• Sleep Medicine and Psychophysiology
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• v.30 no.1
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• pp.3-8
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• 2023

Periodic limb movement disorder (PLMD) is a sleep-related movement disorder characterized by involuntary, rhythmic limb movements during sleep. While PLMD itself is not considered life-threatening, its association with certain underlying health conditions raises concerns about mortality risks. PLMD has been found to be associated with cardiovascular diseases such as hypertension and cardiovascular disease. The fragmented sleep caused by the repetitive limb movements and associated arousals may contribute to sympathetic activation, chronic sleep disruption, sleep deprivation, and subsequent cardiovascular problems, which can increase mortality risks. The comorbidities and health factors commonly associated with PLMD, such as obesity, diabetes, and chronic kidney disease, may also contribute to increased mortality risks. PLMD is often observed alongside other neurological disorders, including restless legs syndrome (RLS) and Parkinson's disease. The presence of PLMD in these conditions may exacerbate the underlying health issues and potentially contribute to higher mortality rates. Further research is needed to elucidate the specific mechanisms linking PLMD to mortality risks and to develop targeted interventions that address these risks.

• Korean Journal of Head & Neck Oncology
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• v.36 no.1
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• pp.21-25
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• 2020

Kimura's disease is a rare disease of unknown etiology, commonly presenting with slow-growing head and neck subcutaneous nodules. It primarily involves the head and neck region, presenting as deep subcutaneous masses and is often accompanied by regional lymphadenopathy and salivary gland involvement. Clinically it is often confused with a parotid tumor or lymph node metastasis. It is difficult to diagnose before surgery, and fine needle aspiration cytology has only limited value. Even though this disease has not shown any malignant transformation, it is often difficult to cope with because of its high recurrence rate. Surgery, steroids, and radiotherapy have been used widely as the first-line recommendation, but none of them is standard procedure until now because of high recurrence rates. The recurrence of the disease reported up to 62%. We recently experienced a case of Kimura's disease, not accompanying peripheral eosinophilia, on the parotid gland treated by surgical resection in an 82-year-old woman with polycythemia vera. Here, we report this case with a review of the literature.

• Korean Journal of Bronchoesophagology
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• v.6 no.1
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• pp.21-28
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• 2000

Background:Subacute necrotizing lymphadenitis or Kikuchi's disease is unknown ethiology and self-limiting process. This disease predominantly affects young women age but rarely affects pediatrics, and usually manifests as lymphadenopathy and fever. Even though this disease is self-limited, benign process, many cases are misidentified as malignant lymphoma. The purpose of this study is to report the clinicopathologic finding, radiological finding and many labolatory test and to compare with characteristics of adult patients in this disease. Meterial and Methods:We reviewed 27 pediarics patients with subacute necrotizing lymphadenitis by excision biopsy or fineneedle aspiration cytology.Result:The most common symptomes were palpation of cervical lymh node(88.9%) and fever(66.7%). The common site of the involvement was cervical lymph node. The multiple involvement was 93% and bilateral involvement was 59%. Leukopenia(52%) and elevated erythrocyte sedimentation rates(93%) appeared in abnormal laboratory data. Microscopically, the characteristic finding was the wide area of florid nuclear dusts engulfed by histiocytes and well-circumscrbed area with eosinophilic fibrinoid material. There was a striking degree ofkaryorrhexis and an absence of granulocyte with paucity of plasma cell. All patients recovered with the conservative treatment and there was no specific complication and recurrence. Conclusion : We reviewed pediatric patients with this disease. Characteristics of this disease inpediatric patients were similar to adult patients.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.7
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• pp.3067-3072
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• 2015

