• Title/Summary/Keyword: systemic risk

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Metastatic Colorectal Cancer Treatment and Survival: the Experience of Major Public Hospitals in South Australia Over Three Decades

  • Roder, David;Karapetis, Christos S;Wattchow, David;Moore, James;Singhal, Nimit;Joshi, Rohit;Keefe, Dorothy;Fusco, Kellie;Buranyi-Trevarton, Dianne;Sharplin, Greg;Price, Timothy J
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5923-5931
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    • 2015
  • Background: Registry data from four major public hospitals indicate trends over three decades from 1980 to 2010 in treatment and survival from colorectal cancer with distant metastases at diagnosis (TNM stage IV). Materials and Methods: Kaplan-Meier product-limit estimates and Cox proportional hazards models for investigating disease-specific survival and multiple logistic regression analyses for indicating first-round treatment trends. Results: Two-year survivals increased from 10% for 1980-84 to 35% for 2005-10 diagnoses. Corresponding increases in five-year survivals were from 3% to 16%. Time-to-event risk of colorectal cancer death approximately halved (hazards ratio: 0.48 (0.40, 0.59) after adjusting for demographic factors, tumour differentiation, and primary sub-site. Survivals were not found to differ by place of residence, suggesting reasonable equity in service provision. About 74% of cases were treated surgically and this proportion increased over time. Proportions having systemic therapy and/or radiotherapy increased from 12% in 1980-84 to 61% for 2005-10. Radiotherapy was more common for rectal than colonic cases (39% vs 7% in 2005-10). Of the cases diagnosed in 2005-10 when less than 70 years of age, the percentage having radiotherapy and/or systemic therapy was 79% for colorectal, 74% for colon and 86% for rectum (&RS)) cancers. Corresponding proportions having: systemic therapies were 75%, 71% and 81% respectively; radiotherapy were 24%, 10% and 46% respectively; and surgery were 75%, 78% and 71% respectively. Based on survey data on uptake of offered therapies, it is likely that of these younger cases, 85% would have been offered systemic treatment and among rectum (&RS) cases, about 63% would have been offered radiotherapy. Conclusions: Pronounced increases in survivals from metastatic colorectal cancer have occurred, in keeping with improved systemic therapies and surgical interventions. Use of radiotherapy and/or systemic therapy has increased markedly and patterns of change accord with clinical guideline recommendations.

Fontan Procedure for Functional Single Ventricle with Major Aortopulmonary Collateral Arteries (주요대동맥-폐동맥 측부혈관이 동반된 기능적 단심실 환자에서의 폰탄수술)

  • 홍순창;박한기;조범구;박영환
    • Journal of Chest Surgery
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    • v.37 no.6
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    • pp.539-542
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    • 2004
  • Not only morphology of pulmonary artery or pulmonary artery resistance, but major aortopulmonary collateral arteries are risk factors of Fontan procedure. We report a successful Fontan procedure after rehabilitation of pulmonary arteries by unifocalization and systemic to pulmonary shunt in a high risk Fontan candidate with functional single ventricle combined with hypoplastic pulmonary arteries and major aortopulmonary collateral arteries supplying most of the bilateral lung field.

Liquidity Risk and Asset Returns : The Case of the Korean Stock Market

  • Choe, Hyuk;Yang, Cheol-Won
    • The Korean Journal of Financial Management
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    • v.26 no.4
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    • pp.103-140
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    • 2009
  • This paper investigates various channels through which liquidity can affect stock returns and examines whether behavioral explanation for liquidity risk is reasonable. First, we examine whether liquidity level (average liquidity) plays a significant role in determining asset returns. The result is consistent with the hypothesis that a stock with higher average illiquidity will have a higher expected return. Second, we focus on the argument that liquidity has a non-diversifiable systematic component. If systemic liquidity has a different impact across individual securities, a stock that is more sensitive to systematic liquidity will have a higher expected return. The results of various tests are inconsistent with each other, not completely supporting the argument. Finally, the intra-market tests in Korea support the behavioral explanation for the liquidity premium, and the effect is stronger in the liquidity level than in the liquidity beta related to systematic liquidity.

