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Survival Benefit of Perioperative Chemotherapy in Patients with Locally Advanced Gastric Cancer: a Propensity Score Matched Analysis

  • Eom, Bang Wool;Kim, Sohee;Kim, Ja Yeon;Yoon, Hong Man;Kim, Mi-Jung;Nam, Byung-Ho;Kim, Young-Woo;Park, Young-Iee;Park, Sook Ryun;Ryu, Keun Won
    • Journal of Gastric Cancer
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    • v.18 no.1
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    • pp.69-81
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    • 2018
  • Purpose: It has been reported that the survival of patients with locally advanced gastric cancer (LAGC) is better in East Asia countries than in developed western countries; however, the prognosis of LAGC remains poor. This study aimed to evaluate the effects of perioperative chemotherapy on the long-term survival of East Asia patients with LAGC. Materials and Methods: From October 2006 through August 2008, 43 patients with LAGC received perioperative S-1 combined with weekly docetaxel in a phase II study (neoadjuvant group). These patients were matched using propensity scores to patients who underwent surgery without neoadjuvant chemotherapy during the same period (surgery group). The surgical outcomes and long-term survivals were compared between the 2 groups. Results: After matching, 43 and 86 patients were included in the neoadjuvant and surgery groups, respectively, and there was no significant difference in their baseline characteristics. Although the operating time was longer in the neoadjuvant group, there was no significant difference in postoperative complications between the 2 groups. The neoadjuvant group had a significantly higher 5-year overall survival (OS) rate (73.3% vs. 51.1%, P=0.005) and a trend towards higher 5-year progression-free survival (PFS) (62.8% vs. 49.9%, P=0.145). In the multivariate analysis, perioperative chemotherapy was an independent factor for OS, with a hazard ratio of 0.4 (P=0.005) and a marginal effect on the PFS (P=0.054). Conclusions: Perioperative chemotherapy was associated with better long-term survival without increasing postoperative complications in the setting of D2 surgery for patients with LAGC, suggesting that perioperative chemotherapy can be a therapeutic option in East Asia countries.

Factors Related to Balance Ability in Healthy Elderly (노인의 균형유지 능력에 영향을 미치는 요인)

  • Kim, Won-Ho;Yi, Chung-Hwi;Chung, Bo-In;Cho, Sang-Hyun
    • Physical Therapy Korea
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    • v.5 no.3
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    • pp.21-33
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    • 1998
  • The purposes of this study were to ascertain differences of the sensory system, central processing system, effector system, and balance ability according to general characteristics (sex, fall experience, and age), and to identify the contributions of the sensory, central processing, and effector system to balance ability in 83 healthy elderly subjects. The subjects were elderly (over 60 years) who live in Wonju City. All subjects participated in six tests (position sense test, visual acuity, vestibular stepping test, Mini-Mental Status Exam-Korea, strength of dorsiflexors, and Berg Balance Test). Collected data were analyzed by the independent t-test, one-way ANOVA, and stepwise multiple regression. The results were as follows: 1. The results of the six tests according to sex showed that vestibular function was significantly better in women than in men. But visual acuity, cognitive function, strength of dorsiflexors, and balance ability were significantly better in men than in women (p<0.05). 2. There were no significant differences in position sense, visual acuity, vestibular function, cognitive function, strength of dorsiflexors, and balance ability between fallers and non-fallers (p>0.05). 3. However, the results of the six tests according to age (group A: 60-69 years, group B: 70-79 years, group C: 80-89 years) showed significant differences in five tests. In the Scheff$\acute{e}$ test, position sense, visual acuity, and cognitive function showed significantly different results between in group A and group C: the strength of the dorsiflexors was significantly different between in group A and group B, and balance ability was significantly different between in group A and group C, and between in group B and group C (p<0.05). 4. Cognitive function and position sense were positively associated with balance ability. Their power of explanation regarding balance ability was 38% (p<0.05). These results suggest that cognitive function and position sense play an important role in balance ability. This would seem to suggest that programs for evaluation or improvement of elderly's balance ability in the elderly should consider cognitive function and position sense.

