Background: This study investigated the survival benefit of radiotherapy (RT) of the supra- and infraclavicular lymphatic drainage area in Chinese women with T1-2N1M0 breast cancer receiving mastectomy. Methods: A total of 593 cases were retrospectively reviewed from 1998 to 2007. The relationship between supra- or infraclavicular fossa relapse (SCFR) and post-operative RT at the supra-/infraclavicular lymphatic drainage area was evaluated. Results: The majority of patients (532/593; 89. 8%) received no RT while 61 patients received RT. The median follow-up was 85 months. Among patients without RT, 54 (10. 2%) developed recurrence in the chest wall or ipsilateral SCFR. However, none of the 61 patients who underwent RT demonstrated SCFR. One patient who received RT (1. 6%) experienced recurrence in the chest wall. Univariate analysis revealed that age and molecular subtype (both P < 0. 05) were two prognostic factors related to supraclavicular and infraclavicular fossa relapse-free survival (SFRFS). Multivariate analysis revealed that only Her-2 positive status (P = 0. 011) was an independent predictor of SFRFS. RT had no influence on distant metastasis (P = 0. 328) or overall survival (P = 0. 541). SCFR significantly affected probability of distant metastasis (P < 0. 001) and overall survival (P < 0. 001). Conclusion: Although RT was not significantly associated with SFRFS, postoperative RT was significantly associated with a lower locoregional (i. e., supraclavicular/infraclavicular and chest wall) recurrence rate. SCFR significantly influenced distant metastasis-free survival, which significantly influenced the overall survival of T1-2N1M0 breast cancer patients after mastectomy. Thus, prophylactic RT is recommended in T1-2N1M0 breast cancer patients, especially those who have Her-2 positive lesions.
Background: Pervious studies suggested occupational workers exposure to pentachlorophenol (PCP) might contribute to increased risk of cancer. However, few studies have focused on associations between PCP and cancer risk at the community level. Objective: The present study was to explore the cancer risk for the community population living long-term in a PCP contaminated area. Methods: All the cancer cases diagnosed in 2009-2011 in Tongling City were collected. The cancer patients' residencies were geo-referenced in each district. The historical PCP usage for each district of Tongling was calculated as the PCP pollution index, which was further used to divide into PCP exposure categories. Standardized rate ratios (SRRs) of cancer incidence were applied to detect the cancer risk as exposure grade elevated. Correlation analysis was performed to analyze the relationship between PCP pollution and cancer incidence. Results: A total of 5,288 cancer cases (3,451 male and 1,837 female) were identified. PCP usage was correlated with the incidence of leukemia (r=0.88, P=0.002) for males, and with cancer of the esophagus for males (r=0.83, P=0.008) and females (r=0.71, P=0.020). Compared with the low exposure category, significant SRRs for total cancer sites was obtained for high PCP exposure category (SRR=1.61, 95%CI=1.59-1.62). Most SRR values of the cancer sites were significantly increased as exposure grade elevated and exposure time extended. Conclusion: The present study found that community residents living in the PCP contaminated area had increased risk of cancers. Leukemias, lymphomas and nasopharyngeal and esophageal cancers are most possibly associated with PCP exposure.
Kim, Ji-Youn;Kim, Soung-Min;Myoung, Hoon;Hwang, Soon-Jung;Seo, Byoung-Moo;Lee, Jong-Ho;Choung, Pill-Hoon;Kim, Myung-Jin;Choi, Jin-Young
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.37
no.1
/
pp.81-85
/
2011
The uvulopalatal flap (UPF) technique is a modification of uvulopalatopharyngoplasty (UPPP) for the surgical treatment of obstructive sleep apnea. In the UPF technique, an uvulopalatal flap is fabricated and sutured to the residual mucosa of the soft palate to expand the antero-posterior dimensions of the oropharyngeal inlet. In the extended uvulopalatal flap (EUPF) technique, an incision at the tonsillar fossa is added to the classical UPF technique followed by the removal of mucosa and submucosal adipose tissue for additional expansion of the lateral dimension. The EUPF technique is more conservative and reversible than UPPP. Therefore, complications, such as velopharyngeal insufficiency, dysphagia, dryness, nasopharyngeal stenosis and postoperative pain, are reduced. In the following case report, the patient was diagnosed with obstructive sleep apnea and treated with the EUPF technique. The patient's total respiratory disturbance events per hour (RDI) was decreased to 15.4, the $O_2$ saturation during the sleep was increased, and the excessive daytime sleepiness had disappeared after the surgery without complications. The authors report this case with a review of the relevant literature.
