Background: To evaluate treatment outcomes of patients with stage I-III endometrial cancer treated with postoperative radiation. Materials and Methods: A retrospective review of 166 endometrial cancer patients, undergoing surgery and postoperative radiotherapy at Siriraj Hospital from 2005-2008 was performed. Pathology was reviewed. Results of treatment were reported with 5-year loco-regional recurrence free survival (LRRFS), 5-year overall survival (OS), patterns of failure and toxicity, and according to stage and risk groups. Results: Median follow up time was 62.8 months. Pathological changes were found in 36.3% of the patients after central reviews, leading to 19% changes in risk groups. Most of the patients (83.7%) received pelvic radiation (PRT) and vaginal brachytherapy (VBT). Five-year LRRFS and OS of all patients were 94.9% and 85.5%, respectively. There was no recurrence or death in low and low-intermediate risk groups. For the high-intermediate risk group, 5-year LRRFS and OS were 96.2% and 90.8%, respectively, and for the high risk group 90.5% and 71%. Late grade 3 and 5 gastrointestinal toxicity was found in 3% and 1.2% of patients, respectively. All of them received PRT 5,000 cGy in 25 fractions. Conclusions: Low and intermediate risk patients had good results with surgery and adjuvant radiation therapy. For high risk patients, postoperative radiation therapy alone appeared to be inadequate as the most common pattern of failure was distant metastasis.
Kim, Byung-Seok;Lim, Hyun-Sul;Lee, Kwan;Min, Young-Sun;Yoon, Young-Sil;Jeong, Hye-Sook
Journal of Preventive Medicine and Public Health
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v.48
no.1
/
pp.53-61
/
2015
Objectives: The seroprevalence of hepatitis E virus (HEV) among high-risk groups overseas is high, but studies in these groups are rare in South Korea. We conducted the present study from April to November 2012 to obtain data on the seroprevalence and associated risk factors for HEV among slaughterhouse workers in South Korea. Methods: Slaughterhouse workers from 80 workplaces nationwide were surveyed in South Korea in 2012. The subjects comprised 1848 cases: 1434 slaughter workers and 414 residual products handlers. By visiting 80 slaughterhouses, which were mixed with 75 of which also performed residual products handling, we conducted a questionnaire survey for risk factors and obtained blood samples in order to determine the seropositivity and seroprevalence of HEV. Anti-HEV IgG and IgM were measured using HEV IgG and IgM enzyme-linked immunospecific assay kits and HEV antigen was measured by reverse transcription polymerase chain reaction (RT-PCR). Results: The seropositivity of anti-HEV IgG was 33.5% (slaughter workers 32.8% and residual products handlers 36.2%), and among the seropositive individuals the seroprevalence of anti-HEV IgM was 0.5% (slaughter workers 0.5%, residual products handlers 0.7%). The response rate of HEV-antigen as measured by RT-PCR was 0.2%. Risk factors significantly related to anti-HEV IgG seropositivity were age, sex, and working duration (slaughter workers only). Conclusions: There were significant risk factors (sex, age, and working duration) for HEV identified in our study. All three positive cases for HEV-antigen by RT-PCR were related to pig slaughter but without statistical significance. To prevent HEV, an educational program and working guidelines may be needed for high risk groups.
Choi, Eun Hee;Ko, Mi Suk;Lee, Shin Ae;Park, Jung Ha
Journal of Korean Clinical Nursing Research
/
v.26
no.2
/
pp.265-273
/
2020
Purpose: The purpose of this study was to test the predictive validity of the Fall Assessment Scale-Korean version (FAS-K) and to find the most appropriate cutoff score to screen high-risk fall groups in adult patients in general hospitals in Korea. Methods: We performed a prospective evaluation study in medical and surgical ward patients at two major general hospitals in Seoul. Data were collected from Nov. 1, 2018 to Feb. 28, 2019, nurses performed 651 observation series. The researcher measured the fall risk assessment score by applying FAS-K, MFS (Morse Fall Scale), and JHFRAT (Johns Hopkins Hospital Fall Risk Assessment tool) to the patients twice a week between 10 am and 12 noon. Data were analyzed using Pearson's corelation coefficients, and the sensitivity, specificity, predictive value, and the area under the curve (AUC) of the three tools. Results: The FAS-K was positively correlated with the MFS (r=.70, p<.001) and the JHFRAT (r=.82, p<.001). According to the receiver operating characteristics (ROC) curve analysis of the FAS-K, sensitivity, specificity, and positive and negative prediction values were 85.3%, 49.4%, 8.5%, and 98.4%, respectively, when the FAS-K score was 4. Therefore, the cut-off score of the FAS-K to identify groups with high fall risk was 4. Conclusion: The FAS-K is a valid tool for measuring fall risk in adult inpatients. In addition, the FAS-K score, 4, can be used to identify high-risk fall groups and know specific points in time to provide active interventions to prevent falls.
