improved outcomes.

• Radiation Oncology Journal
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• 제31권3호
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• pp.155-161
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• 2013

Purpose: To evaluate the treatment outcomes of preoperative versus postoperative concurrent chemoradiotherapy (CRT) on locally advanced rectal cancer. Materials and Methods: Medical data of 114 patients with locally advanced rectal cancer treated with CRT preoperatively (54 patients) or postoperatively (60 patients) from June 2003 to April 2011 was analyzed retrospectively. 5-Fluorouracil (5-FU) or a precursor of 5-FU-based concurrent CRT (median, 50.4 Gy) and total mesorectal excision were conducted for all patients. The median follow-up duration was 43 months (range, 16 to 118 months). The primary end point was disease-free survival (DFS). The secondary end points were overall survival (OS), locoregional control, toxicity, and sphincter preservation rate. Results: The 5-year DFS rate was 72.1% and 48.6% for the preoperative and postoperative CRT group, respectively (p = 0.05, the univariate analysis; p = 0.10, the multivariate analysis). The 5-year OS rate was not significantly different between the groups (76.2% vs. 69.0%, p = 0.23). The 5-year locoregional control rate was 85.2% and 84.7% for the preoperative and postoperative CRT groups (p = 0.98). The sphincter preservation rate of low-lying tumor showed significant difference between both groups (58.1% vs. 25.0%, p = 0.02). Pathologic tumor and nodal down-classification occurred after the preoperative CRT (53.7% and 77.8%, both p < 0.001). Acute and chronic toxicities were not significantly different between both groups (p=0.10 and p = 0.62, respectively). Conclusion: The results confirm that preoperative CRT can be advantageous for improving down-classification rate and the sphincter preservation rate of low-lying tumor in rectal cancer.

• 대한수의학회지
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• 제49권2호
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• pp.149-155
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• 2009

The objective of this study was to analyze data from the planned national serological monitoring program for Aujeszky's disease (AD) using a simulation model to evaluate probable outcomes expected in the sample derived from the simulated herds at predefined within-herd prevalence and herd prevalence. Additionally, prevalence at animal- and herd-level estimated by the stochastic simulation model based on the distributions of the proportion of infected herds and test-positive animals was compared with those of data from a national serological survey in 2006, in which 106,762 fattening pigs from 5,325 herds were tested for AD using a commercial ELISA kit. A fixed value of 95% was used for test sensitivity, and the specificity was modeled with a minimum, most likely and maximum of 95, 97 and 99%, respectively. The within-herd prevalence and herd prevalence was modeled using Pert and Triang distributions, respectively with a minimum, most likely and maximum point values. In all calculations, population size of 1,000 was used due to lack of representative information. The mean number of infected herds and true test-positives was estimated to be 27 herds (median = 25; 95% percentile 44) and 214 pigs (median = 196; 95% percentile 423), respectively. When testing 20 pigs (mean of 2006 survey) in each herd, there was a 3.3% probability that the potential for false-positive reactions due to less than 100% specificity of the ELISA test would be detected. It was found that the model showed prevalence of 0.21% (99% percentile 0.50%) and 0.5% (99% percentile 0.99%) at animal- and herd-level, respectively. These rates were much similar to data from the 2006 survey (0.62% versus 0.83%). The overall mean herd-level sensitivity of the 2006 survey for fattening pigs was 99.9%, with only a 0.2% probability of failing to detect at least one infected herd.

• 한국환경과학회지
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• 제25권10호
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• pp.1349-1368
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• 2016

