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Favorable Outcome in Elderly Asian Patients with Metastatic Renal Cell Carcinoma Treated with Everolimus: The Osaka Urologic Oncology Group

  • Inamoto, Teruo;Azuma, Haruhito;Nonomura, Norio;Nakatani, Tatsuya;Matsuda, Tadashi;Nozawa, Masahiro;Ueda, Takeshi;Kinoshita, Hidefumi;Nishimura, Kazuo;Kanayama, Hiro-Omi;Miki, Tsuneharu;Tomita, Yoshihiko;Yoshioka, Toshiaki;Tsujihata, Masao;Uemura, Hirotsugu
    • 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.

The Conditions of Patients' Oral Health and Their Quality of Life at 'E' College Dental Practice (E대학 실습환자의 구강건강관리실태와 삶의 질에 대한 조사)

  • Kim, Ki-Eun;Choi, Moon-Sil;Han, Ji-Hyoung
    • Journal of dental hygiene science
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    • v.7 no.3
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    • pp.141-146
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    • 2007
  • A questionnaire survey of patients for practical training of dental hygiene department of E college was conducted from August 28th 2006 to December 8th 2006. Before scaling, the purpose of the study and the questionnaires were fully explained and the patients were requested to complete the questions personally. The survey were conducted under their consent and 256 copies were collected and used for the analysis. The survey shows the patients' habit for oral health care according to the gender and age and their standards for the quality of life. 1. For gender, male occupied 117(45.7%) and female occupied 139(54.3%). For age, 158 of the patients were in their twenties(61.7%) and 60 of them were aged from 10 to 19(23,4%). 16 patients were aged from 40 to 49(6.3%) and 11 patients were aged from 30 to 39(4.3%) and the number of patients who are older than 50 was 11(4.3%). 2. For the mouth health care, according to gender, 37.6% of male answered that they had scaling and 46.8% of female patients answered that they had scaling experiences. Without distinction of gender, most patients answered they brushed their teeth twice a day. For 91.5% of male patients and 89.9% of female patients answered that they brushed their teeth after meals. Also, 41% of male patients and 53.2% of female patients use rolling method. For using mouth aids, 68.4% of male patients and 65.5% of female patients do not use any aids. 3. For brushing way, most teenagers and patients in their twenties use rolling method and patients older than thirty use vertical and horizontal method. The frequency of brushing shows that most of the respondents brush their teeth twice a day after meals. 4. The standard of quality of life according to gender, under 'clear pronunciation' head, male patients mark 4.42 points and female patients mark 4.17 points. Under 'every day going out' head, male patients mark 4.53 points and female patients mark 4.29 points. Under 'maintenance of emotion' male patients mark 4.27 points and female patients mark 4.27 points. 5. The standard of quality of life according to age, teenage patients show 4.28 points under 'having meals' and under 'clear pronunciation' head, patients in their forties mark 4.44 points. Under 'keeping teeth or denture clean' head, patients in their thirties mark 4.55 points. Patients in their fifties show the lowest grades in most questionnaires.

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The relationship between the time from arrival at a hospital to delivery and the occurrence of cerebral palsy in premature infants of less than 34 weeks of gestational age (재태주령 34주 이전에 출생한 미숙아에서 병원도착시점에서 분만까지 소요된 시간과 뇌성마비 발생과의 관련성)

  • Hwang, Jae Woong;Heo, A Lum;Koo, Soo Hyun;Lee, Hae Jung;Lee, Jun Wha;Lee, Joo Seok;Cho, Kyung Lae
    • Clinical and Experimental Pediatrics
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    • v.52 no.11
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    • pp.1228-1233
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    • 2009
  • Purpose : This study aimed to evaluate whether a shorter time from the arrival at a hospital to delivery is related to the occurrence of cerebral palsy in premature infants of less than 34 weeks of gestational age. Methods : We studied 142 newborns of less than 34 weeks of gestational age. The time from the arrival at the hospital to delivery was measured. The correlation between the time required for delivery and the occurrence of cerebral palsy was elucidated by diagnosing cerebral palsy in neonates using the Korean Infant Development Screening Test and neurological examination. Results : Preliminary result suggested that a shorter time from hospital arrival to delivery was related to a lower development score for gross motor activity and to a higher frequency of cerebral palsy occurrence. Moreover, it was responsible for a tendency of obtaining lower Apgar scores at 1 and 5 minutes. The shorter delivery time was associated with a higher probability of respiratory distress syndrome (RDS) occurrence when the length of delivery time was less than 6 hours and there was a higher probability of a shorter gestation period. However, the multifactor analysis revealed that there was little impact of delivery time on the occurrence of cerebral palsy. Conclusions : The length of hospital arrival time to delivery did not significantly influence the occurrence of cerebral palsy in premature infants of less than 34 weeks of gestational age.

