• Title/Summary/Keyword: Hazard Index

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Nutritional Status Indicators Affecting the Tolerability of Postoperative Chemotherapy After Total Gastrectomy in Patients With Gastric Cancer

  • Toyota, Kazuhiro;Mori, Masayuki;Hirahara, Satoshi;Yoshioka, Shoko;Kubota, Haruna;Yano, Raita;Kobayashi, Hironori;Hashimoto, Yasushi;Sakashita, Yoshihiro;Yokoyama, Yujiro;Murakami, Yoshiaki;Miyamoto, Katsunari
    • Journal of Gastric Cancer
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    • v.22 no.1
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    • pp.56-66
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    • 2022
  • Purpose: Nutritional problems after gastrectomy affect continuation of postoperative chemotherapy. There have been no studies limited to total gastrectomy, which is particularly prone to nutritional problems. In this study, we aimed to investigate the factors that predict the continuation of postoperative chemotherapy. Materials and Methods: We included 101 patients who underwent curative total gastrectomy and postoperative chemotherapy at Hiroshima Memorial Hospital. The effects of 37 factors, including perioperative inflammatory, nutritional, and tumor status, on the persistence of postoperative chemotherapy were analyzed. Results: In univariate analysis of preoperative factors, age, carbohydrate antigen 19-9, platelet-to-neutrophil ratio, Onodera's prognostic nutritional index (PNI), controlling nutritional status score, and nutritional risk screening (NRS-2002) score were significantly associated with the duration of postoperative chemotherapy. In multivariate analysis of preoperative factors, age (≥74 years) was an independent factor for a shorter duration of postoperative chemotherapy (hazard ratio [HR], 5.24; 95% confidence interval [CI], 2.19-12.96; P<0.01). In univariate analysis of factors before postoperative chemotherapy, intraoperative blood loss, perioperative weight loss rate, postoperative performance status, PNI, albumin-to-bilirubin index, and NRS-2002 score were significantly associated with the duration of postoperative chemotherapy. In multivariate analysis of factors before postoperative therapy, age (≥74 years) (HR, 5.75; 95% CI, 1.90-19.49; P<0.01) and PNI (<39) (HR, 3.29; 95% CI, 1.26-8.56; P=0.02) were independent factors for a shorter duration of postoperative chemotherapy. Conclusions: Age and PNI are useful predictors of postoperative chemotherapy intolerance after total gastrectomy and may determine the treatment strategy and timing of chemotherapy initiation.

Risk of Osteoporotic Fractures Among Obese Women Based on Body Mass Index and Waist Circumference: A Nationwide Cohort in South Korea

  • Gyeongsil Lee;Seulggie Choi;Yoosun Cho;Sang Min Park
    • Clinical Nutrition Research
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    • v.11 no.1
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    • pp.32-41
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    • 2022
  • We evaluated the association between obesity status by body mass index (BMI) or waist circumference (WC) and osteoporotic fracture risk. We collected data of 143,673 women with a mean age of 58.5 years without history of osteoporotic fracture from the Korean National Health Insurance Service Cohort. Participants were divided into four groups according to obesity by BMI and WC, normal BMI/WC (BMI 18.5-24.9 kg/m2 and WC < 85 cm, reference), obese BMI/normal WC (BMI ≥ 25 kg/m2 and WC < 85 cm), normal BMI/obese WC (BMI < 25 kg/m2 and WC ≥ 85 cm), and obese BMI/WC (BMI ≥ 25 kg/m2 and WC < 85cm). Cox proportional hazards regression analyses were performed to obtain hazard ratios (HRs) with 95% confidence intervals (CIs) for the subsequent median 6.0 years, which were adjusted for age, socioeconomic status, lifestyle, morbidity index, and osteoporosis medication. Compared with the normal group, normal BMI/obese WC was associated with a higher osteoporotic fracture risk after multivariable adjustment (HRs [95% CI], 1.13 [1.05-1.21]), and obese BMI/normal WC was associated with a lower osteoporotic fracture risk (0.89 [0.84-0.94]). Obese BMI/normal WC was associated with a lower risk for hip fractures (0.75 [0.57-0.99]). Obese BMI/normal WC was associated with decreased risk of osteoporotic fracture, whereas normal BMI/obese WC was associated with increased risk of osteoporotic fracture compared with the normal group among East Asian women in their late 40s or more.

