• Asian Pacific Journal of Cancer Prevention
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• 제15권1호
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• pp.61-67
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• 2014

Background: Solid cancers with bone marrow metastases are rare but lethal. This study aimed to identify clinical factors predictive of survival in adult patients with solid cancers and bone marrow metastases. Methods: A total of 83 patients were enrolled consecutively between January 1, 2000 and December 31, 2012. Bone marrow metastases were confirmed by biopsies. Patient clinical features and laboratory data were analyzed for associations. Results: The median age of the patients was 54 years (range, 23-88 years), and 58% were male. The 3 most common primary tumor locations were the stomach (32 patients, 39%), prostate (16 patients, 19%), and lungs (12 patients, 15%). The median overall survival was 49 days (range, 3-1423 days). Patients with Eastern Cooperative Oncology Group performance status 1, cancers of prostate origin, platelet counts over 50,000/ml, and undergoing antitumor therapies had a significantly better prognosis in the multivariate analysis. The median survival times were 173 and 33 days for patients with 2-3 more favorable parameters (n=24) and those with 0-1 (n=69), respectively (hazard ratio 0.30; 95% CI 0.17-0.52, p<0.001). Conclusions: Solid cancers with bone marrow metastases are dismal and incurable diseases. Understanding prognostic factors to these diseases helps medical personnel to provide appropriate treatments and better inform patients about outcomes. Antitumor therapies may improve outcomes in selected patient cohorts.

• Radiation Oncology Journal
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• 제32권3호
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• pp.147-155
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• 2014

Purpose: This study was conducted to observe the outcomes of postoperative radiotherapy (PORT) with or without concurrent chemotherapy in resected non-small cell lung cancer (NSCLC) in single institution. Materials and Methods: From 2002 to 2013, 78 patients diagnosed with NSCLC after curative resection were treated with radiotherapy alone (RT, n = 48) or concurrent chemoradiation (CCRT, n = 30). The indications of adjuvant radiation therapy were N2 node positive (n = 31), close or involved resection margin (n = 28), or gross residual disease due to incomplete resection (n = 19). The median radiation dose was 57.6 Gy (range, 29.9 to 66 Gy). Results: Median survival time was 33.7 months (range, 4.4 to 140.3 months). The 5-year overall survival (OS) rate was 49.5% (RT 46% vs. CCRT 55.2%; p = 0.731). The 3-year disease-free survival rate was 45.5% (RT 39.4% vs. CCRT 55.3%; p = 0.130). The 3-year local control rate was 68.1% (RT 64.4% vs. CCRT 77.7%; p = 0.165). The 3-year DMFS rate was 56.1% (RT 52.6% vs. CCRT 61.7%; p = 0.314). In multivariate analysis, age ${\geq}66$ years and pathologic stage III were significant poor prognostic factors for OS. Treatment failure occurred in 40 patients. Four patients had radiologically confirmed grade 3 radiation pneumonitis. Conclusion: In NSCLC, adjuvant RT or CCRT after curative surgery is a safe and feasible modality of treatment. OS gain was seen in patients less than 66 years. Postoperative CCRT showed a propensity of achieving better local control and improved disease-free survival compared to RT alone according to our data.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.2091-2095
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• 2013

Background: The $7^{th}$ TNM staging is the first authoritative standard for evaluation of effectiveness of treatment of gastric cancer worldwide. However, revision of pN classification within TNM needs to be discussed. In particular, the N3 sub-stage is becoming more conspicuous. Methods: Clinical data of 302 pN3M0 stage gastric cancer patients who received radical gastrectomy in Tianjin Medical University Cancer Institute and Hospital from January 2001 to May 2006 were retrospectively analyzed. Results: Location of tumor, depth of invasion, extranodal metastasis, gastric resection, combined organs resection, lymph node metastasis, rate of lymph node metastasis, negative lymph nodes count were important prognostic factors of pN3M0 stage gastric cancers. TNM stage was also associated with prognosis. Patients at T2N3M0 stage had a better prognosis than other sub-classification. T3N3M0 and T4aN3aM0 patients had equal prognosis which followed the T2N3M0. T4aN3bM0 and T4bN3aM0 had lower survival rate than the formers. T4bN3bM0 had worst prognosis. In multivariate analysis, TNM stage group and rate of lymph node metastasis were independent prognostic factors. Conclusions: The sub-stage of N3 may be useful for more accurate prediction of prognosis; it should therefore be applied in the TNM stage system.

