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Statistical Estimates from Black Non-Hispanic Female Breast Cancer Data

  • Khan, Hafiz Mohammad Rafiqullah;Ibrahimou, Boubakari;Saxena, Anshul;Gabbidon, Kemesha;Abdool-Ghany, Faheema;Ramamoorthy, Venkataraghavan;Ullah, Duff;Stewart, Tiffanie Shauna-Jeanne
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8371-8376
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    • 2014
  • Background: The use of statistical methods has become an imperative tool in breast cancer survival data analysis. The purpose of this study was to develop the best statistical probability model using the Bayesian method to predict future survival times for the black non-Hispanic female breast cancer patients diagnosed during 1973-2009 in the U.S. Materials and Methods: We used a stratified random sample of black non-Hispanic female breast cancer patient data from the Surveillance Epidemiology and End Results (SEER) database. Survival analysis was performed using Kaplan-Meier and Cox proportional regression methods. Four advanced types of statistical models, Exponentiated Exponential (EE), Beta Generalized Exponential (BGE), Exponentiated Weibull (EW), and Beta Inverse Weibull (BIW) were utilized for data analysis. The statistical model building criteria, Akaike Information Criteria (AIC), Bayesian Information Criteria (BIC), and Deviance Information Criteria (DIC) were used to measure the goodness of fit tests. Furthermore, we used the Bayesian approach to obtain the predictive survival inferences from the best-fit data based on the exponentiated Weibull model. Results: We identified the highest number of black non-Hispanic female breast cancer patients in Michigan and the lowest in Hawaii. The mean (SD), of age at diagnosis (years) was 58.3 (14.43). The mean (SD), of survival time (months) for black non-Hispanic females was 66.8 (30.20). Non-Hispanic blacks had a significantly increased risk of death compared to Black Hispanics (Hazard ratio: 1.96, 95%CI: 1.51-2.54). Compared to other statistical probability models, we found that the exponentiated Weibull model better fits for the survival times. By making use of the Bayesian method predictive inferences for future survival times were obtained. Conclusions: These findings will be of great significance in determining appropriate treatment plans and health-care cost allocation. Furthermore, the same approach should contribute to build future predictive models for any health related diseases.

Genetic Variations in the HIF1A Gene Modulate Response to Adjuvant Chemotherapy after Surgery in Patients with Colorectal Cancer

  • Zhang, Yi;Wang, Peng;Zhou, Xing-Chun;Bao, Guo-Qiang;Lyu, Zhuo-Ming;Liu, Xiao-Nan;Wan, Shao-Gui;He, Xian-Li;Huang, Qi-Chao
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.11
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    • pp.4637-4642
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    • 2014
  • Background: Hypoxia-inducible factor $1{\alpha}$ (HIF-$1{\alpha}$) plays an important role in regulating cell survival and angiogenesis, which are critical for tumor growth and metastasis. Genetic variations of HIF1A have been shown to influence the susceptibility to many kinds of human tumors. Increased expression of HIF-$1{\alpha}$ has also been demonstrated to be involved in tumor progression. However, the prognostic value of single nucleotide polymorphisms (SNPs) inthe HIF1A gene remains to be determined in most cancer types, including colorectal cancer (CRC). In this study, we sought to investigate the predictive role of HIF1A SNPs in prognosis of CRC patients and efficacy of chemotherapy. Materials and Methods: We genotyped two functional SNPs in HIF1A gene using the Sequenom iPLEX genotyping system and then assessed their associations with clinicopathological parameters and clinical outcomes of 697 CRC patients receiving radical surgery using Cox logistic regression model and Kaplan Meier curves. Results: Generally, no significant association was found between these 2 SNPs and clinical outcomes of CRC. In stratified analysis of subgroup without adjuvant chemotherapy, patients carrying CT/TT genotypes of rs2057482 exhibited a borderline significant association with better overall survival when compared with those carrying CC genotype [Hazard ratio (HR), 0.47; 95% confidence interval (95% CI): 0.29-0.76; P < 0.01]. Moreover, significant protective effects on CRC outcomes conferred by adjuvant chemotherapy were exclusively observed in patients carrying CC genotype of rs2057482 and in those carrying AC/CC genotype of rs2301113. Conclusions: Genetic variations in HIF1A gene may modulate the efficacy of adjuvant chemotherapy after surgery in CRC patients.