Concentrations of fine particulate matter ($PM_{2.5}$) and several of its particle constituents measured outside homes in Houston, Texas, and Los Angeles, California, were characterized using multiple regression analysis with proximity to point and mobile sources and meteorological factors as the independent variables. $PM_{2.5}$ mass and the concentrations of organic carbon (OC), elemental carbon (EC), benzo-[a]-pyrene (BaP), perylene (Per), benzo-[g,h,i]-perylene (BghiP), and coronene (Cor) were examined. Negative associations of wind speed with concentrations demonstrated the effect of dilution by high wind speed. Atmospheric stability increase was associated with concentration increase. Petrochemical source proximity was included in the EC model in Houston. Area source proximity was not selected for any of the $PM_{2.5}$ constituents' regression models. When the median values of the meteorological factors were used and the proximity to sources varied, the air concentrations calculated using the models for the eleven $PM_{2.5}$ constituents outside the homes closest to influential highways were 1.5-15.8 fold higher than those outside homes furthest from the highway emission sources. When the median distance to the sources was used in the models, the concentrations of the $PM_{2.5}$ constituents varied 2 to 82 fold, as the meteorological conditions varied over the observed range. We found different relationships between the two urban areas, illustrating the unique nature of urban sources and suggesting that localized sources need to be evaluated carefully to understand their potential contributions to $PM_{2.5}$ mass and its particle constituents concentrations near residences, which influence baseline indoor air concentrations and personal exposures. The results of this study could assist in the appropriate design of monitoring networks for community-level sampling and help improve the accuracy of exposure models linking emission sources with estimated pollutant concentrations at the residential level.

• Korean Journal of Acupuncture
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• 제29권1호
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• pp.83-92
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• 2012

Objectives : The purpose of this research was to develop the magnetic acupuncture system which used solenoid coil for magnetizing acupuncture needle. The system could generate the meridian electric potential (MEP) similar to the potential by manual acupuncture. Thus, we tried to confirm the therapeutic effect that is caused by the MEP generation. Methods : To confirm the MEP, we stimulated the magnetic acupuncture with at 2Hz, $92.7{\pm}2mT$, PEMFs (Pulsed Electro-Magnetic Fields) at ST37 and measured the evoked potential between ST36 and ST41. Also, we conducted a fatigue recovery test using isokinetic exercise in order to identify the therapeutic effect on musculoskeletal disorders. We chose LR9 as a stimulation point. To observe the state of fatigue, we measured the EMG and analyzed median frequency and peak torque for 20minutes. Results : We observed that MEP which incurred from magnetic acupuncture was higher than he reported MEP induced by manual acupuncture. Moreover, its modes were divided into two types by the direction of magnetic flux. When generating magnetic flux in the direction of acupoint, the positive peak voltage of the MEP was generated. In contrast, negative peak voltage of the MEP was generated whenever meganetic flux generated in the outward direction. As a result of fatigue recovery, the median frequency (MF) of the magnetic acupuncture group were recovered faster than that of the non-stimulation group. However, the peak torques of both groups were not restored until after 20 minutes. Conclusions : We confirmed that the magnetic acupuncture system can lead to the MEP similar to manual acupuncture. Moreover, the MEP had a therapeutic effect on the musculoskeletal disorders.

• Journal of Microbiology and Biotechnology
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• 제31권3호
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• pp.380-386
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• 2021

The coronavirus disease 2019 (COVID-19) pandemic has become a public health emergency of global concern. In China, traditional Chinese medicine has been widely administered to COVID-19 patients without sufficient evidence. To evaluate the efficacy of Shenhuang Granule (SHG) for treating critically ill patients with COVID-19, we included in this study 118 patients who were admitted to the ICU of Tongji Hospital between January 28, 2020 and March 28, 2020. Among these patients, 33 (27.9%) received standard care plus SHG (treatment group) and 85 (72.1%) received standard care alone (control group). Enrolled patients had a median (IQR) age of 68 (57-75) years, and most (79 [67.1%]) were men. At end point of this study, 83 (70.3%) had died in ICU, 29 (24.5%) had been discharged from ICU, and 6 patients (5.2%) were still in ICU. Compared with control group, mortality was significantly lower in treatment group (45.4% vs. 80%, p < .001). Patients in treatment group were less likely to develop acute respiratory distress syndrome (ARDS) (12 [36.3%] vs. 54 [63.5%], p = 0.012) and cardiac injury (5 [15.1%] vs. 32 [37.6%], p = 0.026), and less likely to receive mechanical ventilation (22 [66.7%] vs. 72 [84.7%], p = 0.028) than those in control group. The median time from ICU admission to discharge was shorter in treatment group (32 [20-73] days vs. 76 [63-79] days, p = 0.0074). These findings suggest that SHG treatment as a complementary therapy might be effective for critically ill adults with COVID-19 and warrant further clinical trials.