Studies on Estimation of Fish Abundance Using an Echo Sounder ( 1 ) - Experimental Verification of the Theory for Estimating Fish Density- (어군탐지기에 의한 어군량 추정에 관한 기초적 연구 ( 1 ) - 어군량추정이론의 검증실험 -)

  • 이대재
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.27 no.1
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    • pp.1-12
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    • 1991
  • An experiment has been carefully designed and performed to verify the theory for the echointergration technique of estimating the density of fish school by the use of steel spheres in a laboratory tank. The spheres used to simulate a fish school were randomly distributed throughout the insonified volume to produce the acoustic echoes similar to those scattered from real fish schools. The backscattered echoes were measured as a function of target density at tow frequencies of 50kHz and 200kHz. Data acquisition, processing and analysis were performed by means of the microcomputer-based sonar-echo processor including a FFT analyzer. Acoustic scattering characteristics of a 36cm mackerel was investigated by measuring fish echoes with frequencies ranging from 47.8kHz to 52.0kHz. The fluctuation of bottom echoes caused by the effects of fish-school attenuation and multiple scattering which occurred in dense aggregations of fishes was also examined by analyzing the echograms of sardine schools obtained by a 50kHz telesounder in the set-net's bagnet, and the echograms obtained by a scientific echo sounder of 50kHz in the East China Sea, respectively. The results obtained can be summarized as follows: 1. The measured and the calculated echo shapes on the steel sphere used to simulate a fish school were in close agreement. 2. The waveform and amplitude of echo signals by a mackerel without swimbladder fluctuated irregularly with the measuring frequency. 3. When a collection of 30 targets/m super(3) lied the shadow region behind another collection of 5 targets/m super(3), the mean losses in echo energy for the 30 targets/m super(3) were about -0.4dB at 50kHz and about -0.2dB at 200kHz, respectively. 4. In the echograms obtained in the East China Sea, the bottom echoes fluctuated remarkably when the dense aggregations of fish appeared between transducer and seabed. Especially, in the case of the echograms of sardine school obtained in a set-net's bagnet, the disappearance of bottom echoes and the lengthening of the echo trace by fish aggregations were observed. Then the mean density of the sardine school was estimated as 36 fish/m super(3). It suggests that when the distribution density of fishes in oceans is greater than this density, the effects of fish-school attenuation and multiple scattering must be taken into account as a possible source of error in fish abundance estimates. 5. The relationship between mean backscattering strength (, dB) and target density ($\rho$, No./m super(3)) were expressed by the equations: =-46.2+13.7 Log($\rho$) at 50kHz and =-43.9+13.4 Log($\rho$) at 200kHz. 6. The difference between the experimentally derived number and the actual number of targets gradually decreased with an increase in the target density and was within 20% when the density was 30 targets/m super(3). From these results, we concluded that when the number of targets in the insonified volume is large, the validity of the echo-integration technique of estimating the density of fish schools could be expected.

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An Analytical Study of the Quality of Life in Dental Hygienists in Seoul (서울지역 치과위생사의 삶의질(Quality of Life)에 관한 분석 연구)

