• Title/Summary/Keyword: Clinical stress

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Ki67 Frequency in Breast Cancers without Axillary Lymph Node Involvement and its Relation with Disease-free Survival

  • Shandiz, Fatemeh Homaei;Shabahang, Hossein;Afzaljavan, Fahimeh;Sharifi, Nourieh;Tavasoli, Alireza;Afzalaghaee, Monavar;Roshanzamir, Emane;Pasdar, Alireza
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1347-1350
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    • 2016
  • Background: Breast cancer prognosis is influenced by several histopathology and clinical factors including expression of Ki67 which may have a predictive role in lymph node negative breast cancer patients. The aim of this study was to assess Ki67 expression in breast cancers without axillary lymph node involvement and to evaluate its prognostic value with regard to disease-free survival. Materials and Methods: Subjects were selected from non-metastatic invasive breast cancer patients who were referred to the oncology department of Ghaem hospital during 1 April 2001 to 1 April 2008. Ki67 levels were measured using immunohistochemistry (IHC) and compared with clinicopathological features. The relation of Ki67 expression with disease-free survival was also analysed. Results: A total of 106 women with a mean age of 49 were examined. Some 94.3% were classified as having invasive ductal carcinomas and the mean tumour diameter at the time of diagnosis was 2.8 cm. Some 50.9% of cases were ER positive and 47.2% were PR positive. P53 expression was positive in 48.1% of the cases. According to the IHC results, only 8.5% of the patients were Her2/neu positive. Ki67 was positive in 66 (62.3%) with a significant relation to lower age (p=0.0229) and P53 positivity (p=0.005). After an average of 40-months follow up, 13 (12.3%) demonstrated recurrence, most commonly systemic. Of 13 cases with relapse, 10 patients (77%) were Ki67 positive. Conclusions: In our population Ki67 appeared to be an independent prognostic factor for three-year survival. However, we stress that a survival study with a bigger sample size would help to support this conclusion.

Two-Bundle Anterior Cruciate Ligament Reconstruction with Single Femoral Tunnel and Tibialis Anterior Tendon Allograft (단일 대퇴 터널과 전경골 동종건을 이용한 이중 다발 전방십자인대 재건술)

  • Kim, Yeung-Jin;Chae, Soo-Uk;Yang, Jung-Hwan;Lee, Ji-Wan;Shim, Sung-Woo
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.2
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    • pp.107-113
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    • 2010
  • Purpose: To evaluate the outcome of the two-bundle anterior cruciate ligament reconstruction with single femoral tunnel and tibialis anterior tendon allograft and to determine any functional advantages. Materials and Methods: From June 2006 to March 2008, we performed single femoral tunnel and two-bundle ACL reconstruction with tibialis anterior tendon allograft in 26 cases. Mean age was 35.5 years. 20 cases were male and 6 cases were female. Average follow-up period was 2 years and 5 months, range from 1 year to 3 years and 5 months. Subjective and objective parameters were utilized in analyses, such as the mean range of motion, Lysholm knee score, Tegner activity score, Lachman test and IKDC score. Results: Postoperative mean Lysholm knee score, IKDC Evaluation Form, Tegner activity scale, Pivot shift test, and anterior displacement by the Telos stress test demonstrated statistically significant differences compared to the preoperative. Conclusion: Two-bundle anterior cruciate ligament reconstruction with single femoral tunnel showed good clinical results and was good operative technique.

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Antihypertensive Effects of Novel Isoflavone-Free Black Soy Peptide Mixture as HO-1 Inducer (Heme 산화효소 발현 유도체로서 Isoflavone-Free 검은콩 펩타이드의 항고혈압 활성)

  • Shin, Mi-Kyung;Kwon, Yong-Hyun;Ahn, Chang-Won;Shin, Dong-Seok;Park, Soo-Hyun;Choi, Bo-Hwa;Hong, Soon-Sun;Kang, Ju-Hee;Park, Chang-Shin
    • YAKHAK HOEJI
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    • v.56 no.3
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    • pp.191-197
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    • 2012
  • We previously reported that the novel isoflavone-free peptide mixture (black soybean peptide, BSP) had several beneficial effects like antiobesity and hypotriglyceridemic effect. However, there are no reports for BSP on anti-hypertensive activity. BSP induced heme oxygenase-1 (HO-1) in HUVECs, thus investigated the HO-1-induced activity in HUVECs and the anti-hypertensive effects in SHR animal model. BSP significantly induced HO-1 expression both at transcriptional and protein levels in a time- and dose-dependent manner as measured by RT-PCR and Western blot analysis, respectively. These inductions were abolished by pretreatment of N-acetyl-cystein (NAC, 1~10 mM), but not by employing Tempol, a superoxide dismutase (SOD) mimetic (1~5 mM). As expected, enzymatic activity (~2 fold) determined by bilirubin formation assay and cGMP concentration (~6 fold) were significantly increased in BSP-treated cells. Based on the numerous evidences on the beneficial effects of HO-1 and our results, we investigated in vivo effects of BSP on the antihypertensive activity. The administration of BSP (1% in drinking water) significantly decreased mean blood pressure (BP) (from $218.6{\pm}6.99$ to $190.0{\pm}3.42$ mm Hg, p<0.01). This result indicates that BSP is strong inducer of HO-1 expression, which may be triggered by oxidative stress, and has anti-hypertensive activity.

