• Journal of agricultural medicine and community health
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• v.37 no.2
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• pp.76-83
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• 2012

Objectives: The purpose of this study was to define the underserved emergency medical services (EMS) areas in Daejeon metropolitan city, as well as to identify their distinctive characteristics in public health perspectives. Methods: An underserved EMS area was operationally defined as an area in which it is difficult to arrive at an emergency medical center within 30 minutes. Using a cost-weighted distance algorithm with a geographic information system (GIS), the underserved EMS area was calculated. The characteristics of the underserved areas were analyzed by the Chi-square test. The SPSS statistical software package was used to perform the statistical analysis. All statistical tests were two-sided, and a p-value<0.05 was considered statistically significant. Results: Twelve administrative sectors ('Dong' in Korean) were included in the underserved areas, accounting for a population of approximately 8,100 citizens. The relationships between underserved EMS area and populations of agriculture, fishery, and forestry; citizens who are recipients of national basic livelihood security program; disabled; or aged 65 or older were statistically significant. Conclusion: It was found that 12 administrative sectors were included in the underserved EMS areas. Revealing underserved EMS areas using GIS analysis based on a cost-weighted distance algorithm of road data was an effective analytic method. However, as this study was confined to Daejeon City, South Korea, a nation-wide study should be performed to provide a more accurate conclusion.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.215-217
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• 2016

Background: Chronic lymphocytic leukemia (CLL) is the most frequent form of leukemia in Europe and North America, and it mainly affects older individuals. Many approaches are implemented in the management of CLL from a watch and wait (W&W) strategy to chemotherapeutic regimens. We here reviewed our clinical practice for the relevance of the W&W strategy in Lebanese CLL patients. Materials and Methods: A total of 95 patients with CLL diagnosed in four institutions in Lebanon, between 1992 and 2013, were selected and their files were reviewed. Characteristics of these patients were noted including age, sex, RAI and Binet scores, CBC values, presence of hepatomegaly or splenomegaly, performance of bone marrow biopsy or peripheral blood flux cytometry for diagnosis, adoption of W&W strategy, different chemotherapeutic regimens and the indications for treatment. Results: Some 38 patients (40%) diagnosed with CLL were women and 57 (60%) were men with a mean age of 65.1 years [36-89]. Of the total, 50.5%, 17.2%, 14%, 7.5% and 10.8% had an RAI score at diagnosis of 0, 1, 2, 3 and 4, respectively, while 65.6%, 17.2% and 17.2% had Binet scores of I, II and III. The mean lymphocyte count at diagnosis was $39885/mm^3$ [1596-290000], the mean hemoglobin level was 12.7 g/dl [6.2-17] and the mean platelet count was $191255/mm^3$ [14000-458000]. While 26.3% of patients with CLL had splenomegaly, only 7.4% had hepatomegaly. Some 33.7% had undergone a bone marrow biopsy, 66.3% flow cytometry of circulating blood and 5.3% a lymph node biopsy. Overall, the W&W was adopted in 62.4% (58) of patients with a mean duration of 37.7 months [3-216]. The W&W was used in 82.6%, 73.3%, 46.2%, 14.3% and 0% of patients having RAI scores of 0, 1, 2, 3 and 4, respectively, and, it was used in 80%, 46.7% and 6.25% with Binet scores of I, II and III. The most frequent indication for treatment was anemia and thrombocytopenia, accounting for 32.7% of cases. The most frequently used chemotherapeutical regimens were chlorambucil until the end of the last century and flufarabine-cyclophosphamide-rituximab during the last decade. Conclusions: This retrospective review of CLL clinical practice showed an important implementation of the W&W strategy with a long duration, especially in early stage cases with low RAI or Binet scores.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.12
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• pp.5063-5069
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• 2016