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Technical Management Planning Process of Engineering Project (개발 프로젝트의 기술관리 계획 프로세스)

  • Yoo, Il Sang;Park, Young Won
    • Journal of the Korean Society of Systems Engineering
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    • v.1 no.2
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    • pp.63-68
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    • 2005
  • This study developed the planning process for technical management of engineering project applying systems engineering process in order to correctly design technical management activities early during the system development projects. The developed process describes a systemic design process of a product to be developed as well as the development process and the personnel team of project organization. As an outcome of the process implemented by a Model-Based Systems Engineering(MBSE) software, a systems engineering management plan(SEMP) and a risk management plan can easily be produced.

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Functionality of Dairy Foods on Osteoporosis

  • Moon, Yong-Il;Lee, Sunho;Oh, Sangnam;Kim, Younghoon
    • Journal of Dairy Science and Biotechnology
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    • v.34 no.3
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    • pp.157-164
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    • 2016
  • Osteoporosis is a systemic skeletal disease characterized by decreased bone mass, which results in a markedly increased risk of traumatic fractures. This disease is a worldwide health problem with a high prevalence. Recently, various dietary components have been found to minimize the risk of developing osteoporosis through their ability to stimulate bone formation and optimize bone health. Among them, probiotics and fermented milk can have beneficial effects to human health. Bioactive compounds derived from probiotics in fermented milk can especially modulate physiological functions related to bone health. Here, we review the evidence to support these insights into newly found functionality of dairy foods for osteoporosis prevention.

Recent Improvements in the Treatment of High-Risk Thyroid Cancer (예후가 좋지 않은 갑상선암에 대한 최신 치료 방침)

  • Lee, Eun Kyung
    • Korean Journal of Head & Neck Oncology
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    • v.38 no.1
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    • pp.1-9
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    • 2022
  • Thyroid cancer is one of the slow-growing tumors with excellent oncological outcomes. However, a small set of patients with unexpectedly severe outcomes are usually ignored. Anaplastic thyroid cancer (ATC) remains one of the most aggressive and lethal solid tumors. Recently, dabrafenib and trametinib combination therapy or neoadjuvant BRAF induction therapy has shown promising results. In addition, a combination of targeted drugs, immunotherapy, surgery, and radiation therapy can improve overall survival in ATC patients. Another disease for which there is no breakthrough treatment is radioactive iodine-refractory differentiated thyroid cancer (DTC). To date, multikinase inhibitors (sorafenib, lenvatinib) targeting the growth factor signaling pathway have been developed and approved as anticancer agents for patients with advanced DTC. This review includes results from multikinase inhibitors to the emergence of new target molecules, including rearrangements during transformation (RET) and tropomyosin receptor kinase (TRK).

Considerations for Invasive Dental Treatment in Disabled Patients

  • Eun-Jung Kwak
    • Journal of Korean Dental Science
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    • v.16 no.1
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    • pp.1-8
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    • 2023
  • Dental treatment for the disabled should be a customized that considers the characteristics and degree of cooperation of each disabled patient. There are additional considerations during implant treatment and tooth extraction in disabled patients. Since some brain lesion disorder or cardiac disease patients may be taking antiplatelet or anticoagulant medications, it is necessary to evaluate whether these medications should be discontinued before an invasive procedure. Precautions should be taken for patients with heart valve disease considering the risk of infective endocarditis, especially during invasive dental procedures. Moreover, disabled patients may have difficulty in following instructions and cautions. There are specific considerations for each stage of implant treatment in disabled patients. In the case of patients who are in the pre- or post-transplant state, it is necessary to assess their general condition and oral disease due to the risk of infection. Since disabled patients with various systemic diseases may visit the dental clinic, it is important to understand their characteristics and treatment process in order to flexibly adjust the dental treatment plan accordingly.