Jung, Seungwon;Lee, Joon Hee;Kang, Jin Han;Lee, Hak Sung;Choi, Jae Won;Ma, Sang Hyuk;Lee, Jaywon
Pediatric Infection and Vaccine
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v.24
no.1
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pp.23-30
/
2017
Purpose: The objective of this study was to compare the clinical characteristics of influenza A and B infections and analyze the effect of oseltamivir in hospitalized children. Methods: We investigated children under the age of 15, who were diagnosed with influenza A/H1N1, A/H3N2, or B from January to April 2014. The subjects were admitted to the Changwon Fatima Hospital and diagnosed using a rapid antigen test from nasopharyngeal swabs. The medical records of the patients were retrospectively reviewed. Results: A total of 302 pediatric patients with influenza were enrolled. Influenza B infection was the most common type (n=187, 61.9%), followed by A/H3N2 (n=100, 33.1%) and A/H1N1 (n=15, 5.0%). Compared to patients diagnosed with influenza A, patients diagnosed with influenza B were older (P=0.005), and the duration of fever was significantly longer (P=0.001). A total of 161 patients (53.3%) had been vaccinated against influenza during the season, before admission. Among the patients infected with A/H3N2 and B, the duration of fever was shorter in oseltamivir recipients compared to oseltamivir non-recipients (P=0.026 and P=0.004, respectively). Conclusions: There were significant differences between influenza A and B groups in terms of age, demographics, and clinical course. Although the effectiveness of oseltamivir on influenza differs according to the type of influenza, our data provides evidence that oseltamivir is beneficial for both A and B infections.
Yang, Mi Hwa;Park, Chan Sook;Yoon, So Young;Kim, Jae Youn;Ahn, Don Hee
Pediatric Infection and Vaccine
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v.9
no.2
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pp.201-207
/
2002
Purpose : We analyzed clinical features and causal viruses of acute lower respiratory tract infections(LRTIs) in order to improve the management of these infections. Methods : From end of April to early May 2001, amongst 30 children at a local institute for children's adoption and welfare, 13 were admitted to the hospital with the diagnostic impression of acute LRTIs. Nasopharyngeal aspirates were sent in Seoul National University Hospital for viral culture of respiratory syncytial virus(RSV), adenovirus, parainfluenza virus. Results : One or more viral agents were identified in 4 cases(30.7%) : were RSV(15.4%), adenovirus(7.7%), and a mix of these two viruses(7.7%). Initial symptoms were fever(69%), cough(100%), tachypnea(54%), chest retraction(69%), rale(85%) and wheezing(15%). Leukocytosis was noted in 23%, CRP increased more than 10 mg/L in 46%. Chest X-ray abnormalities were 69%. Conclusion : Although viruses were identified in 30.7%, further studies should be made for prevention and treatment of acute viral LRTIs.
Purpose : Adenoviruses(Ad) have been shown to play an important role in the etiology of severely acute respiratory diseases, particulary in infants and young children, and the occurrence of fatal outcome and chronic pulmonary sequelae in association with adenoviral infection has been a cause of great interest and concern. This report presents the resul of a retrospective analysis on 30 cases of lower respiratory infection from which adenovirus was isolated. Patients & Methods : The 30 patients in this study represent all detected cases of adenovial infection out of 240 children who were admitted to Sang Sung Medical Center between February to June 1996 showing signs and symptoms of lower respiratory tract infection. The diagnosis of adenovirus infection was based on microscopic visualization of typical cytopathic effect in HEp-2 tissue culture and used monoclonal Ab with nasopharyngeal aspiration. Results : The male/female ratio was 2:1 and the majority of age range was below 36months. Clinical diagnoses in all 30 patients were pneumonia(n=21), bronchitis and Bronchiolitis(n=5) and ARDS(n=4). We recieved the most of patients in the month of May. The chief complaints were fever(93.3%) and cough(80%) and extrapulmonary symptoms were diarrhea(n=5), seizure(n=4), abdominal pain(n=1). The mean duration of fever was $11.95{\pm}6.54$days. Physical examination on admission were crackles(73.3%), coarse breathing sounds(60%), hepatosplenomegaly(33.3%), decreased brething sounds(30%). In WBC counts, 8cases were below $4000/mm^3$ and 14 cases were above $10,000/mm^3$. In platelets counts, 4cases were below $150,000/mm^3$ and 10 cases were above $450,000/mm^3$. 21 cases were above 1 in CRP. GOT and GPT were abnormal in some cases. Chest X-ray revealed diffuse pulmonary infiltration(n=15), pleural effusion(n=6), consolidation(n=4) and hyperaeration(n=3). Seven patients were treated at the peditric intensive care unit with respiratory support and high dose of gammaglobulin. However, one patients died even through he was treated with NO ventilation and high frequency ventilation. Conclusion : Those with adenoviral pneumonia and respiratory infection having long fever duration and symptoms like bacterial pneumonia must be carefully differentiated in order to provide proper treatement and preventive measures due to possible fatal outcome.