Background: Breast cancer is the most common cancer among women in most countries of the world. It is ranked first in females in Morocco (accounting for 33.4% of the total cancer burden) and more than 60% of cases are diagnosed at stage III or IV. During the last decade, health-related quality of life (HRQOL) has become an important aspect of breast cancer treatment. The objective of this study was to describe self-reported HRQOL in patients with breast cancer and to investigate its associations with sociodemographic and clinical variables. Methods: A prospective study was carried out in the main oncology centers in Morocco. Quality of life was measured using the Moroccan Arabic versions of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C 30 (EORTC QLQ C30) and the Breast Cancer-Specific Quality of Life Questionnaire (EORTC QLQ-BR23). Statistical analyses were performed using descriptive statistics and multivariate analyses. Results: A total of 1463 subjects were included in the study, with a mean age of 55.6 (SD. 11.2) years, 70% being married. The majority had stage II (45.9%) and a few cases stage IV (12.9%) lesions. The participants' global health mean score was 68.5 and in "functional scales", social functioning scored the highest (Mean 86.2 (SD=22.7)). The most distressing symptom on the symptom scale was financial difficulties (Mean 63.2 (SD=38.2)). Using the disease specific tool, it was found that future perspective scored the lowest (Mean 40.5 (SD=37.3)). On the symptom scale, arm symptoms scored the highest (Mean 23.6 (SD=21.6)). Significant mean differences were noted for many functional and symptom scales. Conclusion: Our results emphasized that the general HRQOL for our study population is lower than for corresponding populations in other countries. This study provided baseline information on the quality of life for a large sample of Moroccan women diagnosed with breast cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.4
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• pp.1449-1453
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• 2015

Background: Oral capecitabine is increasingly replacing intravenous 5-fluorouracil in many chemotherapy regimens. However, data on the risk of febrile neutropaenia (FN) and treatment related death (TRD) with the drug remain sparse outside of clinical trial settings despite its widespread usage. This study aimed to determine these rates in a large cohort of patients treated in the University of Malaya Medical Centre (UMMC). Materials and Methods: We reviewed the clinical notes of all patients prescribed with oral capecitabine chemotherapy for any tumour sites in University Malaya Medical Centre (UMMC) from $1^{st}$ January 2009 till $31^{st}$ June 2010. Information collected included patient demographics, histopathological features, treatment received including the different chemotherapy regimens and intent of treatment whether the chemotherapy was given for neoadjuvant, concurrent with radiation, adjuvant or palliative intent. The aim of this study is to establish the pattern of usage, FN and TRD rates with capecitabine in clinical practice outside of clinical trial setting. FN is defined as an oral temperature > $38.5^{\circ}C$ or two consecutive readings of > $38.0^{\circ}C$ for 2 hours and an absolute neutrophil count < $0.5{\times}10^9/L$, or expected to fall below $0.5{\times}10^9/L$ (de Naurois et al., 2010). Treatment related death was defined as death occurring during or within 30 days of last chemotherapy treatment. Results: Between $1^{st}$ January 2009 and $30^{th}$ June 2010, 274 patients were treated with capecitabine chemotherapy in UMMC. The mean age was 58 years (range 22 to 82 years). Capecitabine was used in 14 different tumour sites with the colorectal site predominating with a total of 128 cases (46.7%), followed by breast cancer (35.8%). Capecitabine was most commonly used in the palliative setting accounting for 63.9% of the cases, followed by the adjuvant setting (19.7%). The most common regimen was single agent capecitabine with 129 cases (47.1%). The other common regimens were XELOX (21.5%) and ECX (10.2%). The main result of this study showed an overall FN rate of 2.2% (6/274). The overall TRD rate was 5.1% (14/274). The FN rate for the single agent capecitabine regimen was 1.6% (2/129) and the TRD rate was 5.4% (7/129). All the TRDs were with single agent capecitabine regimen were used for palliative intent. Conclusions: Oral capecitabine is used widely in clinical practice in a myriad of tumour sites and bears a low risk of febrile neutropaenia. However, capecitabine like any other intravenous chemotherapeutic agent carries a significant risk of treatment related death.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.10
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• pp.4193-4198
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• 2015

Background: Globally, retinoblastoma is the most common primary intraocular malignancy occurring in children. This paper documents the recent incidence rates of retinoblastoma by age and sex groups from the Population Based Cancer Registries (PBCRs) of Bangalore, Mumbai, Chennai, Delhi and Kolkata using the data from the National Cancer Registry Programme. Materials and Methods: Relative proportions, sex ratio, method of diagnosis, and incidence rates (crude and age standardized) for each PBCR and pooled rates of the five PBCRs were calculated for the years 2005/06 to 2009/10. Standard errors and 95% confidence limits of ASIRs by sex group in each PBCR were calculated using the Poisson distribution. Standardised rate ratios of ASIR by sex group and rate ratios at risk were also calculated. Results: The maximum retinoblastoma cases were in the 0-4 age group, accounting for 78% (females) and 81% (males) of pooled cases from five PBCRs. The pooled crude incidence rate in the 0-14 age group was 3.5 and the pooled ASIR was 4.4 per million. The pooled ASIR in the 0-4, 5-9 and 10-14 age group were 9.6, 2.0 and 0.1 respectively. The M/F ratio in Chennai (1.9) and Bangalore PBCRs (2.0) was much higher than the other PBCRs. Among the PBCRs, the highest incidence rate in 0-4 age group was found in males in Chennai (21.7 per million), and females in Kolkata (18.9 per million). There was a distinct variation in incidence rates in the PBCRs in different geographic regions of India.