Risk Assessment for Heavy Metals in Soil, Ground Water, Rice Grain nearby Abandoned Mine Areas (국내 폐금속 광산지역에서의 토양, 지하수, 쌀의 중금속 노출에 따른 인체 위해성평가)

  • Na, Eun-Shik;Lee, Yong-Jae;Ko, Kwang-Yong;Chung, Doug-Young;Lee, Kyu-Seung
    • Korean Journal of Environmental Agriculture
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    • v.32 no.4
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    • pp.245-251
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    • 2013
  • BACKGROUND: The objectives of this study are to investigate the contamination levels of heavy metals in soil, ground water, and agricultural product near the abandoned Boeun and Sanggok mine areas in Korea and to assess the health risk for these local residents exposed to the toxic heavy metals based on analytical data. METHODS AND RESULTS: By the results of human health risk assessment for local residents around Boeun and Sanggok, human exposure to cadmium, copper, arsenic from soil and to lead, cadmium, and arsenic from rice grain were higher in Sanggok, but human exposure to zinc and arsenic from ground water was higher in Boeun. By the results of hazard index (HI) evaluation for arsenic, cadmium, copper, lead, and zinc, HI values in both areas were higher than 1.0. This result indicated that the toxicity hazard through the continuous exposure to lead, cadmium, arsenic from rice, ground water, and soil would be likely to occur to the residents in the areas. Cancer risk assessment for arsenic, risks from the rice were exposed to one to two out of 10,000 people in Boeun and one of 1,000 people in Sanggok. These results showed that the cancer risks of arsenic in both areas were 10~100 times greater than the acceptable cancer risk range of US EPA ($1{\times}10^{-6}{\sim}1{\times}10^{-5}$). CONCLUSION(S): Therefore, if these two local residents consume continuously with arsenic contaminated soil, ground water, and rice, the adverse health effects (carcinogenic potential) would be more increased.

A Study on Reforming Threshold Quantities of Toxic Substances in Process Safety Management (PSM 제출대상 독성물질의 규정량 합리화에 대한 연구)

  • Lee, Joo Yeob;Lee, Keun Won;Kim, Tae-Ok
    • Journal of the Korean Institute of Gas
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    • v.21 no.4
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    • pp.6-15
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    • 2017
  • Process safety management(PSM) system was implemented in Korea since 1996. It helps reduce and prevent the occurrence of chemical accidents. There has been no review on the feasibility of the threshold quantities of the existing 21 species and the newly added toxic substances such as hydrogen bromide in the PSM system. The threshold quantities of the target toxic substances(25 species) of PSM were compared with domestic and foreign PSM systems similar to those of Korea. Also, we proposed the toxic harmfulness and hazard equation consisted of inhalation toxicity, NFPA index and others. According to this equation, high risk, medium risk and low risk are classified and reflected in the adjustment of threshold quantities. From the above research, It is expected to help to reduce confusion and burden of the workplaces due to the difference from other PSM system and improve in the threshold quantities.

Landslide Hazard Evaluation using Geospatial Information based on UAV and Infinite Slope Stability Model (UAV 기반의 공간정보와 무한사면해석모형을 활용한 산사태 위험도 평가)

  • Lee, Geun-Sang;Choi, Yun-Woong
    • Journal of Cadastre & Land InformatiX
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    • v.45 no.2
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    • pp.161-173
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    • 2015
  • The influence of climate change on rainfall patterns has triggered landslide and debris flow with casualties and property damage. This study constructed DSM and Orthophoto by using UAV surveying technique and evaluated landslide risk area by applying GIS data into the infinite slope stability model. As a result of the estimation of slope stability in a site, the slope instability has $SI{\leq}1.0$ with cover area 46,396m2, and the distribution percentage was 18.2%. The most dangerous section has $SI{\leq}0.0$ with its cover area 7,988m2, and the ratio was 0.8%. The reviews regarding the risk of landslide and debris flow risk by stability index and river channel analysis respectively help being able to designate the hazard zone due to heavy rainfall. Therefore the analysis result of this study will need to reinforce soil slope and plan their safety measures in the future.

Recovery Cost Evaluation and Practical Application for Index Assessment of Private Facilities Damaged by Natural Disaster (자연재난 복구비용 산정을 위한 기법 및 실용화 연구)

  • Jung, Woo-Young;Kim, Sung-Jun;Choi, Hyun-Kyu
    • Journal of the Korean Society of Hazard Mitigation
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    • v.9 no.3
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    • pp.67-73
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    • 2009
  • Financial supports of private facilities which were damaged by natural disaster are currently performed partially by a government and the guideline of corresponding recovery costs be the natural disaster prevention law in South Korea. However, current financial recovery guidelines for the damaged private facilities has not been estimated objectively so far. This research presents advanced recovery cost search and assesment methods for the damaged private facilities under natural disaster. To produce more accurate data, an investigation for practical field markets which are appointed in Kangwon area is conducted and the proposed recovery values per each item are compared to exact field market values. Finally. more realistic and accurate recovery cost guideline including evaluation and more effective market surveying method are suggested here. A theoretical and practical program for systematic recovery cost calculation is proposed and expected to be used at public institution before long.