A Study on Correlation of Melanin & Pigmentation Disorder and Viscera and Bowels(臟腑) (멜라닌 및 색소 이상 질환과 장부(臟腑)와의 연관성 고찰)

  • Jung, Yu-Jin;Ko, Woo-Shin;Yoon, Hwa-Jung
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.29 no.3
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    • pp.27-41
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    • 2016
  • Objectives : The purpose of this research is to understand melanin with both Korean and Western medicine.Methods : We investigated the comprehension of melanin in both western and Korean medicine through literature review and studied relationships between melanin and five viscera(五臟), especially liver(肝), spleen(脾), kidney(腎). We Also studied representative pigmentary disorders(melasma, vitiligo) in western and Korean medicine to figure out how to understand pigmentary disorders in oriental medicine.Results : The results are as follows. 1. Melanin is associate with liver, because free coursing(疎泄) function of liver is the origin of transport melanin to keratinocyte from melanocyte. Also, melanogenesis factors like MITF and CREB are closely associated with liver and pigmentary disorders occur frequently after stress conditions or women. 2. Melanin is absorbed and scattered in keratinocytes by the function of spleen. Pigmentary disorders result from failure of spleen and formation of phlegm-retained fluid(痰飮). 3. Kidney essence(腎精) is the origin of melanin formation. In addition, corticosteroid, the major hormone of melanogenesis is secreted by adrenalin and adrenalin belongs to kidney(腎) in Korean medicine. 4. Melasma is created by disorder of melanin transport and absorbtion, so melasma is associated liver (肝) and spleen(脾). Therefore the treatment for melasma may focus on improvement function of liver and spleen. 5. The destruction of melanocyte or abnormal melanogenesis by disorder of the immune system, metabolic and affective disorders can make vitiligo, so vitiligo is associated with liver and kidney which are major part of melanin formation. Therefore the treatment of vitiligo can focus on improvement function of liver(肝) and kidney(腎).Conclusion : We compared Korean and western medicine to understand melanin. We also interpreted the mechanism of melanin and pigmantary disorders in western medicine and considered the relationship with visceral manifestation theory(臟象論) in traditional Korean medicine. Further studies are needed to apply comprehension of melanin to clinical stage.

Temporomandibular disorders and risk factors in office workers, service workers, and teachers (측두하악장애의 유병률과 관련요인에 관한 연구 -일부 일반사무직, 서비스직, 교직원을 대상으로-)