Purpose: Overweight can be defined by the body mass index (BMI) and is likely associated with an increased cardiovascular disease risk. However, waist circumference (WC), a central adiposity index, may be a better indicator of cardiovascular disease risk. Studies comparing the effects of BMI and WC on cardiovascular risk factors, such as high blood pressure (BP), are rare in adolescents. Methods: We analyzed the correlations of BMI and WC with BP in 3,363 Korean adolescents (aged 10-19 years), using data from the Korean National Health and Nutrition Examination Surveys (2009-2011). Results: Systolic BP (SBP) in both sexes and diastolic BP (DBP) in boys were higher in the high BMI (>85th percentile) and high WC (>90th percentile) groups. High BMI and high WC were positively correlated with high SBP (>90th percentile) in both sexes, and high DBP (>90th percentile), in boys. BMI maintained its positive associations with SBP, DBP, high SBP, and high DBP in the normal weight ($BMI{\leq}85th$ percentile) and overweight (BMI>85th percentile) groups in both boys and girls, as well as in all subjects of both sexes, even after adjustment for WC. However, WC did not correlate with SBP, DBP, high SBP, or high DBP after adjustment for BMI in any group in either sex. Conclusion: In Korean adolescents, BMI correlated better with BP and high BP levels than WC. Further, BMI was positively associated with BP and high BP in the normal weight group as well as in the overweight group.
Purpose: The purpose of this study was to analyze clinical outcomes from cervical cancer and stratify patients into risk groups for prognostic factors for early-stage disease. Materials and Methods: We retrospectively reviewed patients with stage IB or IIA cervical cancer treated with adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) following primary surgery at Samsung Medical Center from 2001 to 2011. Adjuvant RT was added for patients with intermediate-risk factors, and adjuvant CCRT was performed on high-risk patients after surgery. Results: We reviewed 247 patients-149 in the high-risk group and 98 in intermediate-risk group. The median follow-up was 62 months. Loco-regional failure (LRF) alone occurred in 7 patients (2.8%), distant metastasis alone in 37 patients (15.0%) and LRF with DM in 4 patients (1.6%). The 5-year disease-free survival (DFS) and overall survival (OS) rates for both groups were 79.7% and 87.6%, respectively. In the high-risk group, the 5-year DFS and OS probabilities were 72.5% and 81.9%, respectively. Histologic type, pathologic tumor size, and the number of pelvic lymph node (PLN) metastasis were significant prognostic factors for DFS and OS. We suggest a scoring system (0-3) using these prognostic factors to predict poor prognosis in high-risk patients. Using this system, patients with higher scores have higher recurrence and lower survival rates. Conclusion: In the high-risk cervical-cancer group who received primary surgery and adjuvant CCRT, non-squamous type, large tumor size and the number of PLN metastasis were significant prognostic factors, and the number of these factors was associated with survival rates.
Journal of the Korea Academia-Industrial cooperation Society
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v.22
no.5
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pp.51-59
/
2021
This study was undertaken to identify factors that influence high-risk drinking among women. Seventh National Health and Nutrition Survey data were used, and 3,453 women aged 19 or older were studied. Subjects were divided into general and high-risk drinking groups according to high-risk drinking rate indicators, and these groups were compared to identify demographic and sociological characteristics, differences in health-related characteristics, and factors associated with high-risk drinking. The data analysis was performed using IBM SPSS 25.0. The analysis showed 8.8% of the cohort were high-risk drinkers, and that rates of high-risk drinking were higher among women in their 20s to 30s, smokers, and those with experience of depression. In particular, smoking, and depression were associated with a 4.5 [(95% confidence interval (CI)=2.804-7.372, p<0.001)] and 7.0-fold [(95% CI=2.918-16.855, p<0.001)] increases in rates of high-risk drinking. In addition, the risk of high-risk drinking was high among 15- to 19-year-olds, which indicates an urgent need to develop and implement drinking education programs for women in adolescence and early adulthood. We expect the results of this study to be used to create health policies and health promotion programs aimed at reducing the high-risk drinking rate among women.