• 한국병원경영학회지
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• 제5권1호
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• pp.40-61
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• 2000

The purpose of this study is to promote the efficiency of the management of the controls organization in the university hospitals and general hospitals by evaluating the factors underlying organizational conflict. The subject population included 351 hospital workers randomly selected from two general hospitals of less than 200 beds and two university hospitals over 500 beds in Seoul area. Data were collected through a survey questionnaire. To define related factors for the level of conflict among departments in each hospitals multivariate regression analysis was conducted. Independent factors were characteristics of subjects, conflicting factors between the departments. The results are as follows: 1. Those in high job position group demonstrated significantly higher level of conflict between departments. Those working in the general hospitals, who were older and had long-term tenure at current working hospital had higher level of conflict between the departments. 2. Concerning the involvement of conflicting factors and the level of conflict in the employees' there was statistically significant positive correlation between reliability and job-related and intradepartmental level of conflict in university hospitals. There was a significant positive correlation between interdepartmental conflicting factors of mutual dependence, difference in goal/orientation and interdepartmental level of conflict. 3. In the university hospitals, among the interdepartmental factors, mutual dependence and difference in goal/orientation had statistically significant influence and showed a positive relationship with interdepartmental level of conflict. In the general hospitals, job position was a significant factor which showed that those in high position such as section chief or above, compared to those in general position had higher level of conflict. Among the interdepartmental characteristics, factors of mutual dependence and goal/orientation had statistically significant influence and showed a positive relationship with interdepartmental level of conflict. In the general hospitals setting efforts to reduce conflict in areas among workers with high position, old age, and long tenure and those in medical care department should be made and prudent management and planning for improved manpower and increased budget or efficient allocation and clear definition of job description are necessary to adequately assess. In the university hospitals setting efforts to reexaminitation of the organizational structure and efficiency conveyance of information and efforts to resolve conflict among young workers with lower level of education is need. This study has its own merit in comparing empirically the conflict among hospital workers in the university hospitals and general hospitals. Future study are needed with respect to the relationship between interdepartmental level of conflict and the effectiveness of the hospital organization for improved resolution of conflict in the organization and hospital management.

• Tuberculosis and Respiratory Diseases
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• 제71권2호
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• pp.114-119
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• 2011

Background: There is very limited data present on smoking cessation rates in outpatient departments of pulmonology. In this study, we aimed to investigate the effectiveness of a brief smoking cessation intervention program in an outpatient department of pulmonology and identify predictors of smoking cessation failure. Methods: After a brief recommendation of smoking cessation from pulmonologists, smokers willing to quit smoking were given individual counseling and supplement drugs. Fifty smokers were included in this study and baseline characteristics, smoking history and success rate were reviewed at 3 months. Results: The mean age of the patients was $58.3{\pm}14.6$ years and the total group of patients included 3 women. The rate of smoking cessation success was 74% at 3 months, and there were no differences in age, spirometric indexes and associated diseases between the smoking cessation success and failure group. The rate of supplement drug usage was not different in both groups either. However, body weight, mean number of cigarette usage per day and nicotine dependence scores in the failure group were significantly higher than in the success group. In multivariate analysis, body weight and mean number of cigarette usage per day were significant. Two smokers with a depressive disorder failed the smoking cessation. Conclusion: A smoking cessation intervention program in the outpatient department of pulmonology showed a favorable success rate. More intensive interventions are needed to unfavorable groups which include the obese and heavy smokers.