  • Kim, Yeun-Sun
    • Journal of dental hygiene science
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    • v.5 no.1
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    • pp.39-43
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    • 2005
  • This study was carried out to provide fundamental data for an examination of a health promotion program by determining the influence of the Health Promoting Lifestyle Profile on the quality of life of female dental hygienists. The sample was selected from the population of 1,148 who were registered in the Association of Seoul Dental Hygienists. 800 subjects were randomly selected from 25 districts in Seoul. The data was collected by calling the dental hygienists to, explaining the contents and objective of our study, and sending them a questionnaire by post. The questionnaire consists of the total number of 97 questions: 62 questions on the Health Promoting Lifestyle Profile, 26 questions on the quality of life and 9 general characteristics questions. The data was collected from August 16 to October 15, 2004. Out of 800 subjects, 481(60.1%) completed the questionnaires. For statistical analysis, the frequency, percentage, arithmetic mean, ANOVA, and multiple regression analysis, were analyzed using the SAS 8.1 Analysis program. The significance level was set to 0.05. The results of this study were as follows: First, The average score of the subjects' quality of life was 3.1. For the sub-categories, it was shown that the degree of satisfaction on the condition of society was the highest at 3.2, and the degree of satisfaction on the condition of the individuals was the lowest at 3.1. The average score of the Health Promoting Lifestyle Profile variable was 2.5. For the sub-categories, it was shown that the degree of sanitary life was at 3.2, and degree of the professional health maintenance was the lowest at 1.7. Second, There were significant differences in the Quality of Life benefits of action with the general characteristics. There were significant differences in age, educational level, income, marital status, career, and Perceived Health Status. There were significant difference in Health Promoting Lifestyle Profile benefits of action with the general characteristics. There were significant differences in terms of age, educational level, income, marital status, career, and the Perceived Health Status. Finally, The stepwise multiple regression analysis revealed that the powerful predictors were Health Promoting Lifestyle Profile, income and the Perceived Health Status. These factors accounted for 37.6% of the variance in the Quality of Life patterns. As the subjects were limited to dental hygienists in Seoul, care should be taken when applying these results to all dental hygienists in Korea. In order to generalize the study, a large number of subjects selected from all regions in Korea will be needed.

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Chemistry of mist deposition of organic polymer PEDOT:PSS on crystalline Si

  • Shirai, Hajime;Ohki, Tatsuya;Liu, Qiming;Ichikawa, Koki
    • Proceedings of the Korean Vacuum Society Conference
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    • 2016.02a
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    • pp.388-388
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    • 2016
  • Chemical mist deposition (CMD) of poly(3,4-ethylenedioxythiophene):poly(styrene sulfonate) (PEDOT:PSS) was investigated with cavitation frequency f, solvent, flow rate of nitrogen, substrate temperature $T_s$, and substrate dc bias $V_s$ as variables for efficient PEDOT:PSS/crystalline (c-)Si heterojunction solar cells (Fig. 1). The high-speed camera and differential mobility analysis characterizations revealed that average size and flux of PEDOT:PSS mist depend on f, solvent, and $V_s$. The size distribution of mist particles including EG/DI water cosolvent is also shown at three different $V_s$ of 0, 1.5, and 5 kV for a f of 3 MHz (Fig. 2). The size distribution of EG/DI water mist without PEDOT:PSS is also shown at the bottom. A peak maximum shifted from 300-350 to 20-30 nm with a narrow band width of ~150 nm for PEDOT:PSS solution, whose maximum number density increased significantly up to 8000/cc with increasing $V_s$. On the other hand, for EG/water cosolvent mist alone, the peak maximum was observed at a 72.3 nm with a number density of ~700/cc and a band width of ~160 nm and it decreased markedly with increasing $V_s$. These findings were not observed for PEDOT:PSS/EG/DI water mist. In addition, the Mie scattering image of PEDOT:PSS mist under white bias light was not observed at $V_s$ above 5 kV, because the average size of mist became smaller. These results imply that most of solvent is solvated in PEDOT:PSS molecule and/or solvent is vaporized. Thus, higher f and $V_s$ generate preferentially fine mist particle with a narrower band width. Film deposition occurred when $V_s$ was impressed on positive to a c-Si substrate at a Ts of $30-40^{\circ}C$, whereas no deposition of films occurred on negative, implying that negatively charged mist mainly provide the film deposition. The uniform deposition of PEDOT:PSS films occurred on textured c-Si(100) substrate by adjusting $T_s$ and $V_s$. The adhesion of CMD PEDOT:PSS to c-Si enhanced by $V_s$ conspicuously compared to that of spin-coated film. The CMD PEDOT:PSS/c-Si solar cell devices on textured c-Si(100) exhibited a ${\eta}$ of 11.0% with the better uniformity of the solar cell parameters. Furthermore, ${\eta}$ increased to 12.5% with a $J_{sc}$ of $35.6mA/cm^2$, a $V_{oc}$ of 0.53 V, and a FF of 0.67 with an antireflection (AR) coating layer of 20-nm-thick CMD molybdenum oxide $MoO_x$ (n= 2.1) using negatively charged mist of 0.1 wt% 12 Molybdo (VI) phosphoric acid n-Hydrate) $H_3(PMo_{12}O_40){\cdot}nH_2O$ in methanol. CMD. These findings suggest that the CMD with negatively charged mist has a great potential for the uniform deposition of organic and inorganic on textured c-Si substrate by adjusting $T_s$ and $V_s$.