Treatment Outcomes and Survival Study of Gastric Cancer Patients: A Retrospective Analysis in an Endemic Region

  • Basaran, Hamit;Koca, Timur;Cerkesli, Arda Kaymak;Arslan, Deniz;Karaca, Sibel
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.2055-2060
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    • 2015
  • Purpose: To present information about prognostic factors of gastric cancer patients treated in our Erzurum center including age, gender, tumour location, pathological grade, stage and the effect of treatment on survival. Materials and Methods: This retrospective study was performed on patients who applied to our clinic and diagnosed as gastric cancer. Age and gender of the patients, primary location, histopathological characteristics, TNM stage of the gastric cancers (GCs), treatment applied, oncological treatment modalities and survival outcomes were studied. A univariate analysis of potential prognostic factors was performed with the log-rank test for categorical factors and parameters with a p value < 0.05 at the univariate step were included in the multivariate regression. Results: A total of 228 patients with a confirmed diagnosis of gastric cancer were included in the study with a male/female ratio of 1.47. Median follow-up period was estimated as 22.3 (range, 3 to 96) months. When diagnosis of the patients at admission was analysed, stage III patients were most frequently encountered (n=147; 64.5%). One hundred and twenty-six (55.3%) underwent surgical treatment, while 117 (51.3%) were given adjuvant chemotherapy. Median overall survival time was 18.0 (${\pm}1.19$) months. Mean overall survival rates for 1, 2, 3 and 5 years were $68{\pm}0.031%$, $36{\pm}0.033%$, $24{\pm}0.031%$and $15.5{\pm}0.036%$, respectively. Univariate variables found to be significant for median OS in the multivariate analysis were evaluated with Cox regression analysis. A significant difference was found among TNM stage groups, location of the tumour and postoperative adjuvant treatment receivers (p values were 0.011, 0.025 and 0.001, respectively). Conclusions: This study revealed that it is possible to achieve long-term survival of gastric cancer with early diagnosis. Besides, in locally advanced GC patients, curative resection followed by adjuvant concomitant chemoradiotherapy based on the McDonald regimen was an independent prognostic factor for survival.

Diabetes Mellitus and Risk of Colorectal Cancer Mortality in Japan: the Japan Collaborative Cohort Study

  • Tan, Ce;Mori, Mitsuru;Adachi, Yasushi;Wakai, Kenji;Suzuki, Sadao;Suzuki, Koji;Hashimoto, Shuji;Watanabe, Yoshiyuki;Tamakoshi, Akiko
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.10
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    • pp.4681-4688
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    • 2016
  • Objective: Our aim was to estimate whether diabetes mellitus (DM) may be associated with an increased risk of colorectal cancer (CRC) mortality in Japan. Methods: The Japan Collaborative Cohort (JACC) Study is a nationwide prospective study, initiated in 1988, which involves 110,585 subjects (age range: from 40 to 79 years; 46,395 males and 64,190 females). Our present analysis population comprised 96,081 (40,510 men and 55,571 women) who provided details on DM history. The questionnaire also included age, sex, weight, height, family history of CRC, smoking, drinking and exercise habits, and education. Cox proportional-hazard regression was used to estimate the hazard ratio (HR). We used SPSS 21 software to analyze all data. Results: Among the participants with DM, we followed up for 71,174 person-years and 640. deaths from CRC were confirmed; and, among the non-diabetic participants, 785 CRC deaths were identified during 1,499,324 person-years. After adjusting for multivariate confounding factors, such as age, sex, body mass index (BMI), family history of colorectal cancer, smoking habit, drinking habit, physical activity (sports and walking) and education, DM was associated with an increased risk of CRC death (HR 1.4, 95% confidence interval [CI] 1.0-2.0). Diabetic women, but not diabetic men, experienced increased mortality from CRC (HR 1.7, 95% CI 1.0-3.0). Conclusion: The risk of CRC mortality is significantly increased in both sexes and women with diabetes, but no significant increase was seen for diabetic men among Japanese.