• Tuberculosis and Respiratory Diseases
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• 제79권1호
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• pp.31-36
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• 2016

Background: The purpose of this study was to evaluate the risk factors for mechanical ventilation in the patients with scrub typhus admitted to intensive care unit (ICU) at a university hospital. Methods: We retrospectively selected and analyzed clinical data from the medical records of 70 patients (32 men, 38 women) admitted to the ICU with scrub typhus between 2004 and 2014. The patients had a mean${\pm}$standard deviation age of $71.2{\pm}11.1years$ and were evaluated in two groups: those who had been treated with mechanical ventilation (the MV group, n=19) and those who had not (the non-MV group, n=51). Mean ages of the MV group and the non-MV group were $71.2{\pm}8.3years$ and $71.2{\pm}11.1years$, respectively. Results: Significant differences between the two groups were observed with respect to acute respiratory failure (p=0.008), Acute Physiology and Chronic Health Evaluation (APACHE) II score (p=0.015), Sequential Organ Failure Assessment (SOFA) score (p=0.013), death (p=0.014), and ICU duration (p<0.01). Multivariate analysis indicated that the following factors were significantly associated with mechanical ventilation: acute respiratory failure (p=0.011), SOFA score (p=0.005), APACHE II score (p=0.011), platelet count (p=0.009), and lactate dehydrogenase (LDH) (p=0.011). Conclusion: Thus, five factors-acute respiratory failure, SOFA score, APACHE II score, platelet count, and LDH-can be the meaningful indicators for mechanical ventilation for the patients with scrub typhus admitted to ICU.

• Tuberculosis and Respiratory Diseases
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• 제81권4호
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• pp.311-318
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• 2018

Background: The aim of this study was to examine the influence of body mass index (BMI) on the development of acute kidney injury (AKI) in critically ill patients in intensive care unit (ICU). Methods: Data of patients admitted to medical ICU from December 2011 to May 2014 were retrospectively analyzed. Patients were classified into three groups according to their BMI: underweight (< $18.5kg/m^2$), normal ($18.5-24.9kg/m^2$), and overweight (${\geq}25kg/m^2$). The incidence of AKI was compared among these groups and factors associated with the development of AKI were analyzed. AKI was defined according to the Risk, Injury, Failure, Loss of kidney function, and End-stage (RIFLE) kidney disease criteria. Results: A total of 468 patients were analyzed. Their mean BMI was $21.5{\pm}3.9kg/m^2$, including 102 (21.8%) underweight, 286 (61.1%) normal-weight, and 80 (17.1%) overweight patients. Overall, AKI occurred in 82 (17.5%) patients. The overweight group had significantly (p<0.001) higher incidence of AKI (36.3%) than the underweight (9.8%) or normal group (15.0%). In addition, BMI was significantly higher in patients with AKI than that in those without AKI ($23.4{\pm}4.2$ vs. $21.1{\pm}3.7$, p<0.001). Multivariate analysis showed that BMI was significantly associated with the development of AKI (odds ratio, 1.893; 95% confidence interval, 1.224-2.927). Conclusion: BMI may be associated with the development of AKI in critically ill patients.

• Asian Pacific Journal of Cancer Prevention
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• 제13권8호
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• pp.3879-3887
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• 2012

Background: Development of effective educational strategies should accompany increases in public awareness and the availability of genetic testing for breast cancer (BC). These educational strategies should be designed to fulfill the knowledge gap while considering factors that influence women's interest in order to facilitate decision making. Objective: To determine the possible correlates of Saudi women's interest in BC genes testing including socio-demographics, the level of awareness towards BC genes, the family history of BC and the perceived personal risk among adult Saudi women in Al Hassa, Saudi Arabia. Subjects and methods: This cross-sectional study was carried out during the second BC community-based campaign in Al Hassa, Saudi Arabia. All Saudi women aged ${\geq}18$ years (n=781) attending the educational components of the campaign were invited to a personal interview. Data collection included gathering information about sociodemographics, family history of BC, the perceived personal risk for BC, awareness and attitude towards BC genes and the women's interest in BC genes testing. Results: Of the included women (n=599), 19.5% perceived higher risk for BC development, significantly more among < 40 years of age, and with positive family history of BC before 50 years of age. The participants demonstrated a poor level of awareness regarding the inheritance, risk, and availability of BC genetic testing. The median summated knowledge score was 1.0 (out of 7 points) with a knowledge deficit of 87.8%. The level of knowledge showed significant decline with age (> 40 years). Of the included women 54.7% expressed an interest in BC genetic testing for assessing their BC risk. Multivariate regression model showed that being middle aged (Odds Ratio 'OR'=1.88, confidence intervals 'C.I'=1.14-3.11), with higher knowledge level (OR=1.67, C.I=1.08-2.57) and perceiving higher risk for BC (OR=2.11, C.I=1.61-2.76) were the significant positive correlates for Saudi women interest in BC genetic testing. Conclusion: Saudi women express high interest in genetic testing for BC risk despite their poor awareness. This great interest may reflect the presence of inappropriate information regarding BC genetic testing and its role in risk analysis.