  • Seo, Eui-Gyeong;Kim, Soon-Duck;Lee, June-Young;Rim, Jae-Suk
    • Journal of Korean society of Dental Hygiene
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    • v.12 no.3
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    • pp.563-576
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    • 2012
  • 목적 : 본 연구는 업무형태에 따른 측두하악장애의 유병률과 업무 시 노출되는 직무스트레스 및 구강 내 악습관이 측두하악장애와 어떠한 연관성이 있는지 알아보아 보건학적 기초자료를 제공하고자 실시되었다. 방법 : 본 연구의 자료 수집을 위하여 서울과 경기 일부지역에 근무하고 있는 일반사무직, 서비스직, 교직원으로부터 편의 추출된 452명을 대상으로 2010년 1월부터 2010년 4월까지 설문조사를 실시하였고, 수거된 353명을 연구대상으로 하였다. 설문지는 측두하악장애의 증상, 하악사용에 관한 구강 내 악습관, 직무스트레스, 인구사회학적 특성으로 구성되었다. 측두하악장애의 증상의 정도를 구분하기 위해 설문지의 양성응답 수의 빈도에 따라 무증상인 1단계에서 양성응답 수가 가장 많은 4단계 까지 총 4그룹으로 나누었다. 측두하악장애의 유병률을 알아보기 위하여 빈도분석을 시행하였고, 측두하악장애의 증상의 정도에 따른 여러 요인들 간의 연관성 및 관련요인을 알아보기 위하여 교차분석 및 경향성 분석과 다항로지스틱회기 분석을 시행하였다. 결과 : 측두하악장애의 유병률은 75.4%였고, 측두하악장애에 대한 주관적 증상으로는 관절잡음이 56.4%로 가장 주된 증상 중 하나였으나 남녀 간의 차이는 통계적으로 유의하지 않았다. 다음으로는 두통이나 목의 통증이 36.5%이었고, 귀, 관자놀이, 볼 주위의 통증이 22.1%로 높았다. 측두하악장애의 주관적인 증상 수에 따른 인구사회학적 특성은 증상이 없는 경우 여성에서 19.1%, 남성에서 36.6%로 여성에서 더 높은 유병률을 보였다. 연령별로는 40세 이상의 그룹보다 20 - 30대그룹에서 측두하악장애 증상수가 높아지는 경향을 보였다. 하악 사용과 관련된 악습관 및 직무스트레스는 측두하악장애 증상수와 유의한 관련성이 있는 것으로 나타났는데, 하악 사용과 관련된 습관의 개수가 많아질수록 측두하악장애의 증상의 개수도 많아졌고, 습관이 한 가지씩 늘어날수록 측두하악장애 증상이 없는 1단계보다 3단계가 될 위험이 1.45배, 4단계가 될 위험이 1.57배 높아졌다. 스트레스 수준도 가장 하위단계에서 한 단계 높아지면 측두하악장애 1단계에서 4단계가 될 위험이 2.49배, 두 단계 높아지면 3.43배 높아졌다. 결론 : 본 연구의 결과 측두하악장애와 업무특성에 따른 연관성은 설명하지 못하였지만, 직무스트레스가 높은 경우 측두하악장애 증상의 개수 또한 높아짐을 확인할 수 있었다. 이는 측두하악장애의 주관적인 증상을 발생시키는데 있어서 업무형태 보다는 심인적인 부분이 더 중요한 인자임을 의미한다. 그러므로 측두하악장애 평가 시 신체적인 문제뿐 아니라 행동적, 심리 사회적 문제로 예측인자를 폭넓게 인식함으로써 다각적인 접근을 하는 것이 필요하며, 측두하악장애 증상이 발생된 경우 임상적 치료뿐 아니라 행동요법 및 심리 치료와 자가 관리 등이 함께 수반되어 기여요인 조절을 조절하는 것이 중요하다 하겠다.

The Correlation between The Size and Location of Vocal Polyp and Voice Quality, Before and After Laryngeal Microsurgery (후두미세수술 전후 성대 용종의 크기 및 위치가 음성의 질의 변화에 미치는 영향)

  • Han, Won Gue;Kim, Min-Su;Oh, Kyung Ho;Woo, Jeung Soo;Jung, Kwang Yoon;Kwon, Soon Young
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.27 no.2
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    • pp.102-107
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    • 2016
  • Background and Objectives : Vocal polyps are caused by inflammation induced by stress or irritation. Many patients with vocal polyps complain voice discomfort. For vocal polyps, surgery such as laryngeal microsurgery has been the mainstay of management. We analyzed the clinical features of vocal polyps, and how the size and location of vocal polyps affect the outcomes of surgery. Methods : We retrospectively reviewed 42 patients from March 2014 to December 2015, who were diagnosed as unilateral single vocal polyp. When we operated on a vocal polyp with laryngeal microscopy, we measured their size and location. The quality of voice was evaluated by GRABS scale, jitter, shimmer, NHR (noise to harmonic ratio), MPT (maximum phonation time), and VHI (voice handicap index) before operation and 4 weeks after operation. Results : When we divided the patients into large-sized vocal polyp group (the longest length >3 mm) and small-sized vocal polyp group (the longest length ${\leq}3mm$), all parameter differences tend to be greater at large sized vocal polyp. However, these differences were not statistically significant (p>0.05). When we divided into two groups depending on the volume of vocal polyp, no distinct tendency was found. When we compared the location (anterior, mid and posterior) of vocal polyp with the improvement of voice quality, more change was found at mid portion vocal polyp, except the difference of VHI. However, these differences were also not statistically significant (p>0.05). Conclusion : All parameter differences tend to be greater at large vocal polyp and polyp of the mid location.