Cervical cancer is the most common malignant cancer of the female reproductive organs worldwide. Currently, cervical cancer can be prevented by vaccination and detected at an early stage via various screening methods. Malaysia, as a developing country faces a heavy disease burden of cervical cancer as it is the second most common cancer among Malaysian women. This population based study was carried out to fulfil the primary aim of determining the survival rates of Malaysian women with cervical cancer and associated factors. Data were obtained from two different sources namely, the Malaysian National Cancer Registry (MNCR) and National Health Informatics Centre (NHIC) from 1st January 2000 to 31st December 2005. Kaplan Meier analyses were conducted to identify the overall survival rates and median survival time. Differences in survival among different ethnic and age group were compared using the log-rank test. A total of 5,859 patients were included. The median survival time for cervical cancer in this study was 65.8 months and the 5-year survival rate was 71.1%. The overall observed survival rates at 1, 3 and 5 years were 94.1%, 79.3% and 71.1% respectively. The log-rank test finding also showed that there were significant differences in the 5-year survival rate among different ethnic groups. Malays had the lowest survival rate of 59.2% followed by Indians (69.5%) and Chinese (73.8%). The overall 5-year survival rate among patients with cervical cancer in Malaysia is relatively good. Age and ethnic groups remain as significant determining factors for cervical cancer survival rate.

• Clinical Endoscopy
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• v.57 no.3
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• pp.317-328
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• 2024

Background/Aims: In this meta-analysis, we studied the safety and efficacy of endoscopic submucosal dissection (ESD) for colorectal dysplasia in patients with inflammatory bowel disease (IBD). Methods: Multiple databases were searched, and studies were retrieved based on pre-specified criteria until October 2022. The outcomes assessed were resection rates, procedural complications, local recurrence, metachronous tumors, and the need for surgery after ESD in IBD. Standard meta-analysis methods were followed using the random-effects model, and I²% was used to assess heterogeneity. Results: Twelve studies comprising 291 dysplastic lesions in 274 patients were included with a median follow-up of 25 months. The pooled en-bloc resection, R0 resection, and curative resection rates were 92.5% (95% confidence interval [CI], 87.9%-95.4%; I²=0%), 81.5% (95% CI, 72.5%-88%; I²=43%), and 48.9% (95% CI, 32.1%-65.9%; I²=87%), respectively. The local recurrence rate was 3.9% (95% CI, 2%-7.5%; I²=0%). The pooled rates of bleeding and perforation were 7.7% (95% CI, 4.5%-13%; I²=10%) and 5.3% (95% CI, 3.1%-8.9%; I²=0%), respectively. The rates of metachronous recurrence and additional surgery following ESD were 10% (95% CI, 5.2%-18.2%; I²=55%) and 13% (95% CI, 8.5%-19.3%; I²=54%), respectively. Conclusions: ESD is safe and effective for the resection of dysplastic lesions in IBD with an excellent pooled rate of en-bloc and R0 resection.

• Radiation Oncology Journal
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• v.22 no.4
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• pp.265-270
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• 2004

Purpose: To evaluate the effectiveness of postoperative radiation therapy in cervical cancer patients and define the prognostic factors to affect survival rates. Materials and Methods: Eighty one patients with cervical cancer who were treated with postoperative radiation therapy following surgery at our institution between May 1992 and April 2000 were retrospectivelv analyzed. Forty two patients had stage IB disease, 17 had stage IIA disease, and remaining 22 had stage IIB disease, respectively. Histological examination revealed 76 squamous cell carcinoma and 5 adenocarclnoma. Sixty one patients were noted to have stromal invasion greater than 8 mm and 20 patients were noted to have stromal invasion 7 mm or less. Sixteen patients had parametrial invasion and 65 patients did not. Positive vaginal resection margin was documented in only eight patients and positive lymphovascular invasion was in twelve patients. All of the patients were treated with external beam radiation therapy alone. Majority of the patients were treated with 4 field brick technique to encompass whole pelvis. Total of 5,500 cGy was delivered to the primary surgical tumor bed. Minimum follow up period was four years. Results: Actuarial disease free survival rates for entire group of the patients were 95% and 89% at 2 and 5 years, respectively Five year disease free survival rates for patients with stage IB, IIA, and IIB disease were 97%, 87% and 70%, respectivelv. Local recurrences were documented in 5 patients. Cumulative local failure rate at 3 years was 6% Five year disease free survival rates for patients with stromal invasion greater than 8 mm and 7 mm or less were 88% and 92%, respectively (p>0.05). Five year disease free survival rate for patients with parametrial invasion was significantly lower than those with no invasion (72% vs 92%, p<0.05). Also there was significantly lower survival in patients with positive vaginal resection margin, compared with patients with negative resection margin (64% vs 94%, p<0.05). However, lymphovascular invasion was not a statistically significant prognostic factor Parametrial invasion and positive surgical resection margins were noted to be significant prognostic factors. Conclusions: Postoperative radiation therapy appears to be beneficial in controlling local disease in cervical cancer patients with high pathologic risk factors. Parametrial invasion and positive resection margins were noted to be significant prognostic factors to affect survival and more effective treatment should be investigated in these patients.

