• Title/Summary/Keyword: Clinical patterns

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Trends of Breast Cancer and its Management in the Last Twenty Years in Aden and Adjacent Governorates, Yemen

  • Harhra, Nasser Aa;Basaleem, Huda O.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4347-4351
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    • 2012
  • Background: Breast cancer is the most common cancer of women and the principal cause of death in middle aged women. The objective of this study was to describe the trend of breast cancer and its management in Aden and adjacent south-eastern governorates of Yemen during the last 20 years. Patients and Methods: This is a retrospective analysis of previous studies on patients with breast cancer in Aden and adjacent south-eastern governorates, Yemen (January 1989 through December 2007). The studied variables were: sex, age, time and type of presentation, disease stage, pathological types and the performed surgical treatment. The sources of information were the treatment registry of Aden health office, archives of Al-Gamhouria teaching hospital; major referral and other public and private hospitals in Aden and Aden Cancer Registry. Results: The total number of patients was 476, 99% being females. The age range was 19-88 years. The most affected age was 30-50 years (60.5%), 95% presenting after one month of having breast symptoms. Forty-five percent presented with signs of advanced local disease, while 59.2% had palpable axillary lymph nodes on presentation. Early breast cancer (stages I-II) occurred in 47%, and late breast cancer (stages III-IV) in 51.5%. Invasive ductal carcinoma was the commonest pathology (89.3%). The main surgical treatment was mastectomy (modified radical mastectomy (50%). Conclusion: Breast cancer is predominantly a disease of young with late presentation and advanced disease. Improving health awareness and earlier diagnosis of the disease by health education, encouraging breast self-examination, and providing the mammography equipment and mammary clinics in hospitals are recommended. Establishment of oncology and radiotherapy centers in Aden is a necessity.

Outcome of Surgery and Post-Operative Radiotherapy for Major Salivary Gland Carcinoma: Ten Year Experience from a Single Institute

  • Kaur, Jaspreet;Goyal, Shikha;Muzumder, Sandeep;Bhasker, Suman;Mohanti, Bidhu Kalyan;Rath, Goura Kishore
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8259-8263
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    • 2014
  • Aims: To determine the clinical characteristics, pathological features, local and distant failure patterns in patients with carcinoma of major salivary glands treated with surgery and postoperative radiotherapy (PORT). Materials and Methods: We retrospectively reviewed 106 cases of major salivary gland tumor seen at our centre (1998-2008). Sixty five cases of major salivary gland carcinoma were selected for analysis (exclusions: benign, palliative, non-carcinomas). The patient population treated by surgery and PORT was divided into two groups: 1) Patients who underwent surgery and immediate PORT (Primary PORT); 2) Patients with recurrent carcinoma who underwent at least two surgeries and received PORT in the immediate post-operative period of the last performed surgery (Recurrent PORT). Recurrence free survival (RFS) was assessed using the Kaplan-Meier method. Results: Median age was 35 years with a male: female ratio of 1.3:1. The majority of cancers were located in the parotid gland (86.2%) and the most common histology was mucoepidermoid carcinoma (43%). Thirty nine cases (60%) were primary while 26 (40%) were recurrent. Optimal surgery was performed in 59/65 patients (90.8%). 43 patients (66.2%) underwent neck dissection, of which 14 (32.5%) had nodal metastasis. Overall, 61 (93.8%) patients complied with the prescribed radiotherapy. Median dose of PORT was 60 Gy. Median follow-up was 13.1 months (range 2-70). Relapse free survival was 50.4% at 60 months. Some 12 cases (18.5%) recurred with a median time to recurrence of 16.9 months. Conclusions: Surgery and PORT is an effective treatment for major salivary gland carcinoma with over 90% compliance and <20% recurrence. Early treatment with postoperative radiotherapy may increase the survival rate in major salivary gland carcinoma patients.

