• Asian Pacific Journal of Cancer Prevention
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• v.15 no.23
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• pp.10209-10215
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• 2015

To assess the contribution of tumor necrosis factor $(TNF){\beta}$ +252 polymorphisms to risk and prognosis of hepatocellular carcinoma (HCC), we enrolled 150 pairs of sex- and age-matched patients with HCC, patients with cirrhosis alone, and unrelated healthy controls. $TNF{\beta}$ +252 genotypes were determined by polymerase chain reaction with restriction fragment length polymorphism. Multivariate analysis indicated that $TNF{\beta}$ G/G genotype [odds ratio (OR), 3.64; 95%CI, 1.49-8.91], hepatitis B surface antigen (OR, 16.38; 95%CI, 8.30-32.33), and antibodies to hepatitis C virus (HCV) (OR, 39.11; 95%CI, 14.83-103.14) were independent risk factors for HCC. There was an additive interaction between $TNF{\beta}$ G/G genotype and chronic hepatitis B virus (HBV)/HCV infection (synergy index=1.15). Multivariate analysis indicated that factors associated with $TNF{\beta}$ G/G genotype included cirrhosis with Child-Pugh C (OR, 4.06; 95%CI, 1.34-12.29), thrombocytopenia (OR, 6.55; 95%CI, 1.46-29.43), and higher serum ${\alpha}$-fetoprotein concentration (OR, 2.53; 95%CI, 1.14-5.62). Patients with $TNF{\beta}$ G/G genotype had poor cumulative survival (p=0.005). Cox proportional hazard model indicated that $TNF{\beta}$ G/G genotype was a biomarker for poor HCC survival (hazard ratio, 1.70; 95%CI, 1.07-2.69). In conclusion, there are independent and additive effects between $TNF{\beta}$ G/G genotype and chronic HBV/HCV infection on risk for HCC. It is a biomarker for poor HCC survival. Carriage of this genotype correlates with disease severity and advanced hepatic fibrosis, which may contribute to a higher risk and poor survival of HCC. Chronic HBV/HCV infected subjects with this genotype should receive more intensive surveillance for early detection of HCC.

• The Korean Journal of Nuclear Medicine
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• v.35 no.4
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• pp.251-257
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• 2001

Purpose: We investigated the possibility of early postoperative Tc-99m DTPA scintigraphy in predicting long-term renal transplant survival. Materials and Methods: 64 living donor (LD) grafts were divided into two groups according to the graft function on early post-operative renal scintigraphy. Survival analysis was performed using Kaplan-Meier method and Cox proportional hazard model. Chi-square test was performed to evaluate the difference in the frequency of acute rejection. Results: Cumulative renal transplant survival was decreased in 11 patients with abnormal renal scintigraphy, but it was not statistically significant. Decreased graft function on early post-operative renal scintigraphy was not a predictor of long-term graft survival. The frequency of acute rejection was higher in abnormal scintigraphy group, and the difference was statistically significant. Conclusion: Decreased graft function on early post-operative renal scintigraphy has no direct effect on long-term renal transplant survival in LD transplantation. But it may have an indirect elect through increasing the frequency of acute rejection.

• Journal of Yeungnam Medical Science
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• v.19 no.2
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• pp.126-135
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• 2002

