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Korean Prostate Cancer Patients Have Worse Disease Characteristics than their American Counterparts

  • Kang, Dong Il;Chung, Jae Il;Ha, Hong Koo;Min, Kweonsik;Yoon, Jangho;Kim, Wansuk;Seo, Won Ik;Kang, Pil Moon;Jung, Soo Jin;Kim, Isaac Yi
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6913-6917
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    • 2013
  • Background: Although the PSA test has been used in Korea for over 20 years, the incidence of prostate cancer has risen, and the associated mortality has increased about 13-fold over the 20-year period. Also, several investigators have suggested that Asians in America are more likely to present with more advanced prostate cancer than Caucasians. We compared the characteristics of native Koreans and Americans (Caucasians and African-Americans) undergoing radical prostatectomies in Korea and the US. Materials and Methods: Study subjects comprised patients at Korean and US hospitals from 2004 to 2012 who had undergone radical prostatectomies. We compared the characteristics of the subjects, including age, preoperative prostate-specific antigen (PSA) levels, body mass index (BMI), Gleason score, and pathological T stage. Results: In total, 1,159 males (502 Koreans, 657 Americans) were included. The Korean and American patients had mean ages of $67.1{\pm}6.6$ and $59.2{\pm}6.7$ years, respectively. The mean preoperative PSAs were $15.4{\pm}17.9$ and $6.2{\pm}4.6ng/mL$ (p=0.0001) and the mean BMIs were $23.6{\pm}2.6$ and $28.7{\pm}4.4kg/m^2$ (p=0.0001), respectively. Pathological localized prostate cancer represented 71.7% of cases for Koreans and 77.6% for Americans (p=0.07). According to age, Koreans had higher T stages than Americans in their 50s (p=0.021) and higher Gleason scores than Americans in all age groups. According to PSA, Koreans had higher Gleason scores than Americans for PSA >10 ng/mL (p<0.05). According to prostate size and Gleason scores, Koreans had higher PSA values than Americans (p<0.01). Conclusions: These results show that Korean patients have elevated risk of malignant prostate cancers, as indicated by the significantly higher Gleason scores and PSAs, suggesting a need for novel prostate cancer treatment strategies in Korea.

The Threshold of 0.5% Salt-water Taste and Risk of Stomach Cancer (0.5% 소금물에 대한 역치와 위암발생의 위험도)

  • Ohrr, Hee-Chul;Lee, Kang-Hee;Yi, Sang-Wook
    • Journal of agricultural medicine and community health
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    • v.25 no.2
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    • pp.293-302
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    • 2000
  • The relationship between sodium intake and stomach cancer risk has been studied much in Japan but a great portions still remain controversial. There has been few studies on relationship between sodium intake and stomach cancer in Korea. The goal of this nested case-control study is to investigate the association between sodium intake and stomach cancer risk in a rural county of Korea We estimated sodium intake indirectly by the threshold of salt-water taste of patients. This study was based on both of the data from 'Kangwha Cohort Study' which had been conducted from March 1985 and 'Kangwha Community Cancer Registry' which had been launched on July in 1982 by the College of Medicine, Department of Preventive Medicine. Yonsei University. A total of 145 patients who developed stomach cancer in Kangwha County were initially recruited as the case group. We tried to get two community-controls per stomach cancer case by matching age and gender. Finally we got information from 90 cases and 146 controls about the threshold of the salt taste and preference of salty food and so on. Some 79% of the information about ease group came from proxy respondents and 56% among controls. Risk ratios of developing stomach cancer adjusted for smoking, body mass index and self-stated health level were estimated. No statistically significant association between the threshold of salt taste and stomach cancer risk found in this study. We recommend some further studies utilizing urinary salt excretion, diet record method for better estimating of salt intake with a paticular emphasis on interaction effect between salty and spicy food in hospital-based case-control study designs.