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Technical Details Imaging Axillary Lymph Nodes in Breast-Specific Gamma Imaging (유방특이감마영상검사에서 액와부 영상 획득 방법에 대한 연구)

  • Jang, Ji Yeon;Jung, Eun Mi
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.2
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    • pp.115-119
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    • 2012
  • Purpose : The initial Breast-Specific Gamma Imaging (BSGI) protocol included bilateral breast imaging with 2 views of each breast-craniocaudal (CC) and mediolateral oblique (MLO). Furthermore, Axillary lymph nodes view can be acquired easily. The most meaningful prognosis factor for prediction of breast cancer is whether or not the breast cancer has metastasized to the lymph nodes. However, axillary view doesn't conduct in clinical. This article collates a diverse data of BSGI and describes technical details to acquire optimal imaging. Materials and Methods : A retrospective review was performed on 343 patients who had undergone BSGI between May 2011 and March 2012. Patients who had undergone BSGI received intravenous injection of 740 MBq (20 mCi) $^{99m}Tc$-sestamibi. Results : The following contents are the technical details for optimal axillary imaging. $^{99m}Tc$-sestamibi should be administered using an indwelling venous catheter or scalp needle followed by 10 cc of saline to flush to reduce extravasation and vascular trapping. After administration, patients raise their arm over their head and exercise with stress ball for 1 full minute. A lead shield attached to the gamma camera is removed and patients axilla is placed as close as possible to the camera at a $90^{\circ}$ angle. A lead apron is placed across the shoulder to reduce background from other organs. Acquisition time is enough for 120 sec~180 sec. Conclusion : If patients undergo bilateral axillary imaging as a standard with CC, MLO views, it could improve cancer treatment. Result of this study could maximize efficiency axillary imaging of breast cancer patients.

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INFLUENCE OF COOLING RATE ON THERMAL EXPANSION BEHAVIOR AND FLEXURAL FAILURE OF PFM SYSTEMS (도재 냉각방법의 차이가 금속-도재간 열팽창 양상과 결합력에 미치는 영향)

  • Lim, Ae-Ran;Lim, Ho-Nam;Park, Nam-Soo
    • The Journal of Korean Academy of Prosthodontics
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    • v.28 no.1
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    • pp.165-191
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    • 1990
  • Although a number of studies have been performed to assure that residual stress caused by a mismatch of alloy porcelain thermal expansion can contribute to clinical failure of a ceramometal restoration, the interactive influence of cooling rate on the magnitude of thermal expansion difference and on bond strength between them have not been extensively analyzed. The objective of this study was to determine the influence of cooling rate and the number of firing cycles on the expansion mismatch and the flexural failure resistance of metal porcelain strip. Tested alloys included one Pd-Ag alloy, one Ni-Cr-Be alloy with two kinds of porcelain, Vita and Ceramco. Metal specimens were cast into rods with a height of 13mm and a diameter of 5mm. Subsequently, the castings were subjected to scheduled firing cycles without porcelain. And the porcelain specimens after being fired were trimmed into a bar with a final dimension of $5{\times}5{\times}25mm$. Thermal expansions of the alloys and porcelains were measured by using a push rod or a differential dialometer respecitvely. Porcelain glass transition temperatures and expansion values were derived alloy-porcelain pairs were assessed by comparing expansion values of the components at a porcelain glass transition temperature. Calculations were made using combinations of a Ni-Cr alloy or Pd-Ag alloy with each of two porcelain products. Metal-porcelain strip specimens were subjected to four point loading in an Instron testing machine until crack occured at the metal-cramic interface at the time of sharp decrease of load on recorder. On the basis of this study, the following conclusions may be stated: 1. Regardless of the kinds of ceramometal combinations, both of calculated and experimental data revealed that the double fired specimens exhibited a significantly lower flexural strength. 2. By the rise of the amount of mismatch, bond strength were decreased. 3. Thermal expansion value of Pd-Ag alloys were higher than that of Ni-Cr alloys. 4. Expansion curves of metal were proportional to the increase of temperature and were not affected by the experimental conditions, however porcelains did not show the same magnitude of metal, and a shift of the glass transition temperature to higher temperatures was observed when cooled rapidly 5. Alloy-porcelain thermal compatibility appeared more dependent on the porcelain than the alloy.