Background: Neovascular glaucoma is common secondary glaucoma at high risk for failure of glaucoma filtering surgery. Recently, trabeculectomy with adjunctive mitomycin C trabeculectomy has been tried to improve the surgical success rate of conventional trabeculectomy. But, the long-term effects of mitomycin C trabeculectomy for neovascular glaucoma are unknown. Thus, we evaluated the long-term effects of mitomycin C trabeculectomy and its prognostic factors influencing the outcome. Materials and Methods: Medical records of 62 eyes of 55 neovascular glaucoma who had undergone mitomycin C trabeculectomy were retrospectively reviewed. Surgical success was defined as intraocular pressures of 21 mmHg or less with or without glaucoma medications and no loss of light perception. Surgical failure was defined as postoperative loss of light perception in patients with preoperative vision better than light perception, additional glaucoma surgery, or phthisis bulbi in patients with preoperative vision of no light perception. Results: Postoperative success was obtained in 37 (60%) out of 62 eyes after mean followup period of $23.9{\pm}16.2$ months. Using Kaplan-Meier survival analysis, cumulative success rate at the 6-, 12-, 24- and 36-month intervals were 85%, 71%, 57% and 52%, respectively. Success rate was greater in eyes with diabetic retinopathy than other causes(p=0.005) and in eyes with preoperative panretinal photocoagulation(PRP) than without PRP(p=0.015). However, Cox proportional hazard regression analysis revealed that preoperative PRP was not a significant risk factor for surgical failure. Conclusion: Prognosis of neovascular glaucoma caused by diabetic retinopathy was better than that caused by the other disorders following mitomycin C trabeculectomy. The author would suggest that mitomycin C trabeculectomy could be effective and relatively safe as the first procedure of choice before performing glaucoma drainage device implantation or cyclodestructive procedure.

• Korean Journal of Radiology
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• v.24 no.5
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• pp.424-433
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• 2023

Objective: To assess the safety and efficacy of balloon dilatation under dual guidance using fluoroscopy and bronchoscopy for treating bronchial stenosis following lung transplantation (LT), and to elucidate the factors associated with patency after the procedure. Materials and Methods: From September, 2012, to April, 2021, 50 patients (mean age ± standard deviation, 54.4 ± 12.2 years) with bronchial stenosis among 361 recipients of LT were retrospectively analyzed. The safety of balloon dilatation was assessed by evaluating procedure-related complications. Efficacy was assessed by evaluating the technical success, primary patency, and secondary patency. Primary and secondary cumulative patency rates were calculated using the Kaplan-Meier method. The factors associated with patency after the procedure were evaluated using multivariable Cox hazard proportional regression analysis. Results: In total, 65 bronchi were treated with balloon dilatation in 50 patients. The total number of treatment sessions was 277 and the technical success rate was 99.3% (275/277 sessions). No major procedure-related complications were noted. During the mean follow-up period of 34.6 ± 30.8 months, primary patency was achieved in 12 of 65 bronchi (18.5%). However, the patency rate improved to 76.9% (50 of 65 bronchi) after repeated balloon dilatation (secondary patency). The 6-month, 1-year, 3-year, and 5-year secondary patency rates were 95.4%, 90.8%, 83.1%, and 78.5%, respectively. The presence of clinical symptoms was a significant prognostic factor associated with reduced primary patency (adjusted hazard ratio [HR], 0.465; 95% confidence interval [CI], 0.220-0.987). Early-stage treatment ≤ 6 months (adjusted HR, 3.588; 95% CI, 1.093-11.780) and prolonged balloon dilatation > 5 min (adjusted HR, 3.285; 95% CI, 1.018-10.598) were associated with significantly higher secondary patency. Conclusion: Repeated balloon dilatation was determined to be safe and effective for treating bronchial stenosis following LT. Early-stage treatment and prolonged balloon dilatation could significantly promote long-term patency.

• Korean Journal of Radiology
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• v.23 no.6
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• pp.615-624
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• 2022