• Nutrition Research and Practice
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• 제16권5호
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• pp.604-615
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• 2022

BACKGROUND/OBJECTIVES: This study aimed to investigate cancer-specific survival (CSS) and associated risk factors in elderly gastric cancer (EGC) patients. SUBJECTS/METHODS: EGC patients (≥ 70 yrs) who underwent curative gastrectomy between January 2013 and December 2017 at our hospital were included. Clinicopathologic characteristics and survival data were collected. Receiver operating characteristic (ROC) analysis was used to extract the best cutoff point for body mass index (BMI). A Cox proportional hazards model was used to determine the risk factors for CSS. RESULTS: In total, 290 EGC patients were included, with a median age of 74.7 yrs. The median follow-up time was 31 (1-77) mon. The postoperative 1-yr, 3-yr and 5-yr CSS rates were 93.7%, 75.9% and 65.1%, respectively. Univariate analysis revealed risk factors for CSS, including age (hazard ratio [HR] = 1.08; 95% confidence interval [CI], 1.01-1.15), intensive care unit (ICU) admission (HR = 1.73; 95% CI, 1.08-2.79), nutritional risk screening (NRS 2002) score ≥ 5 (HR = 2.33; 95% CI, 1.49-3.75), and preoperative prognostic nutrition index score < 45 (HR = 2.06; 95% CI, 1.27-3.33). The ROC curve showed that the best BMI cutoff value was 20.6 kg/m². Multivariate analysis indicated that a BMI ≤ 20.6 kg/m² (HR = 2.30; 95% CI, 1.36-3.87), ICU admission (HR = 1.97; 95% CI, 1.17-3.30) and TNM stage (stage II: HR = 5.56; 95% CI, 1.59-19.43; stage III: HR = 16.20; 95% CI, 4.99-52.59) were significantly associated with CSS. CONCLUSIONS: Low BMI (≤ 20.6 kg/m²), ICU admission and advanced pathological TNM stages (II and III) are independent risk factors for CSS in EGC patients after curative gastrectomy. Nutrition support, better perioperative management and early diagnosis would be helpful for better survival.

• 암석학회지
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• 제25권2호
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• pp.151-163
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• 2016

거창지역의 쥬라기 화강암에서 발달하는 결의 특성을 분석하였다. 3개 면, 3개 결에 대한 평가는 (1) 미세균열의 간격의 빈도수(N), (2) 총 간격(${\leq}1mm$), (3) 평균 간격($S_{mean}$), (4) 평균 간격과 중앙 간격($S_{median}$) 사이의 차이값($S_{mean}-S_{median}$), (5) 간격의 밀도(${\rho}$), (6) 도표의 전체구간에 대한 두 지수 사이의 차이값(${\lambda}_H-{\lambda}_L$), (7) 지수의 평균값(${\lambda}_M$), (8) 지수의 상수의 평균값($a_M$), (9) 최초 교차점 이하의 구간에 대한 두 지수 사이의 차이값(${\lambda}t_H-{\lambda}t_L$), (10) 지수의 평균값(${\lambda}t_M$) 및 (11) 지수의 상수의 평균값($at_M$)과 같은 파라미터를 이용하여 수행하였다. 3개 결 그리고 3개 면에 대한 파라미터의 값 사이의 상관성 분석의 결과는 다음과 같다. (I) 파라미터(1, 2, 7 및 8) 및 (II) 파라미터(3, 4 및 5)의 값은 (I) H(3번 결, (H1 + H2)/2) < G(2번 결, (G1 + G2)/2) < R(1번 결, (R1 + R2)/2) 및 (II) R < G < H의 순서이다. 반면에 3개 면에 대한 상기 두 그룹(I~II)의 파라미터의 값은 역순을 보여준다. 그 외에도, 3개 면에 대한 파라미터 $6({\lambda}_H-{\lambda}_L)$, 파라미터 $9({\lambda}t_H-{\lambda}t_L)$, 파라미터 $10({\lambda}t_M)$ 및 파라미터 $11(at_M)$의 값은 각각 R(1번 면, (G1 + H2)/2) < H(3번 면, (R2 + G2)/2) < G(2번 면, (R1 + H2)/2), H < G < R, H < R < G 및 R < H < G의 순이다. 3개 결에 대한 상기 네 파라미터의 값은 R < H < G, R < H < G, H < G < R 및 H < G < R의 다양한 순을 각각 보여준다. 한편, 두 방향의 도표 사이의 최초 접촉점 및 교차점에 해당되는 간격값을 도출하였다. 3개 결에 대한 상기 간격값은 1번 결(R1 및 R2) < 2번 결(G1 및 G2) < 3번 결(H1 및 H2)의 순이다. 3개 면에 대한 간격값은 1번 면(G1 및 H1) < 3번 면(R2 및 G2) < 2번 면(R1 및 H2)의 순이다. 특히 3개 결과 3개 면에 대한 교차각은 1번 결 및 1번 면 < 3번 결 및 3번 면 < 2번 결 및 2번 면의 순이다. 따라서, 1번 결(R1 및 R2) 및 1번 면(G1 및 H1)의 두 도표는 보다 높은 접촉점 또는 교차점의 빈도수를 보여준다. 이러한 변화 특성은 3개 면 및 3개 결의 종합도를 통하여 도출하였다. 마지막으로, 분포 형태와 함께 파라미터의 값을 통한 상관성 분석은 3개 채석면의 판별에 유용하다.