Physical Modeling of Horizontal Force on the Inland Vertical Structure by Tsunami-like Waves (육상의 직립구조물에 미치는 지진 해일에 의한 수평 파력 및 파압에 대한 수리모형실험)

  • Park, Hyongsu;Cox, Daniel;Shin, Sungwon
    • Journal of Korean Society of Coastal and Ocean Engineers
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    • v.29 no.6
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    • pp.363-368
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    • 2017
  • The tsunami flood the coastal cities and damage the land structures. The study on wave pressure and force on land structures is one of the important factors in designing the stability of inland structures. In this study, two - dimensional wave flume tests on the horizontal wave force and pressure of tsunamis on a simplified box-type structure was conducted. Vertical distribution and wave power of horizontal wave pressure over time were measured by pressure sensors and force transducer. Also, those were measured from the different wave breaking types. The vertical distribution of horizontal wave pressure was uniform at the moment when the horizontal wave force to the structure was maximum under the breaking wave condition. A surf similarity parameter was employed in order to figure out the relationship between the maximum horizontal wave force on the structure as a function of various incident wave conditions. As a result, the non - dimensionalized horizontal wave force tends to decrease exponentially as the surf similarity parameter increases.

Factors Affecting the Diffusion of Health Center Information System (보건소 정보화시스템의 도입에 영향을 미친 요인)

  • Do, Young-Gyoung;Lee, Jung-Gyu;Park, Gi-Dong;Kim, Chang-Yup;Kim, Yong-Ik;Lee, Jin-Yong
    • Journal of Preventive Medicine and Public Health
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    • v.36 no.4
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    • pp.359-366
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    • 2003
  • Objectives : This study was conducted to review the diffusion process and factors affecting the adoption of the Health Center Information System (HIS). Methods : Data were collected from POSDATA (private company), MOHW, other Ministries and local governments. To specify the date of adoption, supplementary information was collected from 40 health centers. The following three kinds of factors were analyzed. Internal factors included type, size, and innovativeness of health centers. Community factors were composed of population sire, economic status, and level of education. Organizational environmental factors consisted of information score of the municipalities, financial support of the from central government, and the neighborhoodness of innovator health centers. Results : All health centers in the metropolitan cities of Seoul, Gwangju and Jeju adopted the HIS. The laggards were those in the metropolitan cities of Busan (18.8%), Incheon (20.0%) and Daejun (20.0%), and cities with population more than 300,000 (54.8%) and counties with health center hospitals (47.1%). Financially supported rural health centers adopted the HIS more rapidly than those not supported. The factors identified as being statistically significant (p<0.05), from a univariate analysis by Kaplan-Meier method, were: (1) internal factors of the type, size and innovativeness of health centers; (2) community factors of population size and economic status; (3) organizational environmental factors of the central government financial support and the neighborhoodness of innovator health centers. A multivariate analysis, using a Cox proportional hazard method, proved the innovativeness of health centers, central government financial support and the neighborhoodness of innovator health centers, were statistically significant (p<0.05). Conclusions : The innovativeness of health centers, financial support from central government and the neighborhoodness of innovator health centers, rather than community factors related to regional socioeconomic status, affected ffe adoption of the HIS in health centers. Further in-depth studies, modifying the MOHW's strategy to propagate the HIS to the laggard health confers, are recommended.