• Radiation Oncology Journal
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• v.26 no.4
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• pp.204-212
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• 2008

Purpose: This study was performed to evaluate the disease-free survival and risk factors of recurrence in early breast cancer patients who have undergone breast conserving surgery and radiation therapy. Materials and Methods: From March 1997 to December 2002, 77 breast cancer patients who underwent breast conserving surgery and radiation therapy were reviewed retrospectively. The median follow-up time was 58.4 months (range $43.8{\sim}129.4$ months) and the mean subject age was 41 years. The frequency distribution of the different T stages, based on the tumor characteristics was 38 (49.3%) for T1, 28 (36.3%) for T2, 3 for T3, 7 for T is and 1 for an unidentified sized tumor. In addition, 52 patients (67.5%) did not have axillary lymph metastasis, whereas 14 patients (18.1%) had $1{\sim}3$ lymph node metastases and 3 (0.03%) had more than 4 lymph node metastases. The resection margin was negative in 59 patients, close (${\leq}2\;mm$) in 15, and positive in 4. All patients received radiation therapy at the intact breast using tangential fields with a subsequent electron beam boost to the tumor bed at a total dose ranging from 59.4 Gy to 66.4 Gy. Patients with more than four positive axillary lymph nodes received radiation therapy ($41.4{\sim}60.4\;Gy$) at the axillary and supraclavicular area. Chemotherapy was administered in 59 patients and tamoxifen or fareston was administered in 29 patients. Results: The 5 year overall survival and disease-free survival rates were 98.08% and 93.49%, respectively. Of the 77 patients, a total of 4 relapses (5.2%), including 1 isolated supraclavicular relapse, 1 supraclavicular relapse with synchronous multiple distant relapses, and 2 distant relapses were observed. No cases of local breast relapses were observed. Lymph node metastasis or number of metastatic lymph nodes was not found to be statistically related with a relapse (p=0.3289) nor disease-free survival (p=0.1430). Patients with positive margins had a significantly shorter disease-free survival period (p<0.0001) and higher relapse rates (p=0.0507). However, patients with close margins were at equal risk of relapse and disease-free survival as with negative margins (p=1.000). Patients younger than 40 years of age had higher relapse rates (9.3% vs. 0%) and lower disease-free survival periods, but the difference was not statistically significant (p=0.1255). The relapse rates for patients with tumors was 14% for tumor stage T2, compared to 0% for tumor stage T1 tumors (p=0.0284). A univariate analysis found that disease-free survival and relapse rates, T stage, positive resection margin and mutation of p53 were significant factors for clinical outcome. Conclusion: The results of this study have shown that breast conservation surgery and radiation therapy in early breast cancer patients has proven to be a safe treatment modality with a low relapse rate and high disease-free survival rate. The patients with a positive margin, T2 stage, and mutation of p53 are associated with statistically higher relapse rates and lower disease-free survival.

