• Title/Summary/Keyword: High-risk group

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Risk Stratification for Serosal Invasion Using Preoperative Predictors in Patients with Advanced Gastric Cancer

  • Park, Sung-Sil;Min, Jae-Seok;Lee, Kyu-Jae;Jin, Sung-Ho;Park, Sunhoo;Bang, Ho-Yoon;Yu, Hwang-Jong;Lee, Jong-Inn
    • Journal of Gastric Cancer
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    • v.12 no.3
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    • pp.149-155
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    • 2012
  • Purpose: Although serosal invasion is a critical predisposing factor for peritoneal dissemination in advanced gastric cancer, the accuracy of preoperative assessment using routine imaging studies is unsatisfactory. This study was conducted to identify high-risk group for serosal invasion using preoperative factors in patients with advanced gastric cancer. Materials and Methods: We retrospectively analyzed clinicopathological features of 3,529 advanced gastric cancer patients with Borrmann type I/II/III who underwent gastrectomy at Korea Cancer Center Hospital between 1991 and 2005. We stratified patients into low-(${\leq}40%$), intermediate-(40~70%), and high-risk (>70%) groups, according to the probability of serosal invasion. Results: Borrmann type, size, longitudinal and circumferential location, and histology of tumors were independent risk factors for serosal invasion. Most tumors of whole stomach location or encircling type had serosal invasion, so they belonged to high-risk group. Patients were subdivided into 12 subgroups in combination of Borrmann type, size, and histology. A subgroup with Borrmann type II, large size (${\geq}7$ cm), and undifferentiated histology and 2 subgroups with Borrmann type III, large size, and regardless of histology belonged to high-risk group and corresponded to 25% of eligible patients. Conclusions: This study have documented high-risk group for serosal invasion using preoperative predictors. And risk stratification for serosal invasion through the combination with imaging studies may collaboratively improve the accuracy of preoperative assessment, reduce the number of eligible patients for further staging laparoscopy, and optimize therapeutic strategy for each individual patient prior to surgery.

A Modified eCura System to Stratify the Risk of Lymph Node Metastasis in Undifferentiated-Type Early Gastric Cancer After Endoscopic Resection

  • Hyo-Joon Yang ;Hyuk Lee;Tae Jun Kim;Da Hyun Jung;Kee Don Choi;Ji Yong Ahn;Wan Sik Lee;Seong Woo Jeon;Jie-Hyun Kim;Gwang Ha Kim;Jae Myung Park;Sang Gyun Kim;Woon Geon Shin;Young-Il Kim;Il Ju Choi
    • Journal of Gastric Cancer
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    • v.24 no.2
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    • pp.172-184
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    • 2024
  • Purpose: The original eCura system was designed to stratify the risk of lymph node metastasis (LNM) after endoscopic resection (ER) in patients with early gastric cancer (EGC). We assessed the effectiveness of a modified eCura system for reflecting the characteristics of undifferentiated-type (UD)-EGC. Materials and Methods: Six hundred thirty-four patients who underwent non-curative ER for UD-EGC and received either additional surgery (radical surgery group; n=270) or no further treatment (no additional treatment group; n=364) from 18 institutions between 2005 and 2015 were retrospectively included in this study. The eCuraU system assigned 1 point each for tumors >20 mm in size, ulceration, positive vertical margin, and submucosal invasion <500 ㎛; 2 points for submucosal invasion ≥500 ㎛; and 3 points for lymphovascular invasion. Results: LNM rates in the radical surgery group were 1.1%, 5.4%, and 13.3% for the low-(0-1 point), intermediate- (2-3 points), and high-risk (4-8 points), respectively (P-fortrend<0.001). The eCuraU system showed a significantly higher probability of identifying patients with LNM as high-risk than the eCura system (66.7% vs. 22.2%; McNemar P<0.001). In the no additional treatment group, overall survival (93.4%, 87.2%, and 67.6% at 5 years) and cancer-specific survival (99.6%, 98.9%, and 92.9% at 5 years) differed significantly among the low-, intermediate-, and high-risk categories, respectively (both P<0.001). In the high-risk category, surgery outperformed no treatment in terms of overall mortality (hazard ratio, 3.26; P=0.015). Conclusions: The eCuraU system stratified the risk of LNM in patients with UD-EGC after ER. It is strongly recommended that high-risk patients undergo additional surgery.

