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Incidence and Clinical Characteristic of Venous Thromboembolism in Gynecologic Oncology Patients attending King Chulalongkorn Memorial Hospital over a 10 Year Period

  • Oranratanaphan, S;Termrungruanglert, W;Khemapech, N
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6705-6709
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    • 2015
  • Background: Venous thromboembolisms (VTEs) constitute a group of diseases including deep vein thrombosis (DVT) and pulmonary embolism (PE). They regarded as the second leading cause of death in cancer patients and several studies have confirmed that VTEs have a negative impact on survival and recurrent rate in both ovarian and endometrial cancer cases. The incidence of VTEs differs worldwide and depends on several risk factors including race, underlying disease, lifestyle, body weight, BMI and genetic risk factors. There is heterogeneity of DVT rates between Asian and Western countries. This study was conducted in order to evaluate the character and incidence of VTEs in gynecologic oncology patients in King Chulalongkorn Memorial Hospital over a 10 year period. Materials and Methods: A retrospective chart review was performed with VTEs defined as objective diagnosis of acute DVT or PE with typical symptoms and signs. Diagnoses were approved byan internist and/or confirmed with imaging studies. Data from both outpatient and inpatient sessions of the affected cases from January 2004 to December 2013 were extracted. General characteristics of the patients were collected with details of the diseases, types of cancer, stage, date of diagnosis of cancer, operative data, treatment outcome, progression free survival and overall survival. Results: Thirty cases of VTEs were identified in a total 2,316 gynecologic oncology cases. The incidence of symptomatic VTEs in total gynecologic oncology patients in our institution is 1.295%. The incidence of VTEs in ovarian cancer patients in our institution was 5.9%. Duration for VTE detection ranged from 13 months before diagnosis of cancer to 33 months after diagnosis of cancer. Most of the VTE cases were detected in ovarian cancer patients (60%). The most common cell type was adenocarcinoma (moderately to poorly differentiated) which accounted for 26.7% of the cases. The second most common cell type was clear cell carcinoma with 23.3% of the cases. Thirty percent of VTE cases developed before cancer was diagnosed, 20% were diagnosed at the same time as cancer detection and fifty percent developed after cancer was diagnosed. Median disease free survival of the gynecologic oncology patients with VTE was 7.5 months. Median overall survival (OS) was 12 months. Median progession free survivals of DVT and PE groups were 11.5 and 5.5 months, respectively. OS of DVT and PE was 12.0 and 11.5 months respectively. Conclusions: The incidence of VTE in Asian countries is believed to be lower than in European or Western countries. From our retrospective review, the incidence of VTEs in all types of gynecologic oncology was 1.295%, much lower than reported in the West. The reason for the lower incidence may genetic differences. Another factor is that VTE in this review was symptomatic, which is less than asymptomatic VTE. More than half of VTEs in this study developed in ovarian cancer patients. The results are compatible with earlier reports that among gynecologic malignancies, the incidence of VTE is highest in ovarian cancer.

Mid-Term Results of Mitral Valve Repair Using a Partial Flexible Band and a Completely Rigid Ring in Patients with Degenerative Mitral Regurgitation (퇴행성 승모판막역류 환자에서 Partial Flexible Band와 Complete Rigid Ring을 이용한 승모판막 성형술의 중기 결과 비교)

  • Kim, Kyung-Hwan;Ahn, Hyuk;Hwang, Ho-Young;Choi, Jin-Ho;Kim, Ki-Bong
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.475-481
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    • 2010
  • Background: We evaluated mid-term results of mitral annuloplasty using a flexible band and a completely rigid ring for mitral valve repair in patients with degenerative mitral regurgitation (MR). Material and Method: From January 2004 to September 2008, 71 patients (M:F=36:35, $55{\pm}13$ years) underwent mitral valve repair with mitral annuloplasty for degenerative MR. Ring annuloplasty was done using a Cosgrove-Edwards flexible band (Group I, n=43) or a Carpentier-Edwards classic ring (Group II, n=28). There were no differences in preoperative characteristics of the participants. Average duration of follow-up was 36 months (range: 2~69 mos). Result: There was no in-hospital mortality. Postoperative morbidity, which included atrial fibrillation (n=7) and low cardiac output syndrome (n=5) in groups I and II were similar. There was one late death in group II. The proportion exhibiting freedom from recurrent mitral regurgitation ($\geq$moderate) at 4 years in Groups I and II were, respectively, 94.5 and 91.8%, (p=0.695). Left ventricular ejection fraction decreased in the early postoperative period ($7{\pm}2$ days) and recovered by last follow-up ($25{\pm}16$ mos; p=0.002). The pattern was similar in groups I and II (p=0.905). Re-operation was performed in 3 patients (1 in Group I and 2 in Group II, p=0.316). Four-year event-free survival (free of adverse valve-related events) was 95.2% for Group I and 92.6% for Group II; this difference was not significant, p=0.646). Conclusion: The type of technique used in mitral annuloplasty to repair the mitral valve repair after degenerative MR did not affect mid-term clinical and functional results.