Lee, Sang Min;Choi, Woo Ik;Kim, Sung Jin;Jin, Sang Chan
Journal of The Korean Society of Clinical Toxicology
/
v.13
no.2
/
pp.87-94
/
2015
Purpose: We investigated comparison of clinical characteristics and prognosis by initial endoscopic severity in caustic injury and then discussed predisposing factors which can be helpful in predicting the prognosis and determining the treatment. Methods: This study was a retrospective review of medical records from patients over the age of 15, who underwent initial endoscopy for caustic injury from April 2007 through November 2014. Patients were classified according to two groups based on the initial endoscopic finding by Zargar's classification: patients with grade 0, I, IIa at esophagus (low risk group) and patients with grade IIb, IIIa, IIIb at esophagus (high risk group). The two groups were then compared. Results: A total of 55 patients were included (low risk group [n=44] vs. high risk group [n=11]). Old age (p<0.001), large amount of ingestion (p<0.05), oropharyngeal symptoms (p<0.01), high SOFA score (p<0.001), high WBC count (p<0.05), low base excess (p<0.01), and HCO3 (p<0.05) were statistically significant factors in the high risk group. A poor prognosis was observed for hospital stay (p<0.001), ICU admission (p<0.001), mortality (p<0.01), and stricture (p<0.001) in the high risk group. Conclusion: Clinical characteristics including age, amount of ingestion, oropharyngeal symptoms, SOFA score, WBC count, base excess, and $HCO_3$ can be helpful in the decision to undergo initial endoscopy and risk assessment by initial endoscopic severity can be helpful in predicting prognosis and determining the treatment plan.
This study was investigated nutrient intakes and dietary evaluation index of the healthy subjects over 85 of Sunchang County to explore the improved dietary pattern for healthy aging of the elderly. The survey was conducted by personal interview to 161 elderly subjects (59 males and 102 females over 85) in 2006, and their daily dietary intake was assessed by 24-hr recalls and weighing one meal. The daily energy intakes of males were 1,335 ${\pm}$ 67 kcal, and those of females were 1,095 ${\pm}$ 38 kcal comprised of 66.8% and 68.4% of the EER for the age group of 75. The proportions of energy from carbohydrate : protein : lipid were 70.7 : 14.6 : 14.6 for males and 68.6 : 14.0 : 17.4 for females. The average protein intakes were 95.4% for males and 85.0% for females of RI, and the average calcium intakes were 54.3% for males and 43.6% for females of RI. The daily vitamin intakes were below 70% except vitamin A, vitamin $B_6$, and vitamin E. The proportion of the relative risk groups of protein, phosphate, iron and vitamin A ranged 40-49% of RI over 75 year groups. The other nutrient intakes showed that there were over 50% risk groups. Especially for nutrients such as calcium, vitamin $B_1$, vitamin $B_2$, vitamin C, folate and niacin over 70% of the subjects were under risk. The median value of all nutrient intakes did not reach AI. The INQ of nutrients were over 0.8 except for folate and vitamin C. Calcium intakes were relatively low and needed attention. However, the ratio of calcium and phosphate showed 1 : 1.6, which appeared to be superior to the other districts. The DVS were higher as the dietary balance scores, KDDS were higher, and the groups with high KDDS had high intakes of nutrients compared to the groups with low KDDS. The high risk groups as judged by simple nutrition screening test had lower nutrient intakes than the groups of middle risk or low risk groups. The subjects in Sunchang area had relatively low intakes of several nutrients. However, judging from the desirable patterns of the energy proportion from three major nutrients, ratio of calcium and phosphate and INQ of nutrients there is a possibility that extended healthy aging might be related to the quality of nutrients and relative ratio between nutrients. To improve nutrient status of the elderly of the surveyed area further application involving KDDS and DVS appeared to be required.
This study investigated the correlations and risk distribution differences between high sensitivity C-reactive protein (hs-CRP) and the diagnosis factors of metabolic syndrome among the residents of a rural community. Two thousand adults aged from 40 to 70 were recruited and 1,968 subjects were included in the study after excluding those with infectious disease or with hs-CRP higher than 10 mg/L in blood. The subjects were then divided into three groups of hs-CRP to examine the correlations and risk ratio with the risk factors of metabolic syndrome. There was a tendency of hs-CRP increasing according to the number of risk factors of metabolic syndrome. The risk ratio with hs-CRP according to metabolic syndrome significantly increased by 2.0 and 2.2 times in the intermediate and high risk group, respectively, compared with the low risk group. The risk ratio with the risk factors of metabolic syndrome according to hs-CRP rose in abdominal obesity, triglyceride, and W/Ht in the intermediate risk group of hs-CRP. The risk ratio also surged in high pressure, W/Ht, ex-drinking (1.7 times), exsmoking (2.0 times) and current smoking (2.0 times) in the high risk group. The results indicate that hs-CRP is related to the risk factors of metabolic syndrome and that it's very important to manage obesity including abdominal obesity and W/Ht and everyday habits including drinking and smoking.
Kim Hee Young;Park Ho Ran;Moon Young Im;Park Jin Hee
Child Health Nursing Research
/
v.11
no.4
/
pp.390-395
/
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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