• The Korean Journal of Applied Statistics
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• v.17 no.2
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• pp.253-267
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• 2004

In some clinical trials, one may see that a significant fraction of patients are cured and their original disease does not recur even after termination of treatment and pro-longed follow-up. This situation occurs frequently in pediatric cancer trials where there are excellent therapeutic results. In such cases, interest concentrated on the difference of cure rates rather than other types of differences in failure distributions. Various authors have investigated the parametric and nonparametric methods for testing the difference of cure rates. In this study, we compare by simulation the power and size of a parametric test and five nonparametric tests in a various range of the alternatives, censoring rates and cure rates. Our objectives are to determine if any test was preferable on the basis of size and power in various situation, and to investigate the effect of the model misspecification.

• Journal of Gastric Cancer
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• v.18 no.3
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• pp.253-263
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• 2018

Purpose: With increasing life expectancy, the presence of comorbidities has become a major concern in elderly patients who require surgery. However, little is known about the impact of different comorbidities on the outcomes of laparoscopic total gastrectomy (LTG). In this study, we investigated the impact of comorbidities on postoperative complications in patients undergoing LTG for gastric carcinoma. Materials and Methods: We retrospectively reviewed the cases of 303 consecutive patients who underwent LTG for gastric carcinoma between 2005 and 2016. The associations between each comorbidity and postoperative complications were assessed using univariate and multivariate analyses. Results: A total of 189 patients (62.4%) had one or more comorbidities. Hypertension was the most common comorbidity (37.0%), followed by diabetes mellitus (17.8%), chronic viral hepatitis (2.6%), liver cirrhosis (2.6%), and pulmonary (27.1%), ischemic heart (3.3%), and cerebrovascular diseases (2.3%). The overall postoperative morbidity and mortality rates were 20.1% and 1.0%, respectively. Patients with pulmonary disease significantly showed higher complication rates than those without comorbidities (32.9% vs. 14.9%, respectively, P=0.003); patient with other comorbidities showed no significant difference in the incidence of LTG-related complications. During univariate and multivariate analyses, pulmonary disease was found to be an independent predictive factor for postoperative complications (odds ratio, 2.14; 95% confidence interval, 1.03-4.64), along with old age and intraoperative bleeding. Conclusions: Among the various comorbidities investigated, patients with pulmonary disease had a significantly higher risk of postoperative complications after LTG. Proper perioperative care for optimizing pulmonary function may be required for patients with pulmonary disease.

• The Journal of the Korean bone and joint tumor society
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• v.2 no.1
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• pp.27-32
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• 1996

Recent advances in imaging techniques, surgery and combination anti-cancer chemotherapy have brought high survival rates in osteosarcoma. To investigate the survival rate, local recurrence and complications in treatment, we analysed 25 osteosarcoma cases who had been treated with preoperative neo-adjuvant chemotherapy, surgery and post operative chemotherapy at Department of Orthopedic Surgery, Catholic University. From May 1988 to April 1995, 42 cases of stage IIB osteosarcoma were admitted in Department of Orthopedic Surgery. Among them, 17 cases who didn't follow our treatment guidance were excluded in this study. The average age were 19 years. There were 21 males and 4 females. The involved sites were 4 humerus, 10 femur, 10 tibia and 1 talus. Eleven cases had received intraarterial cisplatin and intravenous adriamycin chemotherapy, and 7 T-10 protocol and 7 intravenous ifosfamide, ADR, methotrexate, cisplatin. Twenty-three cases were treated with limb salvage surgery, and 2 amputation. The average follow-up was 35 months(3~82). There were 14 cases of continuous disease free, 9 cases of died of disease, 1 case of alive with disease, and 1 case of no evidence of disease at final follow-up. There were three cases of local recurrence at 6,8 and 12 months after operation. The estimated Kaplan-Meier's 5 year survival rates for all, ADR-cisplatin group, T-10 protocol group, and ifosfamide regimen group were 6%, 73%, 44% and 72%, respectively.