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Prognostic Threshold of Neuroendocrine Differentiation in Gastric Carcinoma: a Clinicopathological Study of 945 Cases

  • Zou, Yi;Chen, Linying;Wang, Xingfu;Chen, Yupeng;Hu, Liwen;Zeng, Saifan;Wang, Pengcheng;Li, Guoping;Huang, Ming;Wang, Liting;He, Shi;Li, Sanyan;Jian, Lihui;Zhang, Sheng
    • Journal of Gastric Cancer
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    • v.19 no.1
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    • pp.121-131
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    • 2019
  • Purpose: The significance of neuroendocrine differentiation (NED) in gastric carcinoma (GC) is controversial, leading to ambiguous concepts in traditional classifications. This study aimed to determine the prognostic threshold of meaningful NED in GC and clarify its unclear features in existing classifications. Materials and Methods: Immunohistochemical staining for synaptophysin, chromogranin A, and neural cell adhesion molecule was performed for 945 GC specimens. Survival analysis was performed using the log-rank test and univariate/multivariate models with percentages of NED ($P_{NED}$) and demographic and clinicopathological parameters. Results: In total, 275 (29.1%) cases were immunoreactive to at least 1 neuroendocrine (NE) marker. GC-NED was more common in the upper third of the stomach. $P_{NED}$, and Borrmann's classification and tumor, lymph node, metastasis stages were independent prognostic factors. The cutoff $P_{NED}$ was 10%, beyond which patients had significantly worse outcomes, although the risk did not increase with higher $P_{NED}$. Tumors with ${\geq}10%$ NED tended to manifest as Borrmann type III lesion with mixed/diffuse morphology and poorer histological differentiation; the NE components in this population mainly grew in insulae/nests, which differed from the predominant growth pattern (glandular/acinar) in GC with <10% NED. Conclusions: GC with ${\geq}10%$ NED should be classified as a distinct subtype because of its worse prognosis, and more attention should be paid to the necessity of additional therapeutics for NE components.

Periimplant bone change after alveolar ridge preservation: radiographic retrospective study (발치와 치조제 보존술 후 식립한 임플란트 주위 골 변화: 후향적 방사선학적 분석)

  • Shim, Da-Eun;Pang, Eun-Kyoung
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.3
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    • pp.281-290
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    • 2021
  • Purpose. The aim of this study is to evaluate bone change around the implant in patients who underwent alveolar ridge preservation for implantation in the posterior teeth using radiographic data measuring changes of mesial, distal crestal bone level according to post-implantation, post-final prosthesis delivery and follow-up periods. Materials and methods. In total, 36 implants were placed in 32 patients. The mesial and distal crestal bone level of all the areas where alveolar ridge preservation was performed uses panoramic images taken post-implantation, post-final prosthesis delivery, and follow-up period each was measured and evaluated as a vertical value. The following factors were analyzed: associations between changes of crestal bone level and factors (e.g., age, sex, systemic diseases, dentist, implant location, tooth, bone type, membrane). The statistical analysis was performed using the mean, standard deviation and independent t-test, paired t-test (P < .05). Results. Analysis of crestal bone level differences between periods shows statistically significant differences (P < .05). There was no statistically significant difference when the changes of crestal bone level between post-implantation, post-final prosthesis delivery and follow-up periods were correlated with each factors. Conclusion. After alveolar ridge preservation, bone around the implant remained stable during the maintenance period without being affected by the patient and surgical factors, and alveolar ridge preservation is considered a clinically usable procedure.