Preliminary Study on Development of Pattern Identification Instrument for Polycystic Ovarian Syndrome (다낭성난소증후군 변증도구 개발을 위한 기초연구)

  • Park, Eun-Ji;Jang, Sae-Byul;Baek, Seon-Eun;Kim, Seon-Kyung;Yoo, Ho-Ryong;Yoo, Jeong-Eun;Jung, In-Chul
    • The Journal of Korean Obstetrics and Gynecology
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    • v.30 no.1
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    • pp.68-84
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    • 2017
  • Objectives: Polycystic Ovarian Syndrome (PCOS) is characterized by ovulatory disorder, polycystic ovaries and clinical or laboratory hyperandrogenemia, also associated with an increased risk of various other long-term complications. The purpose of this study is to develop a standard instrument of pattern identifications in Korean medicine for PCOS. Methods: We retrieved the patterns and symptoms from Korean and Chinese literatures which mentioned pattern identifications of PCOS. In order to develop the instrument, we took the consultation from the advisor committee based on the collected informations from literatures. Finally the questionnaire of pattern identification for PCOS was developed. Results: 1) 5 pattern identifications and 53 symptoms and signs were selected from 20 references. 2) We obtained the mean weights which reflected the standard deviations from each symptom of the pattern by 15 experts. 3) We designed the Korean medicine Instrument on pattern identification for PCOS. It was composed of 61 questions, 44 of patient-reported format and 17 of assessor-reported format. Conclusions: Instrument of pattern identification for PCOS was developed through experts' discussion. Further study is required to identify the validity and reliability of this pattern identification instrument for PCOS.

Flumazenil administration in suspected patients with acute hypnotics and sedatives poisoning: risk-benefit re-evaluation (급성 진정제 중독 추정 환자에서 플루마제닐의 투여: 위험도/이익 재평가)

  • Huh, Jae Hong;Choi, Sang Chun;Lim, Yong Gyun;Lampotang, Samsun;Park, Eung Jung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.14 no.2
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    • pp.92-99
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    • 2016
  • Purpose: The use of flumazenil administration in the emergency department is still controversial because of concerns about adverse effects. The present study was conducted to re-evaluate the risk-benefit ratio associated with flumazenil administration to patients suspected of having acute hypnotics and sedatives poisoning in the emergency department. Methods: A retrospective chart review study was conducted for patients whose final diagnoses were "poisoning" and "benzodiazepine" or "sedatives-hypnotics" from Mar. 2006 to Feb. 2015. The basal characteristics of the patients, including past medical history, ingredients and dose of ingested drug and co-ingested drugs were investigated. For patients administered flumazenil, responsiveness and time from admission to flumazenil administration were investigated with supplement. All collected data were analyzed in aspect terms of risk/benefit. Results: A total of 678 patients were included in our study. Benzodiazepine was the most common sedative/hypnotic drug prescribed, and the frequency of prescription continuously increased. The proportion of TCA as co-ingestion decreased from 13.1% to 3.9% in patients with acute sedative/hypnotic poisoning. Flumazenil was administered to 55 patients (8.1%), of which 29 patients (52.7%) were applied to contraindications. Fifty-three patients (96.4%) showed positive responsiveness, including partial responsiveness after flumazenil administration. No severe adverse events were identified. Conclusion: Based on the current trends in prescription patterns for sedative/hypnotic drugs, increased use of non-TCA antidepressants, and responsiveness to administration of flumazenil, benefit seemed weighted more in this study, although the observed benefits were based on limited results. Further prospective multicenter studies will be needed to optimize benefit-risk ratio.

Robotic-assisted gait training applied with guidance force for balance and gait performance in persons with subacute hemiparetic stroke

  • Son, Dong-Wook;Hwang, Sujin
    • Physical Therapy Rehabilitation Science
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    • v.6 no.3
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    • pp.106-112
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    • 2017
  • Objective: Robot assisted gait training is implemented as part of therapy for the recovery of gait patterns in recent clinical fields, and the scope of implications are continuously increasing. However clear therapy protocols of robot assisted gait training are insufficent. The purpose of this study was to investigate the effects of robot-assisted gait training applied with guidance force on balance and gait performance in persons with hemiparetic stroke. Design: Two group pre-test post-test design. Methods: Nineteen persons were diagnosed with hemiparesis following stroke participated in this study. The participants were randomly assigned to the unilateral guidance group or bilateral guidance group to conduct robot-assisted gait training. All participants underwent robot-assisted gait training for twelve sessions (30 min/d, 3 d/wk for 4 weeks). They were assessed with gait parameters (gait velocity, cadence, step length, stance phase, and swing phase) using Optogait. This study also measured the dynamic gait index (DGI), the Berg balance scale (BBS) score, and timed up and go (TUG). Results: After training, BBS scores were was significantly increased in the bilateral training group than in the unilateral guidance group (p<0.05). Spatiotemporal parameters were significantly changed in the bilateral training group (gait speed, swing phase ratio, and stance phase ratio) compared to the unilateral training group (p<0.05). Conclusions: The results of this study suggest that robot-assisted gait training show feasibility in facilitating improvements in balance and gait performance for subacute hemiparetic stroke patients.