Nonlinear Analysis of Functionally Graded Materials Plates and Shells (점진기능재료(FGM) 판과 쉘의 비선형 해석)

  • Han, Sung-Cheon;Lee, Chang-Soo;Kim, Gi-Dong;Park, Weon-Tae
    • Journal of the Korean Society of Hazard Mitigation
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    • v.7 no.5
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    • pp.61-71
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    • 2007
  • Navier's and Finite element solutions based on the first-order shear deformation theory are presented for the analysis of through-thickness functionally graded plates and shells. The functionally graded materials are considered: a sigmoid function is utilized for the mechanical properties through the thickness of the isotropic structure which varies smoothly through the plate and shell thickness. The formulation of a nonlinear 9-node Element-based Lagrangian shell element is presented for the geometrically nonlinear analysis. Natural-coordinate-based strains are used in present shell element. Numerical results of the linear and nonlinear analysis are presented to show the effect of the different top/bottom elastic modulus, loading conditions, aspect ratios and side-to-thickness ratios on the mechanical behaviors. Besides, the result according to the variation of the power-law index of isotropic functionally graded structures is investigated.

Applicability of A Stream Evaluation Method for Stream Restoration (하천복원을 위한 하천평가기법의 적용성 연구)

  • Lee, Joon-Ho;Kang, Tae-Ho;Sung, Young-Du;Yoon, Sei-Eei
    • Journal of the Korean Society of Hazard Mitigation
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    • v.3 no.4 s.11
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    • pp.131-143
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    • 2003
  • The purpose of this study was to develop a new method for evaluation of stream naturalness in order to promote stream managers' understanding on importance of improving stream naturalness, and in order to appraise and prescribe for streams effectively in the process of ecological restoration of stream corridors. In order to analyze the evaluation method of stream naturalness and its applicability to streams, stream naturalness index(SNI) which has seven factors such as channel development, longitudinal profile, lateral section, stream bed structure, low flow channel structure, stream surroundings and water quality was suggested in this paper. For case studies, Bokha stream was selected for the evaluation of stream naturalness. At the Bokha stream, the scores of SNI factors were in range of $2.2{\sim}3.8$, and the average of SNI was 3.1, and the most frequent grade of SNI factors was grade 3. Among the 7 factors, the best was lateral section, and the worst was channel development. In this study, SNI grade can represent the characteristics of stream naturalness well and select the streams which will be restored, and can also decide the segment and the method of restoration for deteriorated streams.

Analyzing the Disaster Vulnerability of Mt. Baekdusan Area Using Terrain Factors (지형 요소를 고려한 백두산 지역의 위험도 분석)

  • Choi, Eun-Kyeong;Kim, Sung-Wook;Lee, Young-Cheol;Lee, Kyu-Hwan;Kim, In-Soo
    • Journal of the Korean earth science society
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    • v.34 no.7
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    • pp.605-614
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    • 2013
  • Most steep slope failures tend to take place in geographically unstable areas. Mt. Baekdusan is known as a potentially active volcano in a typical mountainous terrain. This study prepared a digital elevation model of Mt. Baekdusan area and created a hazard map based on topographical factors and structural lineament analysis. Factors used in vulnerability analysis included geographical data involving aspect and slope distribution, as well as contributory area of upslope, tangential gradient curvature, profile gradient curvature, and the distribution of wetness index among the elements that comprise topography. In addition, the stability analysis was conducted based on the lineament intensity map. Concerning the disaster vulnerability of Mt. Baekdusan region, the south and south west area of Mt. Baekdusan has a highest risk of disaster (grade 4-5) while the risk level decreases in the north eastern region.

Results of Intravesical Chemo-Hyperthermia in High-risk Non-muscle Invasive Bladder Cancer

  • Ekin, Rahmi Gokhan;Akarken, Ilker;Cakmak, Ozgur;Tarhan, Huseyin;Celik, Orcun;Ilbey, Yusuf Ozlem;Divrik, Rauf Taner;Zorlu, Ferruh
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3241-3245
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    • 2015
  • Purpose: To examine the effectiveness of mitomycin-C and chemo-hyperthermia in combination for patients with high-risk non-muscle-invasive bladder cancer. Materials and Methods: Between November 2011-September 2013, 43 patients with high-risk non-muscle-invasive bladder cancer undergoing adjuvant chemo-hyperthermia in two centers were evaluated retrospectively. Treatment consisted of 6 weekly sessions, followed by 6 sessions. Recurrence and progression rate, recurrence-free interval and side effects were examined. Analyzed factors included age, gender, smoking status, AB0 blood group, body mass index, T stage and grade, concominant CIS assets. The associations between predictors and recurrence were assessed using multivariate Cox proportional hazard analyses. Results: A total of 40 patients completed induction therapy. Thirteen (32.5%) were diagnosed with tumor recurrence. Median follow-up was 30 months (range 9-39). Median recurrence-free survival was 23 months (range 6-36). The Kaplan-Meier-estimated recurrence-free rates for the entire group at 12 and 24 months were 82% and 61%. There was no statistically significant difference between patient subgroups. Cox hazard analyses showed that an A blood type (OR=6.23, p=0.031) was an independent predictor of recurrence-free. Adverse effects were seen in 53% of patients and these were frequently grades 1 and 2. Conclusions: Intravesical therapy with combination of mitomycin-C and chemohyperthermia seems to be appropriate in high-risk patients with non-muscle-invasive bladder cancer who cannot tolerate or have contraindications for standard BCG therapy.