• Nutrition Research and Practice
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• v.12 no.1
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• pp.69-77
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• 2018

BACKGROUND/OBJECTIVES: Metabolic risk factors should be managed effectively in patients with type 2 diabetes mellitus (T2DM) to prevent or delay diabetic complications. This study aimed to compare the self-management levels of diet and metabolic risk factors in patients with T2DM, according to the duration of illness, and to examine the trends in self-management levels during the recent decades. SUBJECTS/METHODS: Data were collected from the Korea National Health and Nutrition Examination Surveys (KNHANES, 1998-2014). In our analysis, 4,148 patients with T2DM, aged ${\geq}30years$, were categorized according to the duration of their illness (< 5 years, 5-9 years, and ${\geq}10years$). Demographic and lifestyle information was assessed through self-administered questionnaires, and biomarker levels (e.g., fasting glucose level, blood pressure, or lipid level) were obtained from a health examination. Dietary intake was assessed by a 24-recall, and adherence level to dietary guidelines (meal patterns and intake levels of calories, carbohydrates, vegetable/seaweed, sodium, and alcohol) were assessed. Multivariable generalized linear regression and unconditional logistic regression models were used to compare the prevalence rates of hyperglycemia, dyslipidemia, and hypertension according to the duration of patients' illness, accounting for the complex survey design of the KNHANES. RESULTS: In the multivariable adjusted models, patients with a longer duration (${\geq}10years$) of T2DM had a higher prevalence of hyperglycemia than those with a shorter duration of T2DM (< 5 years) (odds ratio 2.20, 95% confidence interval 1.61-3.01, P for trend < 0.001). We did not observe any associations of disease duration with the prevalence of hypertension and dyslipidemia. In addition, the adherence levels to dietary recommendations did not significantly differ according to disease duration, except adherence to moderate alcohol consumption. There were significant decreasing trends in the prevalence of hyperglycemia in patients with a duration of illness ${\geq}10years$ (P for trend = 0.004). CONCLUSION: Although the proportion of patients with adequate control of glucose levels has improved in recent decades, poorer self-management has been found in those with a longer disease duration. These findings suggest the need for well-planned and individualized patient education programs to improve self-management levels and quality of life by preventing or delaying diabetic complications.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.2
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• pp.997-1001
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• 2013

Background: Lymphangiogenesis, assessed as lymphovascular density (LVD), is the initial step of generalized tumor lymphovascular invasion (LVI). It also involves VEGF-C as the most important protein family. Lymphangiogenesis among breast cancer cases correlations with several clinicopathological factors are important to determine prognosis and treatment strategies, but results have been controversial and require clarification. Aim: To define correlations between VEGF-C expression, LVD and LVI with several clinicopathological parameters from Indonesian breast cancer patients. Materials and Methods: Using a cross-sectional study, a total of 48 paraffin-embedded tissues of breast cancer from Dr. Sardjito General Hospital Indonesia were assessed for VEGF-C expression, LVD and LVI by immunohistochemistry. Correlations of these markers with clinicopathological parameters like patient age, tumor size, lymph node status, grade, ER/PR and Her-2 status, cell proliferation and p-53 expression were investigated by linear analysis. Correlations of VEGF-C expression and LVI with several clinicopathological parameters were analyzed with Coefficient Contingency Chi-Square test. Results: The mean of patients age was 53.0 year, pre and post-menopausal patients accounting for 56.3% and 43.8%, respectively. Some 10.4% were well, 41.7% moderate and 47.9% poorly differentiated. ER positivity was evident in 50% while PR and Her-2 positivity was found in 31.3% and 33.3%, respectively. Breast cancer cells with over-expression of p-53 was 64.6% and with high cell proliferation was 56.3%. Lymph node metastasis was noted in 63.5%, and LVI in 72.9%. Significant correlations were found between LVD and tumor size (p:0.037), grade (p:0.000), lymphnode status (p:0.036), LVI (p:0.003), as well as with p-53 and cell proliferation. There were also significant correlation of VEGF-C (p:0.011) and LVI (p:0.001) with tumor grade. Only ER status was found to have a correlation with tumor size (p:0.027). Conclusions: This study suggested that in Indonesian breast cancer patients, lymphangiogenesis is correlated with tumor size, grade, lymph node status and tumor lymphovascular invasion, the latter also being related with p-53 over expression and high cell proliferation.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2005.04a
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• pp.59-63
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• 2005