Comparison of Laparoscopic and Open Gastrectomy for Patients With Gastric Cancer Treated With Neoadjuvant Chemotherapy: A Multicenter Retrospective Study Based on the Korean Gastric Cancer Association Nationwide Survey

  • Seul Ki Oh;Chang Seok Ko;Seong-A Jeong;Jeong Hwan Yook;Moon-Won Yoo;Beom Su Kim;In-Seob Lee;Chung Sik Gong;Sa-Hong Min;Na Young Kim;the Information Committee of the Korean Gastric Cancer Association
    • Journal of Gastric Cancer
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    • v.23 no.3
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    • pp.499-508
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    • 2023
  • Purpose: Despite scientific evidence regarding laparoscopic gastrectomy (LG) for advanced gastric cancer treatment, its application in patients receiving neoadjuvant chemotherapy remains uncertain. Materials and Methods: We used the 2019 Korean Gastric Cancer Association nationwide survey database to extract data from 489 patients with primary gastric cancer who received neoadjuvant chemotherapy. After propensity score matching analysis, we compared the surgical outcomes of 97 patients who underwent LG and 97 patients who underwent open gastrectomy (OG). We investigated the risk factors for postoperative complications using multivariate analysis. Results: The operative time was significantly shorter in the OG group. Patients in the LG group had significantly less blood loss than those in the OG group. Hospital stay and overall postoperative complications were similar between the two groups. The incidence of Clavien-Dindo grade ≥3 complications in the LG group was comparable with that in the OG group (1.03% vs. 4.12%, P=0.215). No statistically significant difference was observed in the number of harvested lymph nodes between the two groups (38.60 vs. 35.79, P=0.182). Multivariate analysis identified body mass index (odds ratio [OR], 1.824; 95% confidence interval [CI], 1.029-3.234; P=0.040) and extent of resection (OR, 3.154; 95% CI, 1.084-9.174; P=0.035) as independent risk factors for overall postoperative complications. Conclusions: Using a large nationwide multicenter survey database, we demonstrated that LG and OG had comparable short-term outcomes in patients with gastric cancer who received neoadjuvant chemotherapy.

Enzymatic Hydrolysis Optimization of a Snow Crab Processing By-product (홍게 가공부산물의 효소적 단백질 가수분해 최적화)

  • Jang, Jong-Tae;Seo, Won-Ho;Baek, Hyung-Hee
    • Korean Journal of Food Science and Technology
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    • v.41 no.6
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    • pp.622-627
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    • 2009
  • The objectives of this study were to evaluate a protease suitable for the enzymatic hydrolysis of a snow crab processing by-product (SPB) and to optimize the hydrolysis conditions using response surface methodology (RSM). The SPB was hydrolyzed at $50^{\circ}C$ and pH 7.0-7.2 to obtain various degree of hydrolysis (DH) using Flavourzyme at an enzyme/substrate (E/S) ratio of 3.0%. The reaction progress curve exhibited an initial fast reaction rate followed by a slowing of the rate. The DH was increased to 30% at 90 min with a final DH 32 to 36%. A central composite experimental design having three independent variables (reaction temperature, reaction time, and E/S ratio) with five levels was used to optimize the enzymatic hydrolysis conditions. Based on the DH data, the optimum reaction conditions for the enzymatic hydrolysis of the SPB were a temperature of $51.8^{\circ}C$, reaction time of 4 hr 45 min, and an E/S ratio of 3.8%. It was demonstrated that the enzymatic hydrolysate of SPB could be used as a flavoring agent or a source of precursors for the production of reaction flavors.

On-stream Activity and Surface Chemical Structure of CoO2/TiO2 Catalysts for Continuous Wet TCE Oxidation (습식 TCE 분해반응에서 CoO2/TiO2 촉매의 반응활성 및 표면화학적 구조)