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Effects of Administration of Oxytocin Antagonist on Implantation and Pregnancy Rates in Patients with Repeated Failure of IVF/ICSI Treatment (체외수정시술의 반복적인 실패 환자에서 옥시토신 길항제 주입이 착상 및 임신에 미치는 영향)

  • Ahn, Jun-Woo;Kim, Chung-Hoon;Kim, So-Ra;Jeon, Gyun-Ho;Kim, Sung-Hoon;Chae, Hee-Dong;Kang, Byung-Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.36 no.4
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    • pp.275-281
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    • 2009
  • Objective: This study was performed to evaluate the effect of oxytocin antagonist on the outcome of IVF/ICSI cycles in infertile patients with repeated failure of IVF/ICSI treatment. Method: Forty patients who had experienced two or more failures of IVF/ICSI treatment without low ovarian reserve, were recruited for this prospective randomized study. All patients received controlled ovarian stimulation (COS) using GnRH antagonist multidose protocol (MDP). For the intervention group, intravenous administration of atosiban (mixed vasopressin $V_{1A}$/oxytocin antagonist) started with a bolus dose 6.75 mg one hour before embryo transfer (ET) and continued at an infusion rate of 18 mg/hour. After ET, administered atosiban was reduced to 6 mg/hour and continued for 2 hours. The main efficacy endpoints were clinical pregnancy rate and implantation rate. Results: Patients' characteristics were comparable in the intervention and control groups. COS parameters and IVF results were also similar. The number of uterine contractions for 3 minutes measured just before ET was significantly lower in the intervention group than control group ($3.5{\pm}1.4$ vs $8.7{\pm}2.2$, p<0.001). While there was no statistically significant difference in the clinical pregnancy rate between control group and intervention group (20.0% and 40.0%, p=0.168), the implantation rate was significantly higher in the intervention group, with 16.9% (11/65) compared with 6.0% (4/67) in the control group (p=0.047). There were no differences in ectopic pregnancy rate and miscarriage rate between the two groups. Conclusion: This study demonstrates that administration of oxytocin antagonist during ET can improve the implantation rate probably by decreasing the frequency of uterine contractions in infertile patients undergoing IVF/ICSI treatment.

What Factors Affect Mortality over the Age of 40? (40세 이후의 사망에 영향을 주는 요인에 관한 코호트내 환자-대조군 연구)

  • Park, Jong-Ku;Koh, Sang-Baek;Kim, Chun-Bae;Park, Kee-Ho;Wang, Seung-Jun;Chang, Sei-Jin;Sin, Soon-Ae;Kang, Myung-Guen
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.3
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    • pp.383-394
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    • 1999
  • Objectives: This study was conducted to identify the factors influencing the mortality of Koreans over the age of 40 by a nested case-control study. Methods: The cohort consisted of the beneficiaries of Korea Medical Insurance Corporation for Government Employees & Private School Teachers and Staff(KMIC) who received health examinations of KMIC in 1992 and 1993 retrospectively. At that time, they were more than 40 years old. The cases were 19,258 cohort members who had died until December 31, 1997. The controls were 19,258 cohort members who were alive until December 31, 1997. Controls were matched with age and sex distribution of the cases. The data used in this study were the funeral expenses requesting files, and the files of health examinations and health questionnaires gathered in 1992 and 1993. To assess the putative risk factors of death, student t-test, chi-square test, multiple logistic regression analysis were used. Results : In multiple logistic regression analysis, independent risk factors of death were as follows; systolic blood pressure, diastolic blood pressure, blood glucose, AST, urine glucose, urine protein, alcohol drinking(frequency), cigarette smoking and perceived health status, intake of restoratives and blood transfusion showed positive associations with death; coffee consumption showed negative associations with death; and body mass index and serum total cholesterol showed J-shaped association with death. Conclusions: Regarding the direction of association, the result of analysis on the data restricted to '96-'97 was same as that of '93-'97. But in some variables such as obesity, serum cholesterol, the odds ratios of death in the data of '96-'97 were higer than those of '93-'94, which suggested that the data of '93-'94 was bearing effect-cause relationship. We concluded that it suggested further researches using long-term follow-up data to be needed in this area.