High Risk Human Papilloma Virus Genotypes in Kurdistan Region in Patients with Vaginal Discharge

  • Hussein, Nawfal R;Balatay, Amer A;Assafi, Mahde S;Al-Mufty, Tamara Abdulezel;Khalil, Amira S
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3191-3193
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    • 2016
  • Background: The human papilloma virus (HPV) is considered as the major risk factor for the development of cervical cancer. This virus is of different genotypes and generally can be classified into high and low risk types. Objective: To determine the rate of high risk HPV genotypes in women with vaginal discharge and lower abdominal pain in Kurdistan region, Iraq. Materials and Methods: Cervical swabs were taken from 104 women. DNA was extracted and the polymerase chain reaction (PCR) technique was used to determine the presence of high risk genotypes. Results: It was found that 13/104 (12.5%) of the samples were positive for high risk HPV genotypes. Amongst those who were positive, 4/13 (30.7%) were typed as genotype 16 and 7/13 (53.8%) showed mixed genotyping. On the other hand, genotypes 53 and 56 were found in only one sample each. Conclusions: High risk HPV genotypes are not uncommon and further community based study is needed to determine the prevalence of HPV and its genotypes and plan for prevention of infection.

Relationship between Communication Stance and Characteristics of Internet Use (청소년에서의 인터넷 중독 정도 조사 및 이에 따른 의사소통 유형과의 관계)

  • Lee Moon-Soo;Choo Chung-Sook;Joung Yoo-Sook;Hong Sung-DoDavid;Lee Hyeon-Soo;Nam Min;Song Hyoung-Seok
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.17 no.2
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    • pp.141-148
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    • 2006
  • Objectives : Internet became essential component in these days. This study primarily tried to find out the characteristics of high risk internet users through using the communication scale. Methods : We investigated levels of internet addiction using Internet Addiction Scale in 1,193 high school and middle school students. Participants were divided into 3 groups (high risk user group, potential risk user group, normal user group) according to the results from internet addiction scale. We additionally surveyed characteristics of internet use, and patterns of communication and Communication Scale based on Satir theory in 614 from 1,193 participants. Results : Boys showed higher tendencies for internet addiction than girls in internet addiction scale. There were significant differences in mean computer using time especially during weekends among 3 internet user groups. The distribution of communication types in each internet user group was similar and this finding coincided with previous study results. However high risk user group showed higher scores in each inadequate communication pattern such as placating, blaming, super-reasonable and irrelevant stance. Conclusion : These results suggest that adolescents who use internet in addictive patterns may have more problematic communication styles and these may be associated with poor interpersonal relationships.

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The Effects of Warm Water-Filled Bag on Body Temperature, $FiO_2$, Respiration Rate, and Blood Sugar in High Risk Neonates (물주머니를 이용한 가온요법이 고위험신생아의 체온과 산소요구도, 호흡수, 혈당에 미치는 효과)

