• Asian Pacific Journal of Cancer Prevention
• /
• 제17권6호
• /
• pp.2995-2999
• /
• 2016

Background: Triple-negative breast cancer (TNBC) often presents as an interval cancer with short survival upon metastasis and thus represents an important clinical challenge. The present study investigated the clinicopathologic characteristics and long term survival outcome of early and locally advanced TNBC. Materials and Methods: Medical records were reviewed retrospectively for 148 consecutive confirmed cases of TNBC treated in a single unit at our centre. Demographic profile, tumor type, histopathology details, treatment and follow-up information was recorded and immunohistochemistry was performed. Results: Age group >50 years was associated with tumors of clinical stage 3 (53.8%), pathological stage 3 (46.2%), pathological grade 3 (45.7%), presence of extracapsular extension (ECE, 48.5%) and lymphovascular invasion (LVI, 64.9%). Locally advanced breast cancers (LABCs) were characterized by pathological stage 3 (96.2%), presence of ECE (100%) and absence of LVI (46.7%) as compared to early breast cancers (EBCs) which had higher incidence of lower stage tumors (100%), absence of ECE (82%) and presence of LVI (91.9%; p-value <0.001. Better relapse free survival was observed in patients with no axillary involvement (69%; p-value <0.001) and absence of ECE (64%; p-value <0.001). Improved overall survival was seen in patients with EBC (90%; p-value 0.008), clear axilla (86%; p-value <0.001), absence of ECE (87%; p-value <0.001) and negative lymph nodes (90%; p-value 0.006). Conclusions: TNBCs are aggressive tumors which show poor long term survival. Patients with TNBC benefit from chemotherapy, thus better and less toxic treatment options are needed. Identification of newer targets and development of targeted therapies are the need of the hour.

• 한국항해항만학회지
• /
• 제43권6호
• /
• pp.384-394
• /
• 2019

이 연구는 우리나라 외항 상선에 승무하는 외국인 선원 관리제도의 현황을 고찰하고 제도상 문제점과 개선방안을 외국인 선원을 고용하고 있는 선주회사와 선박관리회사 그리고 선원관리회사, 관련 단체 대상으로 설문조사 결과를 분석하여 제시하였다. 그 결과로는 첫째 한국 선원과 같이 적용되는 외국인 선원 관련법 및 단체협약 등을 별도로 적용함이 필요하며, 둘째는 외국인 선원 고용정원의 의사결정 주체를 기존 선박소유자와 노동자 단체에서 선박소유자로 변경하거나 혹은 기존 의사결정 주체를 유지한다면 법률을 개정하여 명확히 하여야 하며 또한 외국인 선원 고용정원을 직책별 및 선종별로 지정할 필요가 있다. 셋째는 외국인 해기사 고용 시 선택의 폭을 확대하기 위하여 동유럽, 아시아 국가로의 해기 면허 인정협정을 확대하여야 하며, 넷째는 외국인 선원 고용 및 승선까지 복잡하고 불필요한 행정절차를 간소화하여야 한다. 다섯째는 외국인 선원과 관련된 회사 및 정부 기관, 협회 등 공동으로 외국인 선원에 대한 체계적인 양성체제 구축이 필요하다는 것이다. 동 연구를 통하여 우리나라 외항 상선에 승선하는 외국인 선원에 대한 더욱 효율적이고 체계적인 관리에 이바지할 수 있을 것이다.