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Effect of Cheongyeoltang (CYT) using Bioconversion on Atopic Dermatitis (청열탕(淸熱湯)의 생물전환을 통한 항아토피피부염 효능(效能) 연구(硏究))

  • Kang, Hyun-Suk;Kim, Seung-Hyung;Gim, Seon-Bin;Kim, Soo-Myung;Kim, Dong-Hee
    • Journal of Haehwa Medicine
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    • v.19 no.2
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    • pp.119-137
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    • 2011
  • In order to improve efficacy of oriental medicines and to study the application of fermented oriental medicine in clinicals, the efficacy of CYT and CYTBH on atopic dermatitis were evaluated. The results and conclusions are as follows. CYT and CYTBH significantly improved the atopic dermatitis symptoms in NC/Nga mice by naked eye evaluation and significantly decreased clinical index in both groups. CYT and CYTBH both decreased the cell numbers of CD3+, CD11b+Gr-1+ cells in dorsal skin. Of the cells, CYT significantly decreased CD11b+Gr-1+ cells whereas CYTBH significantly decreased all immune cells. CYT and CYTBH both decreased the production rate of IL-4 and IFN-${\gamma}$ activated by CD3/CD28. In the case of CYTBH, significant decrease in all cases was observed. CYT and CYTBH decreased the production rate of IL-5, IL-13 and IL-17 in serum. Significant decrease of IL-5 in the case of CYT and IL-5 and IL-13 in the case of CYTBH were observed. CYT and CYTBH significantly decreased transcription of IL-5 mRNA and IL-13 mRNA in skin. Significant decrease in IgG1 and IgE immunoglobulins in serum were oberved in both groups. Significant decrease was only observed in the case of CYTBH. Both CYT and CYTBH significantly decreased the secretion of histamine. Both CYT and CYTBH suppressed erythema, hemorrhage, edema, excoriation, erosion of skin tissues of NC/Nga mice resulting in the decrease of thickness of epidermis. Significant decrease of infiltration of obese cells was also observed. The results above indicated that both CYT and CYTBH had significant efficacy in the treatment of atopic dermatitis through immune modulation. Animal studies showed that CYTBH had superior activity than that of CYT suggesting further and continuous studies on the changes in ingredients or absorption improvement by fermentation should follow.

Assessment of DNA Ploidy Patterns in Connection with Prognostic Factors in Patients with Papillary Thyroid Carcinoma (유두상 갑상선암에서 예후인자와 DNA배수성의 상관관계)

  • Chung Woung-Youn;Lee Jong-Hoon;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.12 no.2
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    • pp.153-160
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    • 1996
  • Regardless of the prognostic factors in papillary thyroid cancer, such as sex, age, size of tumor, extent of disease, and distant metastasis, the prognosis of papillary thyroid cancer is sometimes difficult to predict from clinical and microscopic analysis alone and additional prognostic indicators are needed. Recent studies of thyroid cancer have indicated that DNA aneuploidy may be correlated to the biological behavior of malignancy and inversely correlated to the prognosis, but it still remains contraversal. We performed this study to assess DNA ploidy patterns in relation with the previously known prognostic factors in AMES scoring system and lateral neck node metastasis in papillary thyroid cancer. A series of 132 patients with papillary thyroid cancer and 80 patients with benign thyroid tumor(27 follicular adenomas and 53 adenomatous goiters) as a control group from October 1993 to Feburary 1995 were analyzed and their nuclear DNA content was measured with flow cytometry using fresh tissue specimens. DNA aneuploidy was found in 8(6.1%) in papillary cancer and 8(10%) in benign tumor. S-phase traction(SFP) and proliferative index(PI) were higher in thyroid cancers, being 2.18$\pm$4.24%, 6.34$\pm$4.94% in the papillary thyroid cancers and 1.97$\pm$2.93%, 4.44$\pm$3.80% in the benign tumors, respectively. However there was no significant difference of values between two groups(p>0.05). Among variable prognostic factors studied(age, sex, size of tun or, extent of disease, distant metastasis in AMES scoring system and lateral neck node metastasis), DNA aneuploidy was found to be common in distant metastasis(p<0.001) and in lateral neck node metastasis(p>0.035), but there was no significant difference between the high risk and low risk group according to the AMES scoring system(p<0.08). In our study, DNA aneuploidy was not valuable in determining the presence of malignancy and did not correlate to the AMES scoring system. However, follow-up study of more cases will be needed for accurate information about the DNA ploidy as a independent prognostic factor.