  • Kim Hee Young;Park Ho Ran;Moon Young Im;Park Jin Hee
    • Child Health Nursing Research
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    • v.11 no.4
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    • pp.390-395
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    • 2005
  • Purpose: To investigate the effects of a warm water-filled bag on body temperature, Oxygen demand, respiratory rate and blood sugar in high risk neonates. Method: The infants were assigned to two groups, 16 in the experimental and 20 in the control group. Infants in the experimental group was received $40{\~}42^{\circ}C$ warm water-filled bag therapy for 2 hours under radiant warmers. Infants in the control group were placed under the same kind of radiant warmers but without the warm water-filled bag. The following were measured every 30 minutes: rectal temperature, $O_2$ demand ($FiO_2$), and respiratory rate. Blood sugar was measured hourly. Result: Body temperatures increased significantly in the experimental group (P=0.0138), and there was a difference according to time (P=0.0001). Significant difference were found between the two groups fur $FiO_2$ (P=0.0180). There was no difference in respiratory rates between the two groups and rates according to time for the experimental group were also not significant (P=0.3569). No significant difference between two groups was found for blood sugar (P=0.2152), but there was a significant difference according to the times (P=0.0001). Conclusion: This results of this study indicate that a warm-filled bag is an effective means of resorting body temperature and reducing $O_2$ demand in high risk neonates.

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Determinants of High Risk Drinking in Korea (한국 사회의 고위험 음주 결정요인에 관한 연구: 중도 절단 이변량 프로빗 모형의 적용)

  • Chung Woojin
    • Korea journal of population studies
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    • v.26 no.2
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    • pp.91-110
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    • 2003
  • This study analyzed data from 1997 Korea's Behavioral Risk Factor Surveillance System Survey collected through telephone questionings based on the multi-stage stratified random sampling. We categorized respondents into those who had ever drunk an alcoholic beverage in the last month and those who didn't and, referring to the World Health Organization's guideline, the former group were further categorized into low risk drinking group and high risk drinking group. Employing bivariate probit regression analyses with censoring on independent variables such as preferred type of alcoholic beverage, the number of types of beverages consumed, age, marital status, education, occupation, residential area, current smoking, body mass index and stress suggested (1) that those who prefer soju are more likely to involve high risk drinking than those who and prefer the other alcoholic beverages (2) that those who are relatively older, who live without a partner, who have jobs, who. are vulnerable to stress, or who enjoy more than one type of beverage are more likely to be exposed to high risk drinking than the others.

Association between Employment Status and hs-CRP Level in Korean Wage Workers (국내 임금근로자에서 고용형태에 따른 hs-CRP level과의 연관성)

  • Joo, Jae-Han;Lee, June-Hee
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.31 no.2
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    • pp.119-127
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    • 2021
  • Objectives: We aimed to find the relationships between employment status and hs-CRP level among Korean wage workers using the 2016 Korean National Health and Nutrition Examination (KNHANE, revised). Methods: This study was conducted on 1,937 daytime wage workers over the age of 19 and within a normal weight range (18.5≤BMI≺25). Regular workers were defined as those granted an employment guarantee until reaching retirement age, and non-regular workers were defined as temporary, non-typical, dispatched, short-term workers and contractors. For hs-CRP, three divisions were classified as recommended by the Centers for Disease Control and Prevention (CDC) and American Heart Association (AHA) with less than 1.0 mg/L indicating low risk of cardiovascular disease, above 1.0 mg/L and below 3.0 mg/L considered moderate risk, and more than 3.0 mg/L indicating high risk. To find the relationship between work type and hs-CRP level in Korean wage workers, multinominal logistic regression analysis was performed. Results: For non-regular workers, the odds ratio of the cardiovascular moderate-risk group and cardiovascular high-risk group was statistically significant compared to regular workers. After adjusting for factors such as gender, age, subjective health status, income, education, smoking, and physical labor, the odds ratio of the cardiovascular high-risk group was statistically significant. Conclusions: In this study, the relationship between non-regular workers and high hs-CRP level was examined. Based on this, institutional strategies should be pursued to prevent and manage cardiovascular disease among non-regular workers.