Objective: To compare the therapeutic outcomes of laparoscopic hepatic resection (LHR) and laparoscopic radiofrequency ablation (LRFA) for single subcapsular hepatocellular carcinoma (HCC). Materials and Methods: We screened 244 consecutive patients who had received either LHR or LRFA between January 2014 and December 2016. The feasibility of LRFA in patients who underwent LHR was retrospectively assessed by two interventional radiologists. Finally, 60 LRFA-feasible patients who had received LHR and 29 patients who had received LRFA as the first treatment for a solitary subcapsular HCC between 1 cm and 3 cm were finally included. We compared the therapeutic outcomes, including local tumor progression (LTP), recurrence-free survival (RFS), and overall survival (OS) between the two groups before and after propensity score (PS) matching. Multivariable Cox proportional hazard regression was also used to evaluate the difference in OS and RFS between the two groups for all 89 patients. Results: PS matching yielded 23 patients in each group. The cumulative LTP and OS rates were not significantly different between the LHR and LRFA groups after PS matching (p = 0.900 and 0.003, respectively). The 5-year LTP rates were 4.6% and 4.4%, respectively, and OS rates were 100% and 90.7%, respectively. The RFS rate was higher in LHR group without statistical significance (p = 0.070), with 5-year rates of 78.3% and 45.3%, respectively. OS was not significantly different between the LHR (reference) and LRFA groups in multivariable analyses, with a hazard ratio (HR) of 1.33 (95% confidence interval, 0.12-1.54) (p = 0.818). RFS was higher in LHR (reference) than in LRFA without statistical significance in multivariable analysis, with an HR of 2.01 (0.87-4.66) (p = 0.102). Conclusion: There was no significant difference in therapeutic outcomes between LHR and LRFA for single subcapsular HCCs measuring 1-3 cm. The difference in RFS should be further evaluated in a larger study.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.16
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• pp.6597-6601
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• 2014

Background: Cancer is a non-communicable disease that is considered deadly in many cases. In recent years, the mortality rates from breast cancer have increased with increasing incidences. The present study was conducted to determine five year survival of women with breast cancer in Yazd, in the central region of Iran. Materials and Methods: In a prospective study, data were obtained from the patient's medical records with breast cancer that were referred to the Shahid Sadoughi hospital and radiotherapy center from 2002-2007 and followed up for 5 years. The data collected were analyzed by SPSS/16 and Kaplan-Meyer test and log-rank test and Cox proportional hazard model was used. Results: The mean age of breast cancer diagnosis was $48.3{\pm}11.7$ years. The 1-, 2-, 3-, 4- and 5-year cumulative survivals for breast cancer patients were 95%, 86%, 82%, 76% and 70%, respectively. There were significant differences with age distribution (p=0.006). A significant decrease in the 5-year survival in patients with involvement of lymph nodes was lso observed. Conclusions: Education for early diagnosis in women must be considered and these findings support the need for breast cancer screening programs.

• Nutrition Research and Practice
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• v.12 no.5
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• pp.436-442
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• 2018

BACKGROUND/OBJECTIVES: The aim of this study was to identify the effect of dairy products, milk and yogurt on osteoporosis incidence among Korean postmenopausal women using prospective cohort data. MATERIALS/METHODS: Between 2001 and 2003, 10,038 participants were recruited in rural and urban areas for a baseline examination of a community-based cohort study. Of those, 1,573 postmenopausal women (aged 40-69 years at baseline) were eligible for the present study. Intakes of dairy products, milk, and yogurt were assessed using a validated semi-quantitative food frequency questionnaire. The speed of sound at the radius and tibia were measured using a quantitative ultrasound device and osteoporosis was defined based on the WHO criteria (T-score ${\leq}-2.5$). RESULTS: During the 4-years follow-up study, the cumulative incidence of osteoporosis was 18.4% (273 cases) in the radius and 33.6% (407 cases) in the tibia. The subjects with higher frequency of dairy product consumption showed a decreased risk of radius osteoporosis after adjusting for potential confounders [hazard ratio (HR) = 0.51, 95% confidence interval (CI): 0.33-0.80 for >1 time/day vs. non consumer; P for trend = 0.0027]. Similarly, high frequency of milk and yogurt consumption had a protective effect on radius osteoporosis risk [milk: HR = 0.60, 95% CI: 0.42-0.87 for > 5-6 times/week vs. non consumer (P for trend = 0.0130), yogurt: HR = 0.51, 95% CI: 0.30-0.85 for > 5-6 times/week vs. non consumer (P for trend = 0.0167)]. However, high dairy products consumption was not related with tibia osteoporosis. CONCLUSIONS: This study suggests that daily intake of dairy products could potentially reduce radius osteoporosis incidence among Korean postmenopausal women.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.321-324
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• 2013