• Asian Pacific Journal of Cancer Prevention
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• 제15권17호
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• pp.7097-7103
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• 2014

Over-expression of de novo lipogenesis (DNL) genes is associated with the prognosis of various types of cancers. However, the effects of single nucleotide polymorphisms (SNPs) in these genes on recurrence and survival of non-small cell lung cancer (NSCLC) patients after surgery are still unknown. In this study, a total of 500 NSCLC patients who underwent surgery treatment were included. Eight SNPs in 3 genes (ACACA, FASN and ACLY) of the DNL pathway were examined using the Sequenom iPLEX genotyping system. Multivariate Cox proportional hazards regression and Kaplan-Meier curves were used to analyze the association of SNPs with patient survival and tumour recurrence. We found that two SNPs in the FASN gene were significantly associated with the recurrence of NSCLC. SNP rs4246444 had a significant association with lung cancer recurrence under additive model (hazard ratio [HR], 0.82; 95% confidence interval [95%CI], 0.67-1.00; p=0.05). Under the dominant model, rs4485435 exhibited a significant association with recurrence (HR, 0.75; 95%CI, 0.56-1.01; p=0.05). Additionally, SNP rs9912300 in ACLY gene was significantly associated with overall survival in lung cancer patients (HR, 1.41; 95%CI, 1.02-1.94, p=0.04) under the dominant model. Further cumulative effect analysis showed moderate dose-dependent effects of unfavorable SNPs on both survival and recurrence. Our data suggest that the SNPs in DNL genes may serve as independent prognostic markers for NSCLC patients after surgery.

• 식물분류학회지
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• 제43권4호
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• pp.300-311
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• 2013

플라보노이드 분석을 실시한 결과 한반도 아고산지역에 널리 분포하는 것으로 추정되는 당마가목[Sorbus pohuashanensis (Hance) Hedl.]은 중국 내륙에 분포하는 S. wilsoniana, S. amabilis과 동일한 화학형을 보이거나, 혹은 마가목[S. commixta Hedl.]의 화학형이 집단별로 나타나 잡종 가능성이 제기되었다. 따라서, 근연종과 잡종가능성이 제기되는 중국 내륙의 개체들과 당마가목과 마가목 분포지인 한중일의 721개 개체의 19개 형질에 대한 다변량분석을 시도하여 분류군의 형태적 분화와 형질에 대한 분석을 시도하였다. 정량적 형질에 대한 단변량과 다변량분석에서 마가목분류군 전체 종간에 뚜렷하게 구분할 수 있는 식별형질은 찾지 못한 반면, 정성형질인 동아의 색, 동아와 잎 뒷면의 털의 색깔 및 유무, 탁엽의 모양의 차이와 심피의 모양에서 종간 식별 형질을 확인하였다. 형태 분석과 플라보이드 연구 결과, 한반도에 분포하는 한반도당마가목은 중국동북 3성과 극동러시아의 당마가목(S. pohuashanensis)과는 전혀 다른 화학형으로서, 중국 내륙에 분포하는 S. wilsoniana와 마가목과의 과거 잡종이입에 의한 분류군으로 판단된다. 한반도에 분포하는 추정 교잡종인 당마가목은 정량적, 정성적으로 마가목과 형태적으로 별다른 차이점을 확인할 수 없어, 역사적 종의 개념(historical species concept)에 의한 신 잡종기재보다는 전형질적 종의 개념(phenetic species concept)에 근거하여 마가목과 동일종으로 보는 것이 타당하여 마가목의 이명으로 처리하였다.