• 안보군사학연구
• /
• 통권8호
• /
• pp.1-48
• /
• 2010

The purpose of this study is to examine and analyze the Untied Nations' efforts for peace on Korean peninsular after CCF's participation in Korean War. The Untied Nation tried to negotiate th peace plan between two sides from the end of 1950. Once the CCF's entry into the war had been confirmed, the war situation moved to a new phase, and the UN forces, which had guided the war in an effort to destroy the NKP A forces, and to punish North Korea, had to set up new guidelines to cope with the new situation. Accordingly, in late November, 1950, the UN forces camp, mainly the US Joint Chiefs of Staff and the United Nations Command, discussed various options, such as an expansion of the war up to the Chinese territory, a cease fire along the 38th Parallel, or a forced and inevitable evacuation. The Korean delegation to the UN insisted that "the unification of Korea should be achieved only by victory in the war. The Chinese intervention in the war is a Challenge to the UN in the same way as the North Korean invasion. The UN participation in the war was to repulse the invasion. With the same spirit we should drive back the Chinese Communists." The Korean delegation also emphasized to the friendly nations the political objective and will of unification, and that a cease fire at a threshold of unification might return us to the status quo ante bellum, and would be contrary to the Korean nation's desire. At that time, particularly, the US strongly considered the employment of nuclear weapons as one of the new strategies to cope with the Chinese invasion. The international effects of these casual remarks were realized almost at once. The British Prime Minister who had not wanted the expansion of war in the Far East, especially from the view point of the interest of NATO's security, visited Washington. so the conference had a very important meaning for the UN forces' new strategy. On the other hand, at the UN, on the 5th of December, the very day Truman and Attlee agreed to seek a cease-fire under UN auspices, a group of thirteen Asian and Arab states proposed to ask China and North Korea not to cross the 38th Parallel, and sounded out both sides about a cease fire along the 38th Parallel. The United States and the United Kingdom gave their assent, but China and North Korea gave no direct response. The CCF, who were securing the initiative of operation, were not agreeable with the proposal of the UN forces. The Untied Nation has tried to negotiate th peace plan between two sides from the December of 1950 and January of 1951. The Untied Nations' has achieved great results to negotiate for the peace plan on Korean peninsular after CCF's participation in Korean War. It's the results considering both the operation situation and political opinions.

• Archives of Plastic Surgery
• /
• 제34권1호
• /
• pp.93-98
• /
• 2007

Purpose: Many options are available for the incision and pocket selection in breast augmentation. Each method has its advantages and disadvantages. To leave an invisible operation scar and to achieve easier pocket dissection by the central location of the incision on the breast, we made a transareolar-perinipple incision. To overcome the disadvantages of the transareolar incision, originally advocated by Pitanguy in 1973, we modified the direction of incision line and dissection plane. Methods: To avoid the injury of 4th intercostal nerve responsible for nipple sensation, we made perinipple incision on the medial side of the nipple instead of trans-nipple incision and made the transareolar incision as 11-5 o'clock on the left side and 1-7 o'clock on the right side instead of 3-9 o'clock on both sides. To avoid the possible infection and breast feeding problem caused by the injury to the lactiferous duct, and the possible implant hernia caused by the incisions lying on a same plane of pocket dissection, we made a subcutaneous dissection just above the breast tissue medially down to the bottom of breast tissue and made a subglandular or subfascial pocket, which may avoid the injury of lactiferous duct and create different planes for skin incision and pocket dissection. Other advantages of the transareolar-perinipple incision include easier pocket dissection, less chance of hematoma, and as a result less postoperative pain because of the central location of the approach which allow finger dissection and meticulous bleeding control with direct vision, without any specialized instrument such as an endoscope or long mammary dissectors. As for pocket selection, we made dual pockets. We prefer subglandular or subfascial pocket. Also, we made a subpectoral pocket in the upper 1/4 of the pocket to add more volume on the upper part of the augmented breast, which can make aesthetically more desirable breasts in thin Asian women with small breasts. Possible disadvantages of our method are subclinical infection and scar widening, which could be overcome by meticulous operation techniques, antibiotic therapy, and intradermal tattooing. Results: From September, 2003 to August, 2005, 12 patients underwent breast augmentation using round smooth surface saline implants by our method. During the mean follow-up period of 13 months, there were no complications such as infection, hematoma, capsular contracture, and sensory change of nipple, and results were satisfactory. Conclusion: We suggest breast augmentation via transareolar-perinipple incision and dual pockets(subpectoral-subglandular or subfascial) as a valuable method in thin oriental women with small breasts.