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Reasons and Motivations for Cigarette Smoking and Barriers against Quitting Among a Sample of Young People in Jeddah, Saudi Arabia

  • Baig, Mukhtiar;Bakarman, Marwan A;Gazzaz, Zohair J;Khabaz, Mohamad N;Ahmed, Tahir J;Qureshi, Imtiaz A;Hussain, Muhammad B;Alzahrani, Ali H;Al-Shehri, Ali A;Basendwah, Mohammad A;Altherwi, Fahd B;Al-Shehri, Fahd M
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3483-3487
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    • 2016
  • Background: Cigarette smoking is one of the leading causes of death in the world. Tobacco consumption has grave negative consequences for health so that it is important to understand the reasons and motivations towards cigarette smoking and barriers against quitting smoking among the young generation for developing effective policies to control this widespread problem. Materials and Methods: This cross-sectional survey was carried out at the Faculty of Medicine, Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia. A total of 438 young smokers participated from the University and the general population. Data were collected through anonymous, self-administered questionnaires in the Arabic language that contained questions about the reasons and motivations towards cigarette smoking and barriers against quitting smoking. The questionnaire also contained several questions regarding knowledge and attitude of the participants towards cigarette smoking. The data was analyzed on SPSS-16. Results: The mean age of the respondents was $22.9{\pm}3.48$, out of 438 subjects 87 (19.9%) were married, and 351 (80.1%) were unmarried, and 331 (75.6%) belonged to urban areas while 107 (24.5%) were from the rural areas. Responding to a question about a number of cigarettes smoked per day, 31% answered 11-20, 29% answered 21-30, and 25% answered 1-10. Questioned about smokers in the family, 34.5% responded more than one, with 19% for brother and 13% for father. About the reasons for not quitting smoking, 26% described lack of willpower, 25% had no reason, 22% said that people around me smoke, and 15.3% responded stress at home/work. The major motivation for smokers was smoker friends (42%), for 33.8% others, for 12% father/brother and 7.8% media. Conclusions: There are several avoidable and preventable reasons and barriers against quitting smoking. However, knowledge and attitude about smoking were good, and the majority of the smokers were well aware of the associated hazards. Therefore, there is a need to search out ways and means to help them to quit this addiction.

Clinical Study of the effect of Ear Acupuncture on 102 Alcoholics (금주환자(禁酒患者) 102명(名)에 대(對)한 임상적(臨床的) 고찰(考察) (강원도지역(江原道地域)을 중심으로))

  • Kang, Jae-Chun
    • The Journal of Korean Medicine
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    • v.17 no.2 s.32
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    • pp.318-330
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    • 1996
  • We had been investigated the effect of ear acupuncture in alcoholics, but in Kang won do province never we have been investigated. so then in Sangji university oriental hospital from Mar. 1. 1995 to Feb. 28. 1996. we clinically analized 102 alcoholics treated The results were summarized as follow: 1. In Age distribution, 40s were the top as 28.4% and next 30s, 50s, 60s 70s, below 3Os. In Sex distribution, these were 92 person in male, 10 person in female. 2. Marrige Status revealed in descending order ; married, single, divorced Sibling order distribution in descending order; eldest son, middle son, youngest son, only son 3. Distribution of education in descending order ; high school, middle school, primary school, collage and graduate school, illiterate 4. Distribution of occupation in descending order; farmer, labor, merchent, salaried and inoccupation, service 5. Distribution of religion in descending order ; none, buddism, protestantism, catholicism 6. Distribution of family history of alcoholism; yes(24.5%), no(69.6%) 7. Distribution of onset of drinking in descending order ; 20s, below 20s, 30s and 40s, 50s 8. Distribution of duration of drinking in descending order ; 20-29 years, 10-19 and below years, 40-49 years, 30-39 years 9. Distribution of the reason of drinking in descending order ; habbit, business and reduce of stress, no reason, syndrome of stop drinking 10. Distribution of frequency of drinking in descending order ; daily, four or five times a week, irregularly, once a week, two or three times a week 11. Distribution of amount of drinking in descending order ; two bottles, one bottle, three bottles, half, bottle above four bottles 12. Distribution of Chief Complaint of Alcohol in descending order ; no appetite and anorexia, diarrhrea insomnia, fatigue, vomitting, tremor, drinking water, hallucination, abdominal pain, constipation 13. Distribution of total MAST score in descending order ; 26-48 score, 13-18 score, 19-25 score, 8-12 score, 0-7 score 14. In the treatment effects according to MAST score, these were complete stop drinking 18.0%, improved 53.0%, unchanged 29.0%. 15. Distribution of liver function test and treatment effects in descending order ; ALAT, ASAT, GGTP, Trigliceride, Alk-phosphatase and Total bilirubin The treatment effects in ear acupuncture were 70.5% effective ones ; stop drinking 17.6%, improved 52.9%. 17. These were headache, nausea, vomitting sense, weakness in revealing symtoms after treatment, but no severe side effect. 18. Distribution of the times of onset in the change of taste in descending order; 3-5 times, below 2 times and above 6 times.

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