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Risk Factors for Complications after Reconstructive Surgery for Sternal Wound Infection

  • Hashimoto, Ichiro;Takaku, Mitsuru;Matsuo, Shinji;Abe, Yoshiro;Harada, Hiroshi;Nagae, Hiroaki;Fujioka, Yusuke;Anraku, Kuniaki;Inagawa, Kiichi;Nakanishi, Hideki
    • Archives of Plastic Surgery
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    • v.41 no.3
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    • pp.253-257
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    • 2014
  • Background Although the utility of flaps for the treatment of sternal wound infections following median sternotomy has been reported for 30 years, there have been few reports on the risk factors for complications after reconstruction. The objective of this investigation was to identify factors related to complications after the reconstruction of sternal wound infections. Methods A retrospective analysis of 74 patients with reconstructive surgery after sternal wound infection over a 5-year period was performed. Clinical data including age, sex, body mass index (BMI), comorbidities, bacterial culture, previous cardiac surgery, wound depth, mortality rate, type of reconstructive procedure, and complication rate were collected. Results The patients' BMI ranged from 15.2 to $33.6kg/m^2$ (mean, $23.1{\pm}3.74kg/m^2$). Wound closure complications after reconstructive surgery were observed in 36.5% of the cases. The mortality rate was 2.7%. Diabetes mellitus significantly affected the rate of wound closure complications (P=0.041). A significant difference in the number of complications was seen between Staphylococcus aureus (S. aureus) and coagulase-negative Staphylococci (P=0.011). There was a correlation between harvesting of the internal thoracic artery and postoperative complications (P=0.048). The complication rates of the pectoralis major flap, rectus abdominis flap, omentum flap, a combination of pectoralis major flap and rectus abdominis flap, and direct closure were 23.3%, 33.3%, 100%, 37.5%, and 35.7%, respectively. Conclusions Diabetes mellitus, S. aureus, harvesting of the internal thoracic artery, and omentum flap were significant factors for complications after reconstruction. The omentum flap volume may be related to the complications associated with the omentum flap transfer in the present study.

Thermal Stratification and Heat Loss in Underground Thermal Storage Caverns with Different Aspect Ratios and Storage Volumes (지하 열저장 공동의 종횡비와 저장용량에 따른 열성층화 및 열손실)

  • Park, Dohyun;Ryu, Dong-Woo;Choi, Byung-Hee;Sunwoo, Choon;Han, Kong-Chang
    • Tunnel and Underground Space
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    • v.23 no.4
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    • pp.308-318
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    • 2013
  • Thermal stratification in heat stores is essential to improve the efficiency of energy storage systems and deliver more useful energy on demand. It is generally well known that the degree of thermal stratification in heat stores varies depending on the aspect ratio (the height-to-width ratio) and size of the stores. The present study aims to investigate the effect of the aspect ratio and storage volume of rock caverns for storing hot water on thermal stratification in the caverns and heat loss to the surroundings. Heat transfer simulations using a computational fluid dynamics code, FLUENT were performed at different aspect ratios and storage volumes of rock caverns. The variation of thermal stratification with respect to time was examined using an index to quantify the degree of stratification, and the heat loss to the surroundings was evaluated. The results of the numerical simulations demonstrated that the thermal stratification in rock caverns was improved by increasing the aspect ratio, but this effect was not remarkable beyond an aspect ratio of 3-4. When the storage volume of rock caverns was large, a higher thermal stratification was maintained for a relatively longer time compared to caverns with a small storage volume, but the difference in thermal stratification between the two cases tended to decrease as the aspect ratio became larger. In addition, the numerical results showed that the heat loss to the surrounding rock tended to increase with an increase in aspect ratio because the surface area of rock caverns increased as the aspect ratio became larger. The total heat loss from multiple small caverns with a reduced storage volume per cavern was larger compared to a single cavern with the same total storage volume as that of the multiple caverns.