The Effect of Chemical Composition and Sintering Temperature on The Improvement of Physical Properties of Mn-Zn Ferrites (Mn-Zn ferrite의 성분 및 소결 온도에 따른 물리적 특성의 향상 연구)

  • 고재귀
    • Journal of the Korean Magnetics Society
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    • v.5 no.4
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    • pp.269-274
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    • 1995
  • The basic composition of Mn-Zn ferrite was $Mn_{0.631}Zn_{0.316}Fe_{2.053}O_{4}$(specimen A), $Mn_{0.584}Zn_{0.312}Fe_{2.104}O_{4}$(specimen B) and $Mn_{0.538}Zn_{0.308}Fe_{2.154}O_{4}$(specimen C) with additional 0.1 mol % $CaCo_{3}$ and 0.04 mol % $V_{2}O_{5}$. For high per¬meability and acceleration of grain growth, $CaCo_{3}$ and $V_{2}O_{5}$. was added. The mixture of the law materials was calcinated at $950^{\circ}C$ for 3 hours and then milled. The compacts of toroidal type were sintered at different temperature($1250^{\circ}C$, $1300^{\circ}C$, $1350^{\circ}C$) for 2 hours in $N_2$ atmosphere. The effects of the various raw material composition and sintered temperature on the physical properties of Mn-Zn ferrite have been investigated. They turned out to be spinel structure by X-ray diffraction and the size of grain from SEM was from $18\;\mu\textrm{m}\;to\;23\;\mu\textrm{m}$. As the sintering temperature was increased from $1250^{\circ}C$ to $1350^{\circ}C$, the initial permeability and magnetic induction has increased and the both of Q factor and coercive force has decreased. The coercive force and curie temperature were almost the same at each specimen Their values were about 0.45 Oe and $200^{\circ}C$. The frequency of specimen will used in the range from 200 kHz to 2 MHz. The basic composition of $Mn_{0.584}Zn_{0.312}Fe_{2.104}O_{4}$(specimen B) sintered at $1300^{\circ}C$ shows the best results at magnetic induction (Br & Bm).

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Physiological studies on the sudden wilting of JAPONICA/INDICA crossed rice varieties in Korea -I. The effects of plant nutritional status on the occurrence of sudden wilting (일(日). 인원연교잡(印遠緣交雜) 수도품종(水稻品種)의 급성위조증상(急性萎凋症狀) 발생(發生)에 관(關)한 영양생리학적(營養生理學的) 연구(硏究) -I. 수도(水稻)의 영양상태(營養狀態)가 급성위조증상(急性萎凋症狀) 발생(發生)에 미치는 영향(影響))

  • Kim, Yoo-Seob
    • Korean Journal of Soil Science and Fertilizer
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    • v.21 no.3
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    • pp.316-338
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    • 1988
  • To identify the physiological phenomena on the sudden wilting of japonica/indica crossed varieties, Pot experiment was carried out under the heavy N application with various levels of potassium in Japan. The results obtained are as follows. 1. Sudden wilting was occurred in both varieties used, Yushin and Milyang 23. The former showed a higher degree than the latter. 2. Sudden wilting was occurred into two types, one at early ripening stage and the other at late ripening stage. The former type was found in the field with low potassium supply and the latter was seemed to be related to varietal wilting tolerence. 3. By the investigation of concerning the effective tillering rate and the change of dry weight of each organ at the heading stage, it was inferred that the growth status from young panicle formation stage to heading stage were related to sudden wilting tolerence. 4. Manganese content at heading stage, ratio of Fe/Mn and Fe. Fe/Mn in stern at late ripening stage and $K_2$ O/N ratio of stem at harvesting stage were recognized as the specific factors in connection with sudden wilting. Mn content in the sudden wilting rice plant was already in creased remarkably at heading stage. In relation to root age and absoption characteristics of Mn, the senility of root before heading stage was inferred as the cause of increase the value of Fe/Mn or Fe. Fe/Mn. 5. The $K_2$ O/N ratio of culm at harvesting stage was lower in upper node than lower node in relation to sudden wilting. And it was well accordance with the fact that the symptoms of sudden wilting proceeded from upper leaf to lower leaf. These phenomenon was different from the usual one that the effect of potassium deficiency was more remarkable in lower node than upper node. 6. All varieties which have a condition of potassium deficiency have a high degree of nitrogen content of leaves at heading stage and the $K_2$ O/N ratio of each organ was low, Especialy, $K_2$ O/N ratio is much lower in sheath and culm than leaves.

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The Effects of Experimental Learning Using Small-Scale Chemistry on the Science Learning Achievement of Elementary School Students and Teachers' Perceptions (Small-Scale Chemistry을 적용한 초등학교 과학실험 수업이 과학 학업성취도에 미치는 영향 및 교사의 인식)

  • Lee, Na-Kyeong;Kim, Sung-Kyu
    • Journal of Science Education
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    • v.38 no.2
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    • pp.302-316
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    • 2014
  • The purpose of this study is to devise a Small-Scale Chemistry (SSC) lab program for primary school learners and to examine its effects on science learning achievement. In addition, it will be examined whether the type of learning groups affects the achievement or not. The participants in the current study were 173 6th graders from 6 classes of Y elementary school in Changwon city, Gyeongnam. Three classes(86) were assigned to the experimental group and the other three, the comparative group after checking the pre-homogeneity between the two groups through t-test on the scores of the science mid-term exam. We conducted five experimental sessions on the Acid and Base in the science textbook for the sixth graders. The students of one experimental class worked in pairs and another class worked individually, but the students of the comparative classes were divided into groups of six(one group with pair, another group with individual work in the SSC program, and the other group conducting the traditional experiment with groups of six students). The data were analyzed by t-test and ANOVA. The results showed that experimental learning using individual work in the SSC program compared to traditional experimental learning was effective in improving science learning achievement. also it was indicated that the teachers could reduce their burden of preparing for classes and of school hours when they utilized the SSC laboratory learning program. Teachers could also actively support students' experimental activities in employing the program. Based on the results, we suggest that the development of the SSC laboratory learning program is meaningful in the sense that this program can help elementary schoolers to improve science learning achievements more than the existing traditional experimental methods.

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