Respiration motion causes movement of internal structures in the thorax and abdomen, making accurate delivery of radiation therapy to tumors in those areas a challenge. Accounting for such motion during treatment, therefore, has the potential to reduce margins drawn around the clinical target volume (CTV), resulting in a lower dose to normal tissues (e.g., lung and liver) and thus a lower risk of treatment induced complications. Among the techniques that explicitly account for intrafraction motion are breath-hold, respiration gating, and 4D or tumor-tracking techniques. Respiration gating methods periodically turn the beam on when the patient's respiration signal is in a certain part of the respiratory cycle (generally end-inhale or end-exhale). These techniques require acquisition of some form of respiration motion signal (infrared reflective markers, spirometry, strain gauge, thermistor, video tracking of chest outlines and fluoroscopic tracking of implanted markers are some of the techniques employed to date), which is assumed to be correlated with internal anatomy motion. In preliminary study for the respiratory gating radiation therapy, we performed to measurement of this respiration motion signal. In order to measure the respiratory motion signals of patient, respiration measurement system (RMS) was composed with three sensor (spirometer, thermistor, and belt transducer), 4 channel data acquisition system and mobile computer. For two patients, we performed to evaluation of respiratory cycle and shape with RMS. We observed under this system that respiratory cycle is generally periodic but asymmetric, with the majority of time spent. As expected, RMS traced patient's respiration each other well and be easily handled for application.

• Korean Journal of Environmental Agriculture
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• v.35 no.1
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• pp.1-5
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• 2016

BACKGROUND: Burcucumber(Sicyos angulatus L.) is an invasive plant species and disturbs ecosystems in Korea. The main method for prevention of burcucumber is cutting or pulling out. However, the studies accounting for the use of the by-product of burcucumber after cutting remain incomplete. Thus, the aim of this study was to investigate the applicability of burcucumber as a substitute for nitrogen fertilizer.METHODS AND RESULTS: Burcucmber plants only including stem, leaves, and petiole were collected from the Sky Park in Seoul and divided in to three categories based on the length of stem of burcucumber; 10-30 cm, 30-100 cm, and 100-200 cm. And they were input into soil with 20 kg-N/10 a. After 4 weeks aging, chemical properties of treated soils and the productivity of lettuce(Lactuca sativa L.) were examined. Both the inorganic nitrogen contents in soils and the growth of lettuce were increased with the decreases in length of burcucumber standing for young plant. And the inorganic nitrogen content and the productivity of lettuce were positively correlated(r= 0.9409).CONCLUSION: The C/N ratio of burcucumber was low, indicating fast decomposition and nitrogen supplying rate, resulting in the increase in lettuce growth. Burcucumber could be a good substitute for nitrogen organic fertilizer.

• Archives of Plastic Surgery
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• v.35 no.1
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• pp.48-55
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• 2008

Purpose: We measured linear distances, angles and inclinations on the cast models of the noses, and compared these indirect measurements with the direct measurements obtained from the nose in order to validate the accuracy of the indirect anthropometry using the cast model. Methods: Subjects were 50 males and 50 females, medical students in twenties(mean 27.1 years). Cast models were made from the alginate impression material and the plaster. In direct anthropometry, 16 linear, 7 angular, and 2 inclination measurements between 11 landmarks on the nose were obtained using sliding caliper, spreading caliper, and fabric tape measure. At the same time, the same measurements were obtained from the cast models of the same people. Total 25 measurements were compared, and tested by the independent t-test of SPSS. Results: The standard values of Korean nose in twenties were obtained. 24 measurements except the columellar labial angle were not statistically different between the indirect anthropometry and the direct anthropometry. Conclusion: Indirect anthropometry on the cast model of the nose revealed no significant difference from the anthropometric measurement statistically, accounting for 24 in 25 measurements(96%). There are two possible reasons that caused the difference of columellar labial angle between direct and indirect anthropometry. First, the columellar labial angle could be decreased by protrusion of the lips which resulted from contracting mouth in which an drinking straw had been applied on the mouth corner for patients' respiration during making cast model. Second, it is generally known that the columellar labial angle could be measured larger when soft tissues were pressed by protractor in direct anthropometry. Using a drinking straw with greater diameter, and scheming respiration through the nostrils that patients don't feel discomfort, the more accurate data would be obtained from the indirect anthropometry using the cast models of the noses.