Clinical Features of Brain Abscesses in Neonates and Children: A Single Center Experience from 1997 to 2006 (단일기관에서 조사한 소아 뇌농양의 임상양상(1997-2006))

  • Lee, Teak Jin;Chu, Jin-Kyong;Kim, Ki Hwan;Kim, Khi Joo;Kim, Dong Soo
    • Pediatric Infection and Vaccine
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    • v.15 no.1
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    • pp.30-35
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    • 2008
  • Purpose : We evaluated clinical presentations of brain abscesses, including predisposing factors, causative organisms, and mortality rate in neonates and children. Methods : We retrospectively reviewed the medical charts of neonates and children with brain abscesses treated at Severance Hospital from January 1997 through December 2006. Results : Among 27 neonates and children with brain abscesses, overall mortality was 22 % and 38% of survivors developed neurologic sequelae. The mortality rate was 38% in 8 infants with brain abscesses. The most common location of brain abscesses were frontal and parietal lobes, followed by temporal lobe. There were 7 cases with multiple brain abscesses. Streptococci (33%), Staphylococci (27%), and Gram-negative enterics (20%) were commonly isolated. The common predisposing conditions were neurosurgical procedure (30 %), cyanotic congenital heart disease (15%), and sinusitis/otitis (7%). Fever (74%), headache (37%), nausea/vomiting (33%), and altered mental status (33%) occurred commonly. Compared with children older than 1 year of age, infants were associated with multiple brain abscesses (63%, P=0.011) and high rates of death or neurologic sequelae (88%, P= 0.033). Conclusion : We should have a high index of suspicion in order to recognize the condition as early as possible, especially in infancy with brain abscesses who presents vague or nonspecific symptoms and signs.

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A Study on the Regional Function of Health Care by the Disease Pattern of the Inpatients (입원환자 질병유형의 구성에 의한 지역별 진료기능에 관한 연구)

  • Choi, Huyn-Rim;Lee, Sang-Il;Shin, Young-Soo;Kim, Yong-Ik
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.2 s.24
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    • pp.390-403
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    • 1988
  • The objectives of the study were to provide the basic informations needed in the development of balanced medical services throughout the nation. As the national health care system was expanding rapidly along with the economic growth, quantitative re-evaluation of the system is of great need. For that reason, characteristics of the admitted patients were analyzed for the case-mix and patients' flow within and through regions. Materials were 421,530 cases of inpatients, who were reported through Korea Medical Insurance Corporation(KMIC) for insurance claim, during the period of March 1, 1985 through February 28, 1987. Korean Diagnosis Related Groups(K-DRGs) classification system was adopted for the study of case-mix and 189 cities and counties were classified into 5 district groups by factor analysis results of K-DRGS. The major findings of this study were as follows ; 1) Factor analysis of case-mix, employing K-DRG system, revealed 5 distinct funtional district groups. Group A(18 districts) was prominent for tertiary medical care. In group B(36 districts), rather simple procedures were prevalent. Group C(26 districts) was distinctive for the medical care of well organized internal medicine practices with qualified clinical laboratories. Group D(17 districts) was characterized by relatively high balanced medical care. Group E (92 districts) was with very low level of medical care. 2) Analysis of the case-flow through the districts showed 3 types of flow patterns : inflow, outflow, and balanced types. Inflow type of case-flow was found in Group A, C and D while Group B and E showed outflow type. Inflow was most prominent in Group A and Group E was of typical outflow type. Group B was consistently the outflow type except for Major Diagnostic Category XX regardless of the disease treaters, but Group C and D were inflow or outflow types according to the disease tracers.