Background: Intra- and extrahepatic cholangiocarcinoma (CCA) is the most common cancer in Thailand, especially in the northeast region. Most extrahepatic CCA patients consult a doctor at a late stage. Surgery is still the best treatment. Objectives: The aim of this study was to evaluate survival rates and factors affecting survival in extrahepatic CCA patients following surgery at Srinagarind Hospital, Khon Kaen University, Thailand. Materials and Methods: A retrospective cohort study was conducted with 58 patients who were diagnosed and treated by surgical resection by the same surgeon at Srinagarind Hospital between 2005 and 2009. The patients were followed up until death or the end of the study (31 December, 2011). Survival rates were calculated by the Kaplan-Meier method, and the Cox proportional hazard model was used to identify independent prognostic factors. Results: The total follow-up time was 1,215 person-months, and the mortality rate was 50 per 100 person-years. The cumulative 1-, 3-, and 5-year survival rates were 62.1%, 21.7% and 10.8%, respectively. The median survival time after resection was 15 months. After adjusting for age, gender, lymph node metastasis and histological type, resection margin remained as a statistically significant prognostic factor for survival following surgery. A positive resection margin was associated with a 2.3-fold higher mortality rate than a negative margin. Conclusions: Resection margins are important prognostic factors affecting survival of extrahepatic CCA patients after surgery. A negative resection margin can reduce the mortality rate by 56%.

• Journal of Gastric Cancer
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• v.16 no.3
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• pp.161-166
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• 2016

Purpose: Lymph node (LN) metastasis is the best prognostic indicator in non-distant metastatic advanced gastric cancer. This study aimed to assess the prognostic value of various clinicopathologic factors in node-negative advanced gastric cancer. Materials and Methods: We retrospectively analyzed the clinical records of 254 patients with primary node-negative stage T2~4 gastric cancer. These patients were selected from a pool of 1,890 patients who underwent radical resection at Memorial Jin-Pok Kim Korea Gastric Cancer Center, Inje University Seoul Paik Hospital between 1998 and 2008. Results: Of the 254 patients, 128 patients (50.4%), 88 patients (34.6%), 37 patients (14.6%), and 1 patient (0.4%) had T2, T3, T4a, and T4b tumors, respectively. In a univariate analysis, operation type, T-stage, venous invasion, tumor size, and less than 15 LNs significantly correlated with tumor recurrence and cumulative overall survival. In a multivariate logistic regression analysis, tumor size, venous invasion, and less than 15 LNs significantly and independently correlated with recurrence. In a multivariate Cox proportional hazards analysis, tumor size (hazard ratio [HR]: 2.926; 95% confidence interval [CI]: 1.173~7.300; P=0.021), venous invasion (HR: 3.985; 95% CI: 1.401~11.338; P=0.010), and less than 15 LNs (HR: 0.092; 95% CI: 0.029~0.290; P<0.001) significantly correlated with overall survival. Conclusions: Node-negative gastric cancers recurred in 8.3% of the patients in our study. Tumor size, venous invasion, and less than 15 LNs reliably predicted recurrence as well as survival. Aggressive postoperative treatments and timely follow-ups should be considered in cases with these characteristics.

• Health Policy and Management
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• v.18 no.4
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• pp.49-65
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• 2008

The single-item question of self-assessed health status has consistently been reported to be associated with mortality in some developed countries, even after controlling for a wide range of health measurements and known risk factors for. mortality. It was intended in this study to find out whether or not such a relationship would also be valid in Korea. This study examined the effect of point of reference year on. the, predictive validity of self-assessed health for mortality in 6-year follow-up period. we need to test the validity of the self-assessed health, as an indicator for assessing health status using Cox's proportional hazard model. For the analysis, we used the data from the 2nd (1999) to the 7th survey of "Korean Labor and Income Panel Study," and assessed relative risk of death based on subjective health state by tracing 11,366 people who replied to the question of self-assessed health state in the 2nd year. According to the result, those who reported poor self assessed health state in the 2nd year showed a relatively high death rate, and their relative risk of death was significantly higher. Such a relationship was accentuated if the predictive value of the 2nd survey result would be replaced by the average of the cumulative data on the past six years. Thus, it can be concluded that self-assessed health state is valid as an index for assessing Korean people's health status.