C-reactive Protein Concentration Is Associated With a Higher Risk of Mortality in a Rural Korean Population

  • Lee, Jung Hyun;Yeom, Hyungseon;Kim, Hyeon Chang;Suh, Il;Kim, Mi Kyung;Shin, Min-Ho;Shin, Dong Hoon;Koh, Sang-Baek;Ahn, Song Vogue;Lee, Tae-Yong;Ryu, So Yeon;Song, Jae-Sok;Choe, Hong-Soon;Lee, Young-Hoon;Choi, Bo Youl
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.5
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    • pp.275-287
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    • 2016
  • Objectives: C-reactive protein (CRP), an inflammatory biomarker, has been widely used as a preclinical marker predictive of morbidity and mortality. Although many studies have reported a positive association between CRP and mortality, uncertainty still remains about this association in various populations, especially in rural Korea. Methods: A total of 23 233 middle-aged participants (8862 men and 14 371 women) who were free from cardiovascular disease, cancer, and acute inflammation (defined by a CRP level ${\geq}10mg/L$) were drawn from 11 rural communities in Korea between 2005 and 2011. Blood CRP concentration was analyzed as a categorical variable (low: 0.0-0.9 mg/L; intermediate: 1.0-3.0 mg/L; high: 3.1-9.9 mg/L) as well as a continuous variable. Each participant's vital status through December 2013 was confirmed by death statistics from the National Statistical Office. Cox proportional hazard models were used to assess the independent association between CRP and mortality after adjusting for other risk factors. Results: The total quantity of observed person-years was 57 975 for men and 95 146 for women, and the number of deaths was 649 among men and 367 among women. Compared to the low-CRP group, the adjusted hazard ratio for all-cause mortality of the intermediate group was 1.17 (95% confidence interval [CI], 0.98 to 1.40) for men and 1.27 (95% CI, 1.01 to 1.61) for women, and the corresponding values for the high-CRP group were 1.98 (95% CI, 1.61 to 2.42) for men and 1.41 (95% CI, 1.03 to 1.95) for women. Similar trends were found for CRP evaluated as a continuous variable and for cardiovascular mortality. Conclusions: Higher CRP concentrations were associated with higher mortality in a rural Korean population, and this association was more prominent in men than in women.

Neuro-inflammation induced by restraint stress causes impairs neurobehavior in mice (스트레스 유발 마우스모델에서 뇌염증 및 신경행동 장애 변화)

  • Oh, Tae woo;Do, Hyun Ju;Kim, Kwang-Youn;Kim, Young Woo;Lee, Byung Wook;Ma, Jin Yeul;Park, Kwang Il
    • Herbal Formula Science
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    • v.25 no.4
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    • pp.483-497
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    • 2017
  • Background : Behavioral stress has been suggested as one of the significant factors that is able to disrupt physiological systems and cause depression as well as changes in various body systems. The stressful events can alter cognition, learning, memory and emotional responses, resulting in mental disorders such as depression and anxiety. Results : We used a restraint stress model to evaluate the alteration of behavior and stress-related blood parameter. The animals were randomly divided into two groups of five animals each group. Furthermore, we assessed the change of body weight to evaluate the locomotor activity as well as status of emotional and anxiety in mice. After 7 days of restraint stress, the body weight had significantly decreased in the restraint stress group compared with the control group. We also observed stress-associated behavioral alterations, as there was a significant decrease in open field and forced swim test, whereas the immobilization time was significantly increased in the stress group compared to the control group. We observed the morphological changes of neuronal death and microglia by immunohistochemistry and western blot. In our study restraint stress did not cause change in neuronal cell density in the frontal cortex and CA1 hippocampus region, but there was a trend for an increased COX-2 and iNOS protein expression and microglia (CD11b) in brain, which is restraint stress. Conclusion : Our study, there were significant alterations observed in the behavioral studies. We found that mice undergoing restraint stress changed behavior, confirming the increased expression of inflammatory factors in the brain.