• Asian Spine Journal
• /
• 제12권6호
• /
• pp.973-980
• /
• 2018

Study Design: Retrospective review. Purpose: To identify the trends in stimulator use, pair those trends with various grafting materials, and determine the influence of stimulators on the risk of revision surgery. Overview of Literature: A large number of studies has reported beneficial effects of electromagnetic energy in healing long bone fractures. However, there are few clinical studies regarding the use of electrical stimulators in spinal fusion. Methods: We used insurance billing codes to identify patients with lumbar disc degeneration who underwent anterior lumbar interbody fusion (ALIF). Comparisons between patients who did and did not receive electrical stimulators following surgery were performed using logistic regression analysis, chi-square test, and odds ratio (OR) analysis. Results: Approximately 19% of the patients (495/2,613) received external stimulators following ALIF surgery. There was a slight increase in stimulator use from 2008 to 2014 (multi-level $R^2=0.08$, single-level $R^2=0.05$). Patients who underwent multi-level procedures were more likely to receive stimulators than patients who underwent single-level procedures (p<0.05; OR, 3.72; 95% confidence interval, 3.02-4.57). Grafting options associated with most frequent stimulator use were bone marrow aspirates (BMA) plus autograft or allograft for single-level and allograft alone for multi-level procedures. In both cohorts, patients treated with bone morphogenetic proteins were least likely to receive electrical stimulators (p<0.05). Patients who received stimulation generally had higher reimbursements. Concurrent posterior lumbar fusion (PLF) (ALIF+PLF) increased the likelihood of receiving stimulators (p<0.05). Patients who received electrical stimulators had similar revision rates as those who did not receive stimulation (p>0.05), except those in the multilevel ALIF+PLF cohort, wherein the patients who underwent stimulation had higher rates of revision surgery. Conclusions: Concurrent PLF or multi-level procedures increased patients' likelihood of receiving stimulators, however, the presence of comorbidities did not. Patients who received BMA plus autograft or allograft were more likely to receive stimulation. Patients with and without bone stimulators had similar rates of revision surgery.

• Parasites, Hosts and Diseases
• /
• 제57권4호
• /
• pp.341-357
• /
• 2019

Acanthamoeba, one of free-living amoebae (FLA), remains a high risk of direct contact with this protozoan parasite which is ubiquitous in nature and man-made environment. This pathogenic FLA can cause sight-threatening amoebic keratitis (AK) and fatal granulomatous amoebic encephalitis (GAE) though these cases may not commonly be reported in our clinical settings. Acanthamoeba has been detected from different environmental sources namely; soil, water, hotspring, swimming pool, air-conditioner, or contact lens storage cases. The identification of Acanthamoeba is based on morphological appearance and molecular techniques using PCR and DNA sequencing for clinico-epidemiological purposes. Recent treatments have long been ineffective against Acanthamoeba cyst, novel anti-Acanthamoeba agents have therefore been extensively investigated. There are efforts to utilize synthetic chemicals, lead compounds from medicinal plant extracts, and animal products to combat Acanthamoeba infection. Applied nanotechnology, an advanced technology, has shown to enhance the anti-Acanthamoeba activity in the encapsulated nanoparticles leading to new therapeutic options. This review attempts to provide an overview of the available data and studies on the occurrence of pathogenic Acanthamoeba among the Association of Southeast Asian Nations (ASEAN) members with the aim of identifying some potential contributing factors such as distribution, demographic profile of the patients, possible source of the parasite, mode of transmission and treatment. Further, this review attempts to provide future direction for prevention and control of the Acanthamoeba infection.

• Asian Pacific Journal of Cancer Prevention
• /
• 제14권12호
• /
• pp.7367-7369
• /
• 2013

Background: Inoperable and metastatic hepatocellular carcinoma (HCC) is associated with a poor prognosis and low chemotherapeutic efficiency. Sorafenib is an oral multi-kinase inhibitor exerting its effects via the RAF/MEK/ERK pathway, vascular endothelial growth factor receptor (VEGFR) and platelet derived growth factor receptor beta (PDGFR-${\beta}$) tyrosine kinases. Randomized studies have shown a significant contribution of sorafenib to life expectancy and quality of life of cancer patients. The aim of the present study is to evaluate the efficacy and side effects of sorafenib therapy in Turkey. Materials and Methods: Data for 103 patients (82 males, 21 females) receiving sorafenib therapy in 13 centers from February 2008 to December 2012 were evaluated. Median age was 61 years and median ECOG performance status was 1 (range: 0-2). 60 patients (58%) had hepatitis B, 15 patients (15%) had hepatitis C infection and 12 patients (12%) had a history of alcohol consumption. All of the patients had Child scores meeting the utilization permit of the drug in our country (Child A). Results: A total of 571 cycles of sorafenib therapy were administered with a median of four per patient. Among the evaluable cases, there was partial response in 15 (15%), stable disease in 52 (50%), and progressive disease in 36 (35%). Median progression-free survival was 18 weeks and median overall survival was 48 weeks. The dose was reduced only in 6 patients and discontinued in 2 patients due to grade 3-4 toxicity, 18 patients (17%) suffering hand-foot syndrome, 7 (7%) diarrhea, and 2 (2%) vomiting. Conclusions: This retrospective study demonstrated better efficacy of sorafenib therapy in patients with advanced HCC compared to the literature while progression-free survival and overall survival findings were comparable. The side effect rates indicate that the drug was tolerated well. In conclusion, among the available treatment options, sorafenib is an efficient and tolerable agent in patients with inoperable or metastatic HCC.