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An Analysis of Teachers' Level of Usage and Concern Over the 7th Science Curriculum (제7차 과학 교육과정에 대한 지구과학 교사들의 관심도와 활용도 분석)

  • Lee, Yong-Seob;An, Hyun-Hee;Kim, Sang-Dal;Kim, Jong-Hee
    • Journal of the Korean earth science society
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    • v.24 no.5
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    • pp.378-392
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    • 2003
  • The purpose of this study is to investigate the depth of earth science teachers' concern over the 7th Science Curriculum and levels of their use of it in reality, using the tools "Concern" and "Levels of use" which are two important tools use in CBAM. The results of the study are as follows. How much concern do the earth science teachers have over the 7th Science Curriculum? There are seven stages (from 0 stage to 6 stage) of teachers' concern over the curriculum. o stage represents teachers' indifference to the curriculum and 98% teachers are placed in this stage. According to the study on teachers' teaching experience, teachers having from 10 to 14 years of teaching experience are the most indifferent to the 7th Science Curriculum, compared to other teachers. Which levels of use of the 7th science curriculum do earth science teachers choose in reality? There are five levels of use (from 1 to 5) of the 7th curriculum. 43.97% of teachers are placed in the 3rd level called "Mechanical level", which represents a teacher-concerned learning method with consideration of learners' response. According to the study on teachers' frequency of level of use in the fields of "Instruction objects, Instruction contents, Instruction methods, Instruction materials and Evaluation.", teachers chose high levels of use in the fields of "Instruction objects and Instruction contents" and low levels of use in the other three fields. What factors are barriers for earth science teachers to perform the 7th Science Curriculum in reality? 80.9% of teachers have trouble performing the 7th Science Curriculum in reality because of too much routine work, official papers, and lack of instructional materials, laboratories, training systems and workshops. The two biggest barriers among the above are routine work and of official papers. According to the study on teachers' teaching experience, teachers having from 0 to years of teaching experience have the most trouble in performing the curriculum in reality, compared to other teachers.

Analysis of DNA Ploidy with Bronchoscopic Brushing Specimen as A Diagnostic Aid for Lung Cancer (폐암 진단에 있어서 기관지솔질표본의 DNA 배수성 검사의 의의)

  • Kim, Young-Chul;Lee, Shin-Seok;Chung, Ik-Joo;Kang, Yu-Ho;Choi, In-Seon;Park, Kyung-Ok;Juhng, Sang-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.4
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    • pp.354-362
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    • 1994
  • Objectives and Methods : The presence of aneuploidy or high proliferative activity in cytologic specimens is considered as complementary for the diagnosis of malignancy. To evaluate the diagnostic usefulness of DNA ploidy and cell cycle analysis in lung cancer, we compared the diagnostic yielding rates of DNA ploidy test by brushing specimens using flow cytometry with bronchoscopic forceps biopsy and brushing cytology. Results : Of the seventy-six cases, 55 cases proved to have malignant diseases(squamous cell cancer: 27, adenocarcinoma: 7, large cell cancer: 1, undifferentiated: 4 and small cell cancer: 16). The incidence of aneuploidy in lung cancer patients was 32.7%(18/55), as opposed to no cases in benign disease. And the proportion of high proliferative activity(S+G2M>22%) in lung cancer patients was 42.9%(15/35), but none in benign diseases. In fifty-six of 75 cases(74.7%), cytology of brushing specimens and DNA analysis(either aneuploidy or high proliferative activity vs. diploidy and low proliferative activity) were in concordance. The sensitivity with only brushing cytology was 41.8%(23/55), but with the addition of DNA analysis, it was increased to 56.4%(31/55), without decreasing the specificity(100%). And there was a case whose clue for malignancy was absent except aneuploidy, and he was confirmed to have squamous cell cancer following open thoracotomy. There were no differences in the frequency of aneuploidy or high proliferative activity between histologic subtypes of bronchogenic malignancy. Conclusions : The diagnostic detection rate of lung cancer was improved with the addition of DNA ploidy and cell cycle analysis, and the presence of aneuploidy or high proliferative activity was a relatively specific indicator of malignant disease. It would be useful to test DNA ploidy and cell cycle analysis with brushing specimen for the diagnosis of bronchogenic malignancy particularly in patients whose biopsy specimen could not be obtainable.

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