Prognostic Value of MAC30 Expression in Human Pure Squamous Cell Carcinomas of the Lung

  • Ding, Hui;Gui, Xian-Hua;Lin, Xu-Bo;Chen, Ru-Hua;Cai, Hou-Rong;Fen, Yan;Sheng, Yun-Lu
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.5
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    • pp.2705-2710
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    • 2016
  • Recent evidence haas indicated that meningioma-associate protein (MAC30) exhibits different expression patterns in various tumors. However, little is known about the value of MAC30 in human squamous cell carcinoma of lung (SQCLC). The purpose of our study was to investigate the expression of MAC30 and to explore its clinical significance in SQCLC patients. A total of 156 Chinese patients diagnosed with SQCLC were selected for this study. The expression of MAC30 in all tissues was confirmed by immunohistochemical staining. Quantitative real-time PCR was performed to analyze MAC30 mRNA expression in 32 cases of SQCLC patients with corresponding non-tumor lung tissues. We observed enhanced mRNA expression of MAC30 in SQCLC as compared to control samples. Further, elevated MAC30 protein expression was strongly associated with poor tumor differentiation, TNM stage, and lymph node metastasis. In addition, we observed that patients with increased MAC30 expression demonstrated poor overall survival. Multivariate analysis explicated that increased MAC30 expression was a valuable independent predictable factor for poor tumor differentiation and short survival in SQCLC patients. Our present study suggests that MAC30 may serve as a biomarker for poor tumor differentiation and outcomes of patients with SQCLC.

Expression of Ids in Preimplantation Mouse Embryos (착상 전 생쥐배아에서 Id 유전자의 발현)

  • Hong, Seok-Ho;Nah, Hee-Young;Lee, Young-Jin;Lee, Ji-Won;Son, Young-Soo;Chae, Hee-Dong;Kim, Sung-Hoon;Kang, Byung-Moon;Kim, Chung-Hoon
    • Clinical and Experimental Reproductive Medicine
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    • v.31 no.4
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    • pp.201-207
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    • 2004
  • Objective: The Id family of helix-loop-helix proteins are thought to affect the balance between cell growth and differentiation by negatively regulating the function of basic-helix-loop-helix (bHLH) transcriptional factors. The aim of this study was to investigate the expression pattern of Ids (Id-1, -2, -3, and -4) in preimplantation mouse embryos at mRNA and protein levels. Methods: Oocytes and preimplantation embryos were collected from reproductive organs of female ICR mice following superovulation. RT-PCR was performed to investigate the mRNA expression patterns of Id genes and their protein were localized by immunofluorescence analysis. Results: Id-1 and Id-3 mRNAs were strongly expressed at the germinal vesicle (GV) oocyte and the blastocyst stages. Id-2 mRNA was expressed throughout preimplantation embryo development, but Id-4 was not expressed. Immunofluorescence showed that Id-1 and Id-2 were predominantly localized in cytoplasmic region, but the immunofluorescence signal of Id-3 was weak throughout preimplantation embryo development. Conclusion: These data show for the first time that Ids are expressed in preimplantation mouse embryos and suggest that Ids may play an important role in early preimplantation embryo development and uterine physiological changes.