Solid tumors in childhood: risk-based management (소아 고형종양 - 위험군에 따른 맞춤 치료 -)

  • Koo, Hong Hoe
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.606-612
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    • 2007
  • Since the introduction of chemotherapy for the treatment of childhood leukemia more than 50 years ago, the results of childhood cancer have improved dramatically. The 5-year survival rate of disease, many of which were uniformly fatal in the prechemotherapy era, reached to more than 75%. This remarkable improvement in survival is a direct result of the incorporation of chemotherapeutics into treatment regimens that previously relied only on surgery or radiotherapy for the primary tumor. The multimodality approach, which integrates surgery and radiotherapy to control local disease with chemotherapy to eradicate systemic or metastatic disease, has become the standard approach to treating most childhood cancers. The overall improvement in outcomes in childhood solid tumors has been related to the development of multidisplinary cooperative studies that has permitted the development of well-designed tumor treatment protocols characterized by uniform staging criteria, sharing informations in pathologic classification, uniform methods for tumor markers, oncogenes, and other biologic and genetic factors. Important advances in the biologic study of cancer and its genetic basis led to a number of observations that impact directly on the management of childhood solid tumors. Identification of specific genes, oncogenes, tumor markers, and other biologic and pathologic factors plays an important role in both staging and clarifying the risk categorization of individual patients. Treatment of the patient is influenced by the recognition of specific risk factors. This knowledge has resulted in a change in the approach to care based not only on staging criteria, but also on risk-based management. This concept uses various risk factors of outcomes. Risk-based management allows for each patient to maximize survival, minimize long-term morbidity and improve the quality of life, especially for children's growth and development.

A retrospective study of the cumulative survival rate of implants installed in combination with sinus elevation (상악동 거상술을 동반한 임플란트의 누적생존율에 대한 연구)

  • Koo, Hae-Jin;Cho, Young-Dan;Ku, Young
    • The Journal of the Korean dental association
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    • v.55 no.2
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    • pp.116-127
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    • 2017
  • Objectives : The aim of this study was to evaluate the cumulative survival rates of the implants placed into grafted sinus and determine the effect of age, gender, smoking, and systemic disease on the implant cumulative survival rates. Materials and Methods : The retrospective study was performed on 51 implants placed in 26 patients by one dentist at the Dental Implant Center, Seoul National University Dental Hospital in the years 2000-2010. The cumulative survival rates were calculated by the Kaplan-Meier method. The differences within the factors were analyzed using log-rank test and the correlations between the factors and implant survival rates were analyzed using Cox proportional hazard model. Results : 1. Among the total of 51 implants placed in 26 patients, 7 implants failed and 44 implants remained stable. The 1-year, 5-year, and 10-year cumulative survival rates were 92%, 88%, and 85%, respectively. 2. Patients in their 50s and in their 70s showed statistically significant difference in the cumulative survival rates (P < 0.05). Gender and the existence of systemic disease did not show significant results. 3. In the implant treatment, smokers showed 7.5 times higher risk of implant failure than non-smokers (P < 0.05). Conclusion: Implants installed in combination with sinus elevation can be considered as a reliable treatment method.

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Genetic Polymorphisms of TCF7L2 Lack Influence on Risk of the Polycystic Ovary Syndrome - a Systemic Analysis

  • Lin, Lin;Yang, Jing;Ding, Yan;Wang, Jing;Ting, Liu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.7
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    • pp.3331-3333
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    • 2014
  • Background: The results of previous researches that analyzed the association between genetic polymorphisms of transcription factor-7-like 2 (TCF7L2, rs7903146) and polycystic ovary syndrome (PCOS) were conflicting. Current systematic analysis was conducted to re-explore this association using updated materials. Materials and Methods: The PubMed database was used for data collection and the final search was conducted on January 3, 2014. For TCF7L2 rs7903146, a non-signficiant slight increase in risk of PCOS development was observed under three genetic models (dominant model: OR=1.06, 95%CI: 0.93-1.21, p>0.05; recessive model: OR=1.12, 95%CI: 0.87-1.43, p> 0.05; homozygous model: OR=1.14, 95%CI: 0.87-1.47, p>0.05). In the subgroup analyses in Asian group, allele susceptibility of PCOS was calculated (allele model: OR=1.00, 95%CI: 0.74-1.35, p>0.05; dominant model: OR=0.98, 95%CI: 0.71-1.35, p>0.05; recessive model: OR=1.79, 95%CI: 0.33-9.84, p>0.05; homozygous model: OR=1.78, 95%CI: 0.32-9.80, p>0.05), the differences were again not statistically significant. Conclusions: The findings of this systemic analysis suggest that the polymorphism of TCF7L2 rs7903146 may not be associated with the susceptibility to PCOS.