Ahn, Jong Gyun;Choi, Seong Yeol;Kim, Dong Soo;Kim, Ki Hwan
Pediatric Infection and Vaccine
/
v.19
no.2
/
pp.71-78
/
2012
Purpose: Human bocavirus (hBoV), a recently discovered virus, has been detected in children with respiratory tract infections worldwide. The aim of this study was to analyze the frequency and molecular phylogeny of hBoV in the respiratory samples of children with acute respiratory tract infections in 2010. Methods: Nasopharyngeal samples were collected from 953 children with lower respiratory tract infections at Severance children's hospital in Korea from January 2010 to December 2010. We applied the multiplex PCR technique for the identification of 12 respiratory viruses from the samples. Among the total specimens, hBoV positive samples were subjected to phylogenetic analysis by sequencing a fragment of the VP1/VP2 gene junction. Results: hBoV was detected in 141 (14.8%) among 953 patients. The 61.7% of hBoV-positive samples were found to co-exist with other respiratory viruses. The results of phylogenetic analysis showed that all 141 hBoV-positive isolates were identified as hBoV 1, revealing a high similarity among the isolates (>98%). Conclusion: hBoV 1 with minimal sequence variations circulated in children with acute respiratory infections during 2010. More research is needed to determine the clinical severity and outcomes of the minimal sequence variations.
The relationship between past liver disease history and the risk of primary liver cancer was analyzed in a hospital-based case-control study conducted in Seoul on 165 patients with histologically or serologically confirmed hepatocellular carcinoma and individually age- and sex-matched 165 controls in hospital for ophthalmologic, otologic, or nasopharyngeal problems. Significant association were observed for liver deseases occurring 5 or more years before liver cancer diagnosis [OR,4.9;95% confidence interval (CI), $1.6{\sim}14.0$) and family history of liver disease(OR, 9.0;95% CI, $2.1{\sim}38.8$). These associations were not appreciably modified by allowance for major identified potential confounding factors. From these results, it is possible to speculate that liver cell injuries caused by various factors might be a common pathway to developing primary liver carcinoma. Considering the significant effect of family history of liver diseases on PLCA risk after adjusting past liver disease history, there might be genetic susceptibility in the carcinogenic mechanism of liver cancer. Further investigations are needed to clarify the effect of family history of liver disease on PLCA risk.
Formaldehyde is defined as carcinogen causing leukaemia, lymphoma or nasopharyngeal carcinoma at high level of exposure. Furniture-manufacturing workers can be exposed to formaldehyde, which implies serious impact on health of the workers. The authors carried out ambient monitoring of formaldehyde in the field, and identified the source of formaldehyde generated during the working process by testing the condition in the laboratory settings. After sampling formaldehyde in the air with 2,4-DNPH (2,4-dinitrophenylhydrazine) coated silica gel, we extracted formaldehyde derivative with acetonitrile and analyzed the extract using HPLC with UV detector at 360 nm. Formaldehyde was separated by ACQUITY UPLC BEH $C_{18}$ column at a flow rate of 0.5 mL/min using 45% acetonitrile as mobile phase. The workers were exposed to higher level of formaldehyde than normal air. Formaldehyde up to 0.31 ppm was detected in the process of veneer attachment, which exceeded 0.3 ppm, the ceiling value of ACGIH standard. The laboratory test of measuring formaldehyde generated from the glue and veneer used in the attachment process resulted in more formaldehyde generation as the temperature increased, and more from the veneer. Heating the veneer to $100-150^{\circ}C$ following the real condition of the manufacturing site generated 1.14-2.70 ppm of formaldehyde from the sample, which was 2-5 times higher level than Korean limit of exposure (0.5 ppm). As the workers handling and processing the veneer which was produced by wet process had high possibility to be exposed to formaldehyde, urgent improvement and management of working environment of furniture manufacturer is demanded.
Yoo, Shin;Ahn, Kyong Ouk;Park, Eun Hye;Cho, Hyun Sang;Park, Chong Young;Lee, Hae Ran
Clinical and Experimental Pediatrics
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v.45
no.5
/
pp.603-608
/
2002
Purpose : Pertussis is a highly communicable infectious disease in children with high mortality, especially in young infants. The incidence of pertussis in South Korea has decreased to about 10 cases a year in late '90s. Doubting previously reported incidences of pertussis, we designed this study to establish exact epidemiology and a diagnostic basis of pertussis. Methods : From Mar. 2000 to Mar. 2001, polymerase chain reaction(PCR) and cultures of nasopharyngeal aspirates were taken from 49 patients who were clinically suspected of pertussis in Kangdong Sacred Heart Hospital. Results : Among 49 patients suspected of pertussis, 10 cases showed positive results by PCR method. Four out of those 10 cases were positive in culture. The peak outbreak was noticed in the spring(Mar.-May) and the autumn(Sep.-Nov.). The mean age of the patients was 3.6 months. Eight of the 10 cases which were PCR positive results proved not to be immunized against pertussis. Conclusion : Most of the pertussis patients in our study were diagnosed as bronchiolitis, pneumonia or bronchitis at the beginning of the disease and only a few patients showed typical clinical manifestations of pertussis, including whooping. When the above results are taken together, we suggest the possibility that the actual prevalence of pertussis in South Korea might be higher than that of previous reports. The importance of pertussis screen tests should be emphasized in children with severe coughs.
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