Treatment Results in Patients with Salivary Gland Malignancy (타액선 악성 종양 환자에 대한 치료성적)

  • Song Dal-Won;Ahn Jae-Hyun;Sohn Jin-Sik;Kim Tae-Jong;Ahn Byung-Hoon
    • Korean Journal of Head & Neck Oncology
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    • v.16 no.1
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    • pp.46-51
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    • 2000
  • Objectives: Primary malignant tumors in the salivary glands are relatively rare. Because of the rarity and the different histopathologic patterns, it is difficult to establish a uniform treatment strategy. The prime treatment of salivary gland malignancy is the surgery, but the role of radiotherapy has been under debate. Radiation therapy combined with conservative surgical procedures may be as successful and perhaps more rational treatment than radical surgery alone. The aim of this study is to evaluate clinical pattern, incidence, treatment modality and outcome of the salivary gland maligancy. Materials and Methods: The medical records of 32 patients with malignant neoplasm of salivary gland who treated at the Keimyung university Dongsan hospital were analyzed retrospectively. Results: The overall 5 year survival rate was 77.9% stage I : 100%, stage II : 75%, stage III : 66.7%, stage IV : 55.6%). The 5 year survival rate according to tumor grade was 100% in low grade malignancy, 71.8% in high grade malignancy. The 5 year survival rate according to treatment modalities was as follows: Surgery only group was 83.3%, combined treatment group with surgery and posoperative radiation was 74.6%. Conclusion: The factors affecting prognosis is variable, but the stage at the time of diagnosis, site of lesion, tumor grade, histologic subtype were important factors. Surgery was the prime treatment tool and postoperative radiotherapy was also imperative in higher stage patient, high grade tumor, or patients with positive surgical margin.

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A Study on the Node Split in Decision Tree with Multivariate Target Variables (다변량 목표변수를 갖는 의사결정나무의 노드분리에 관한 연구)

  • Kim, Seong-Jun
    • Journal of the Korean Institute of Intelligent Systems
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    • v.13 no.4
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    • pp.386-390
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    • 2003
  • Data mining is a process of discovering useful patterns for decision making from an amount of data. It has recently received much attention in a wide range of business and engineering fields. Classifying a group into subgroups is one of the most important subjects in data mining. Tree-based methods, known as decision trees, provide an efficient way to finding the classification model. The primary concern in tree learning is to minimize a node impurity, which is evaluated using a target variable in the data set. However, there are situations where multiple target variable should be taken into account, for example, such as manufacturing process monitoring, marketing science, and clinical and health analysis. The purpose of this article is to present some methods for measuring the node impurity, which are applicable to data sets with multivariate target variables. For illustration, a numerical cxample is given with discussion.

The Clinico-Statisitical Analysis of Ameloblastoma of Mandible (하악골에 발생한 법랑아세포종의 임상통계학적 분석)

  • Yu, Kyoung-Hwan;Kim, Su-Gwan;Moon, Seong-Yong;Oh, Ji-Su;Lee, Jeong-Hoon;Kim, Jin-Ha
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.6
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    • pp.551-557
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    • 2010
  • Purpose: In this study, we evaluated the relation between surgical methods and reccurrence rate by investigating clinical, radiological aspects and histopathological patterns of 26 patients who were diagnosed with amelobalstoma. Patients and Methods: In this study, we retrospectively investigated 26 patients who were diagnosed with ameloblastoma and treated at the Department of Oral and Maxillofacial Surgery of Chosun University Dental Hospital from January 2000 to December 2008. Results: The patients comprised 12 males (46.1%) and 14 females (53.9%), and their ages ranged from 10 to 69 years (average, 37.3 years). All cases presented a mandibular location, and in particular, 13 cases (50%) demonstrated an occurrence in the mandibular body. Clinically, 8 cases (30.8%) presented no symptoms, and the most prevalent chief complaint was swelling in 13 cases (50%). Radiographically, a unilocular type appeared in 14 cases (53.8%), and a multilocular type was observed in 10 cases (38.5%). Histopathologically, there were 8 follicular types (30.8%) and 7 plexiform types (26.9%). Conservative treatment was performed in 5 cases (19.2%), and radical treatment was performed in 21 cases (80.8%). The follow-up period ranged from 1 to 10 years. The total recurrence rate was 15.4%, and the mean duration of recurrence was 6.7 years. Three of the 5 cases (60%) that received conservative treatment demonstrated a recurrence, as compared to 1 of the 21 cases (4.8%) that underwent radical treatment. Conclusion: The radical treatment was more effective than the conservative treatment for recurrence prevention. We should consider a continuous follow-up check after operation.