  • Kim Moon Hyeon;Choo Kwang-Ho
    • Journal of Environmental Science International
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    • v.14 no.2
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    • pp.221-230
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    • 2005
  • Catalytic wet oxidation of trichloroethylene (TCE) in water has been conducted using $TiO_2-supported$ cobalt oxides at $36^{\circ}C$ with a weight hourly space velocity of $7,500\;h^{-1}.\;5\%\;CoO_x/TiO_2$, prepared by using an incipient wetness technique, might be the most promising catalyst for the wet oxidation although it exhibited a transient behavior in time on-stream activity. Not only could the bare support be inactive for the wet decomposition reaction, but no TCE removal also occurred by the process of adsorption on $TiO_2$ surface. The catalytic activity was independent of all particle sizes used, thereby representing no mass transfer limitation in intraparticle diffusion. XPS spectra of both fresh and used Co surfaces gave different surface spectral features for each $CoO_x,\;Co\;2P_{3/2}$ binding energy for Co species in the fresh catalyst appeared at 781.3 eV, which is very similar to the chemical states of $CoTiO_x$ such as $CO_2TiO_4\;and\;CoTiO_3$. The used catalyst exhibited a 780.3-eV main peak with a satellite structure at 795.8 eV. Based on XPS spectra of reference Co compound, the TCE-exposed Co surfaces could be assigned to be in the form of mainly $Co_3O_4$. XRD patterns for $5\%\;CoO_x/TiO_2$ catalyst indicated that the phase structure of Co species in the catalyst even before reaction is quite comparable to the diffraction lines of external $Co_3O_4$ standard. A model structure of $CoO_x$ present predominantly on titania surfaces would be $Co_3O_4$, encapsulated in thin-film $CoTiO_x$ species consisting of $Co_2TiO_4$ and $CoTiO_3$, which may be active for the decomposition of TCE in a flow of water.

A Study of the Hierarchy of the Central Place and the Shopping Area in the Kyeong-ju Si Area (경주시지역 중심지계층과 생활권에 관한 연구)

  • Park, Tae-Hwa;Lee, Jae-Mok
    • Journal of the Korean Geographical Society
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    • v.31 no.3
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    • pp.508-528
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    • 1996
  • The purpose of this study is to analyze the classification of the hierarchy in terms of centrality and the demarcation of shopping areas in the context of goods-purchasing activity in the Kyeong-ju si area (The old Kyeong-ju city and Wol-song Kyn). The basic data for this study include mail questionnaire materials and sources by the on-the-sport survey. The main results of this study are as follows. (1) When forty-two centers within the wide Kyeong-ju area are classified into hierarchies in terms of the functional index and the number of central functions, it is confirmed that there are five hierarchies or classes. Hierachy A is the City of Kyeong-ju. Hierarchy B is the Up of An-gang. Hierarchy Cis made up of three Up of Kam-p'o, Oe-dong and Kon-ch' on. Hierachy D consist of seven Myons and two Ris. Hierarchy E is composed of one Myon and twenty-seven Ris. (2) Hierarchy A has five proper functions of the center. Hierarchy B holds eleven of them. Hierarchy C takes forty-one. Hierarchy D cherish twenty-seven. And hierarchy E has three. Therefor Hierachies C and D have the most functions of all. The threshold populations of the lowest central function is fifty-eight of miscellaneous stores in the central place of Hierarchy E (3) The purchase distance of the central functions of a center becomes farther in the order of barbers' and beauty salons, dental clinics, TV and refrigerator shops, and furniture stores. (4) When the shopping areas are classified according to goods purchase activity, they can be divided into four: the Myon, small Up, big Up, and City areas. Each shopping area can be classified into two categories: the independent areas and compoung areas. The Kyeong-ju city area is the largest city shopping areas of Po-hang and Ull-san are very small.

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Current Status of Pediatric Surgical Practice in Korea -a Survey among the Members of Korean Association of Pediatric Surgeons- (대한소아외과학회 회원의 1995년도 진료현황 및 수련경력 설문조사)