A Comparison of the Factors Influencing the Life Satisfaction of the Elderly According to their Cognitive Impairment Level (노인의 인지 기능 수준에 따른 삶의 만족도 영향 요인 비교)

  • Hwang, Rah-Il;Lim, Ji-Young;Lee, Young-Whee
    • Journal of Korean Academy of Nursing
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    • v.39 no.5
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    • pp.622-631
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    • 2009
  • Purpose: This study was conducted to analyze the factors that influence the life satisfaction of the elderly according to their cognitive impairment level. Methods: This study was conducted by dividing 3,012 elderly residents of a regional community into three groups based on the scores of the Korean version of the Mini-Mental State Examination: a normal group without any cognitive impairment, a suspicious group with a mild level of cognitive impairment, and a high risk group with a high level of cognitive impairment. Researchers made phone calls, house calls, and personal visits to health centers and shelters for the elderly to gather the information required for this study. Results: The results of this study revealed that social relationships, depression, and activities of daily living had a significant impact on life satisfaction for the normal group, while social relationships and depression had a high impact on life satisfaction for the suspicious group, and social relationships had high impact on the life satisfaction of the high risk group. Conclusion: Based on the results of this study, we suggest that programs that promote development of the social relationship networks of the elderly should be established to promote their life satisfaction.

A Study on Health Behaviors by a Risk Level of Metabolic Syndrome among Petty Merchants in Traditional Markets (재래시장 영세상인의 대사증후군 위험도별 건강행위에 대한 연구)

  • Kim, Hee-Gerl;Nam, Hye-Kyung;Yi, Yun-Jeong
    • Korean Journal of Occupational Health Nursing
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    • v.20 no.3
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    • pp.328-336
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    • 2011
  • Purpose: The purpose of this study was to identify the health behaviors by a risk level of metabolic syndrome (MS) among petty merchants in traditional markets. Methods: The data were collected through questionnaires and physical examination on abdominal circumstance, triglyceride, HDL, blood pressure, and FBS of 177 subjects in S city, Korea. The data were analyzed by descriptive statistics, ${\chi}^2$-test (or fisher's exact test) and ANOVA using SPSS/WIN 18.0 program. Results: The prevalence of MS was 15.8%, and risk group was 72.9%. The abdominal circumstance and triglyceride levels were higher in MS group than those of the risk group and normal group. The HDL and systolic blood pressure levels were also higher in MS group than those of the normal group. Conclusion: The prevalence of MS and risk groups was high among petty merchants in traditional markets. However, these merchants did not practice health behaviors nor take institutional health management benefit. Therefore, governmental level community based health management services are requested for them.

The Use of Nafamostat Mesilate as an Anticoagulant during Continuous Renal Replacement Therapy for Children with a High Risk of Bleeding (출혈성 경향이 높은 소아환자의 지속성 신대체 요법시 사용되는 항응고제로서 Nafamostat mesilate의 사용)

  • Lee, Sang Taek;Cho, Heeyeon
    • Childhood Kidney Diseases
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    • v.18 no.2
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    • pp.98-105
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    • 2014
  • Purpose: Nafamostat mesilate (NM), a synthetic serine protease inhibitor, has been investigated as an anticoagulant for adult patients with a high risk of bleeding, who need chronic renal replacement therapy (CRRT). However, little is known about the use of NM as an anticoagulant in pediatric CRRT. The aim of this study was to evaluate the ideal dosage, efficacy, and safety of NM in pediatric CRRT. Methods: We conducted a retrospective study of 40 pediatric patients who had undergone at least 24 h of venovenous CRRTs between January 2011 and October 2013. We divided the patients according to risk of bleeding. Those at high risk received no anticoagulation (group 1) or NM as an anticoagulant (group 2), while those at low risk received heparin (group 3). Results: Forty patients (25 male and 15 female; mean age, $8.2{\pm}6.6$ years) were enrolled. The mean duration of CRRT was 13.0 days, and the survival rate was 57.5%. The mean hemofilter lifespan was 39.3 h in group 1 and 11.3 h in group 3. In group 2, hemofilter lifespan was extended from 7.5 h to 27.4 h after the use of NM (P =0.001). The mean hemofilter lifespan with NM was greater than with heparin (P =0.018). No patient experienced a major bleeding event during treatment with NM. Conclusion: NM may be a good alternative anticoagulant in pediatric patients with a high risk of bleeding requiring CRRT, and is not associated with bleeding complications.