Evaluation of Biochemical Recurrence-free Survival after Radical Prostatectomy by Cancer of the Prostate Risk Assessment Post-Surgical (CAPRA-S) Score

  • Aktas, Binhan Kagan;Ozden, Cuneyt;Bulut, Suleyman;Tagci, Suleyman;Erbay, Guven;Gokkaya, Cevdet Serkan;Baykam, Mehmet Murat;Memis, Ali
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2527-2530
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    • 2015
  • Background: The cancer of the prostate risk assessment (CAPRA) score has been defined to predict prostate cancer recurrence based on the pre-clinical data, then pathological data have also been incorporated. Thus, CAPRA post-surgical (CAPRA-S) score has been developed based on six criteria (prostate specific antigen (PSA) at diagnosis, pathological Gleason score, and information on surgical margin, seminal vesicle invasion, extracapsular extension and lymph node involvement) for the prediction of post-surgical recurrences. In the present study, biochemical recurrence (BCR)-free probabilities after open retropubic radical prostatectomy (RP) were evaluated by the CAPRA-S scoring system and its three-risk level model. Materials and Methods: CAPRA-S scores (0-12) of our 240 radical prostatectomies performed between January 2000-May 2011 were calculated. Patients were distributed into CAPRA-S score groups and also into three-risk groups as low, intermediate and high. BCR-free probabilities were assessed and compared using Kaplan-Meier analysis and Cox proportional hazards regression. Ability of CAPRA-S in BCR detection was evaluated by concordance index (c-index). Results: BCR was present in 41 of total 240 patients (17.1%) and the mean follow-up time was $51.7{\pm}33.0$ months. Mean BCR-free survival time was 98.3 months (95% CI: 92.3-104.2). Of the patients in low, intermediate and high risk groups, 5.4%, 22.0% and 58.8% had BCR, respectively and the difference among the three groups was significant (P = 0.0001). C-indices of CAPRA-S score and three-risk groups for detecting BCR-free probabilities in 5-yr were 0.87 and 0.81, respectively. Conclusions: Both CAPRA-S score and its three-risk level model well predicted BCR after RP with high c-index levels in our center. Therefore, it is a clinically reliable post-operative risk stratifier and disease recurrence predictor for prostate cancer.

Risk Factors for Recurrent Pneumothorax after Primary Spontaneous Pneumothorax (원발 기흉 수술 후 재발의 위험인자)

  • Yu, Jai-Kun;Lee, Seong-Ki;Seo, Hong-Joo;Seo, Min-Bum
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.724-728
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    • 2008
  • Background: The purpose of this study was to identify factors associated with recurrent pneumothorax after wedge resection in primary spontaneous pneumothorax in our hospital. Material and Method: Two hundred thirty-five consecutive patient (98% males; mean age, $23.9{\pm}4.5$ years) who had undergone video-assisted thoracoscopic surgery (VATS) were reviewed retrospectively. The two groups were divided as follows: group A, non-recurrent patients (225 patients [96%]); and group B, recurrent group (10 patients [4%]); the risk factors were compared between the two groups. The single and multiple factors that influenced the recurrence rate were analyzed using Cox's proportional hazard model. Result: There were no significant differences between the recurrent and non-recurrent groups in terms of gender, smoking, site of recurrence, degree of collapse, operative time, and number or weight of resected bullae. The recurrence rate was significantly more common in the following: younger ages, increased height/weight ratio, longer initial air leakage period, and shorter duration of chest drainage. Early aggressive exercise (<30 days) of patients after wedge resection increased the tendency for recurrence. Conclusion: Thoracoscopic wedge resection does not have a higher recurrence rate than open thoracotomy. However, young age, height/weight ratio, continuous air, and duration of chest tube placement were risk factors for a recurrent pneumothorax.