• Radiation Oncology Journal
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• 제3권2호
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• pp.95-101
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• 1985

1979년 7월부터 1985년 3철까지 한양대학병원에서 자궁경암의 표준화된 방사선치료기준, 즉 전 골반의 외부방사선조사와 강내조사의 병용요법으로 112명의 환자를 치료하였다. 전원이 추적 가능하였고 $6\~75$개월의 추적기간에 평균은 31개월이었다. 2명이 선암이고 110명은 펀평상피 세포암이었고 $I_b$병기 9명$(8\%)$, $II_a$병기 14명$(12.5\%)$, $II_b$ 병기 50명$(44.6\%)$, III병기 33명 $(29.5\%)$, 그리고 IV병기는 6명 $(5.4\%)$이었다. 연령분포는 30대 10명$(8.9\%)$, 40대, 50대가 다같이 41명$(36.6\%)$씩으로 $73.2\%$이고 60대 이상이 19명 $(17\%)$이며 특수하게 20세미만이 1예 있었다. 방사선치료는 전 골반에 평행대항 조사야로 $180\~200rad$를 주 5회 $4,000\~4,200rad$ 조사하였고 중앙부 4cm를 차폐하고 $600\~l,000rad$를 자궁방결합조직에 추가 조사하였다. 강내조사는 Cs-137 소선원(20mg 라디움당량)을 자궁강내 $2\~3$개 질강내 2개를 TAO Applicator로 삽입하였고 $7\~12$일 간격으로 2회 시행하였다. 치료기간은 평균 52일간이고 $40\~65$일에 걸쳐서 시행되었다. A점에 조사한 방사선량은 $6,820\~10,500rad$로 평균 8,388rad이고 B점에는 $4,850\~6,899rad$로 평균 5,898rad이었다. 생명표 5년 생존율(actuarial 5year survival rate)은 전체로 $61.8\%$이고, $I_b$병기에서 $84.6\%$, $II_a$병기는 $77.8\%$, $II_b$병기는 $56.7\%$, III병기는 $60.6\%$, 그리고 IV 병기는 $33.3\%$이었다. A점의 방사선량이 8,000rad 이상일 때는 7/18$(38.9\%)$의 실패율이었고 이에 비해서 8,000rad이상일 때는 25/94$(26.5\%)$의 실패율이었다. 또 B점 선량으로 보면 6,000rad이하에서 20/63$(34.9\%)$의 실패율에 비하여 6,000rad이상일 때는 10/49$(20.4\%)$의 실패율이었다. 연령 벨로는 $40\~49$세에서 실패율(14/41 $24.1\%$)이 많았다. 본 성적으로 보아서 생존율은 여러 저자들과 큰 차이가 없음을 알 수 있었고 A점 선량은 8,000rad 이상, B점은 6,000rad이상이 조사되어야 적정선량이 됨을 시사해 주고 있다.