  • Kim, W.K.;Kim, S.Y.;Kim, S.K.;Kim, I.K.;Kim, J.E.;Kim, C.S.;Kim, H.H.;Park, K.W.;Park, Y.S.;Park, W.H.;Park, J.S.;Song, Y.T.;Yang, J.W.;Oh, S.M.;Lee, D.S.;Lee, M.D.;Lee, S.K.;Lee, S.C.;Chang, S.I.;Jung, S.E.;Jung, P.M.;Choi, K.J.;Choi, S.O.;Huh, Y.S.;Hwang, E.H.
    • Advances in pediatric surgery
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    • v.3 no.1
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    • pp.61-67
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    • 1997
  • To understand the current status of pediatric surgical practice of the members of the Korean Association of Pediatric Surgeons, a survey of the practice of the 31 members in both 1994 and 1995. Twenty five members(80%) representing 20 hospitals responded. An average of four hundred and seventy four cases pediatric surgical operations were performed at individual institution in 1995 with 40 newborn cases. Eighteen members(72%) are currently working at university hospital. Fourteen institutions(70%) are currently classified as tertiary by the health insurance agency. The majority(15 to 60%) of members are working in the metropolitan Seoul area, while five in Taegu area. Sixteen members reported having the title of department head/director. Four members reported occasional non-pediatric surgical practice. Nine members out of 20 reported having independent pediatric surgical out-patient clinic before the establishment of the association(1985). Eight out of 15 members reported being appointed chief of pediatric surgery before 1985. In 20 institutions, 34 full time physicians(27 members, reportedly) are working in pediatric surgery. In regarding to pediatric surgical training, 16 members(64%) received an average of 16 months of training abroad, 5 members trained at home and abroad, and 4 from only at home. There are no differences in length of training periods in these groups. Twenty one members received their basic pediatric surgical training before 1985, the year of inauguration of the association. Twelve members received post-pediatric surgery refresher courses averaging 11 months' duration, after 2-11 years. Thirteen participants of this study belongs to the founding members of the association.

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Survival in clinical stage I endometrial cancer with single vs. multiple positive pelvic nodes: results of a multi-institutional Italian study

  • Uccella, Stefano;Falcone, Francesca;Greggi, Stefano;Fanfani, Francesco;De Iaco, Pierandrea;Corrado, Giacomo;Ceccaroni, Marcello;Mandato, Vincenzo Dario;Bogliolo, Stefano;Casarin, Jvan;Monterossi, Giorgia;Pinelli, Ciro;Mangili, Giorgia;Cormio, Gennaro;Roviglione, Giovanni;Bergamini, Alice;Pesci, Anna;Frigerio, Luigi;Uccella, Silvia;Vizza, Enrico;Scambia, Giovanni;Ghezzi, Fabio
    • Journal of Gynecologic Oncology
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    • v.29 no.6
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    • pp.100.1-100.13
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    • 2018
  • Objective: To investigate survival outcomes in endometrioid endometrial cancer (EEC) patients with single vs. multiple positive pelvic lymph nodes. Methods: We performed a retrospective evaluation of all consecutive patients with histologically proven International Federation of Gynecology and Obstetrics (FIGO) stage IIIC1 EEC who underwent primary surgical treatment between 2004 and 2014 at seven Italian gynecologic oncology referral centers. Patients with pre- or intra-operative evidence of extra-uterine disease (including the presence of bulky nodes) and patients with stage IIIC2 disease were excluded, in order to obtain a homogeneous population. Results: Overall 140 patients met the inclusion criteria. The presence of >1 metastatic pelvic node was significantly associated with an increased risk of recurrence and mortality, compared to only 1 metastatic node, at both univariate (recurrence: hazard ratio [HR]=2.19; 95% confidence interval [CI]=1.2-3.99; p=0.01; mortality: HR=2.8; 95% CI=1.24-6.29; p=0.01) and multivariable analysis (recurrence: HR=1.91; 95% CI=1.02-3.56; p=0.04; mortality: HR=2.62; 95% CI=1.13-6.05; p=0.02) and it was the only independent predictor of prognosis in this subset of patients. Disease-free survival (DFS) and disease-specific survival (DSS) were significantly longer in patients with only 1 metastatic node compared to those with more than 1 metastatic node (p=0.008 and 0.009, respectively). Conclusion: The presence of multiple metastatic nodes in stage IIIC1 EEC represents an independent predictor of worse survival, compared to only one positive node. Our data suggest that EEC patients may be categorized according to the number of positive nodes.