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The non-linear FEM analysis of different connection lengths of internal connection abutment (내측 연결형 임플란트 지대주의 체결부 길이 변화에 따른 비선형 유한요소법적 응력분석)

  • Lee, Yong-Sang;Kang, Kyoung-Tak;Han, Dong-Hoo
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.2
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    • pp.110-119
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    • 2016
  • Purpose: This study is aimed to assess changes of stress distribution dependent on different connection lengths and placement of the fixture top relative to the ridge crest. Materials and methods: The internal-conical connection implant which has a hexagonal anti-rotation index was used for FEM analysis on stress distribution in accordance with connection length of fixture-abutment. Different connection lengths of 2.5 mm, 3.5 mm, and 4.5 mm were designed respectively with the top of the fixture flush with residual ridge crest level, or 2 mm above. Therefore, a total of 6 models were made for the FEM analysis. The load was 170 N and 30-degree tilted. Results: In all cases, the maximum von Mises stress was located adjacent to the top portion of the fixture and ridge crest in the bone. The longer the connection length was, the lower the maximum von Mises stress was in the fixture, abutment, screw and bone. The reduction rate of the maximum von Mises stress depending on increased connection length was greater in the case of the fixture top at 2 mm above the ridge crest versus flush with the ridge crest. Conclusion: It was found that the longer the connection length, the lower the maximum von Mises stress appears. Furthermore, it will help prevent mechanical or biological complications of implants.

Effect of Xylanase on Performance and Apparent Metabolisable Energy in Starter Broilers Fed Diets Containing One Maize Variety Harvested in Different Regions of China

  • O'Neill, H.V. Masey;Liu, N.;Wang, J.P.;Diallo, A.;Hill, S.
    • Asian-Australasian Journal of Animal Sciences
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    • v.25 no.4
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    • pp.515-523
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    • 2012
  • The objective of this study was to investigate the variability in broiler performance, apparent metabolisable energy (AME) and ileal digestible energy (IDE) between five different maize samples fed with and without xylanase at 16,000 U/kg. Various in vitro characterisations were conducted to determine if any could predict performance or AME. Samples of the maize were harvested in five diverse regions and fed individually in a mash diet as follows (g/kg): test maize 608.3; soya bean meal (SBM) 324.1; poultry fat 25.2; salt 4.6; met 2.6; lys 1.6; thr 0.5; limestone 9.7, dical 18.4; vit/min 5.0; CP 210 and ME (kcal/kg) 3,085. The diets were fed to 720 broilers with 6 replicates, each containing 12 birds per treatment, from 0 to 18 d of age. Maize samples were analysed for starch, protein, crude fibre, fat, protein solubility index (PSI) and vitreousness using near infra red reflectance spectroscopy (NIR). They were also assayed using an in vitro starch digestibility method. The results showed that there was no effect of harvest region on the feed intake (FI), body weight gain (BWG) or feed conversion ratio (FCR) of the broilers over the 18 d period (p = 0.959, 0.926, 0.819 respectively). There was an improvement in all parameters with the addition of xylanase (FI p = 0.011; BWG and FCR p<0.001). There was a significant positive effect of xylanase on IDE, AME, IDE Intake (IDEI) and AME intake (AMEI) (p<0.0001 in all cases). Although there was no significant effect of maize source, there was a strong trend towards variability in IDE (p = 0.066) and AME (p = 0.058). There were no significant correlations (p<0.05) between any proximate or physiochemical values and any performance or AME values. This may suggest that none of those selected were suitable predictors for performance or AME. The broilers performed well according to the breed guidelines, with slightly increased FI, increased BWG and similar FCR prior to the addition of xylanase. When FCR and BWG were analysed with FI as a covariate, xylanase addition remained significant suggesting that the improvement in BWG and FCR was driven by an increase in digestibility and nutrient availability.