Background: Prognostic factors of postoperative early and late recurrence in patients with hepatocellular carcinoma (HCC) undergoing curative resection remain to be clarified. The aim of this study was to identify risk factors for postoperative early (${\leq}$ 2 year) and late (> 2 year) intrahepatic recurrences in patients with single HCCs without macrovascular invasion. Methods: A total of 280 patients from December 2004 to December 2007 were retrospectively included in this study. Intrahepatic recurrence was classified into early (${\leq}$ 2 year) and late (> 2 year) and the Chi-Square test or Fisher's exact test and multivariate logistic regression analysis were performed to determine significant risk factors. Results: During the follow-up, 124 patients had intrahepatic recurrence, early and late in 82 and 42 patients, respectively. Multivariate logistic regression analysis showed that microvascular invasion (p=0.006, HR: 2.397, 95% CI: 1.290-4.451) was the only independent risk factor for early recurrence, while being female (p = 0.031, HR: 0.326, 95% CI: 0.118-0.901), and having a high degree of cirrhosis (P=0.001, HR: 2.483, 95% CI: 1.417-4.349) were independent risk factors for late recurrence. Conclusions: Early and late recurrence of HCC is linked to different risk factors in patients with single HCC without macrovascular invasion. This results suggested different emphases of strategies for prevent of recurrence after curative resection, more active intervention including adjuvant therapy, anti-cirrhosis drugs and careful follow-up being necessary for patients with relevant risk factors.
Abdullah, Nor Aini;Mahiyuddin, Wan Rozita Wan;Muhammad, Nor Asiah;Ali, Zainudin Mohamad;Ibrahim, Lailanor;Tamim, Nor Saleha Ibrahim;Mustafa, Amal Nasir;Kamaluddin, Muhammad Amir
Asian Pacific Journal of Cancer Prevention
/
v.14
no.8
/
pp.4591-4594
/
2013
Breast cancer is the most common cancer among Malaysian women. Other than hospital-based results, there are no documented population-based survival rates of Malaysian women for breast cancers. This populationbased retrospective cohort study was therefore conducted. Data were obtained from Health Informatics Centre, Ministry of Health Malaysia, National Cancer Registry and National Registration Department for the period from $1^{st}$ January 2000 to $31^{st}$ December 2005. Cases were captured by ICD-10 and linked to death certificates to identify the status. Only complete data were analysed. Survival time was calculated from the estimated date of diagnosis to the date of death or date of loss to follow-up. Observed survival rates were estimated by Kaplan-Meier method using SPSS Statistical Software version 17. A total of 10,230 complete data sets were analysed. The mean age at diagnosis was 50.6 years old. The overall 5-year survival rate was 49% with median survival time of 68.1 months. Indian women had a higher survival rate of 54% compared to Chinese women (49%) and Malays (45%). The overall 5-year survival rate of breast cancer patient among Malaysian women was still low for the cohort of 2000 to 2005 as compared to survival rates in developed nations. Therefore, it is necessary to enhance the strategies for early detection and intervention.
Hoseini, L;Kashani, F Lotfi;Akbari, S;Akbari, ME;Mehr, S Sarafraz
Asian Pacific Journal of Cancer Prevention
/
v.17
no.sup3
/
pp.185-190
/
2016
Breast cancer is the first or second malignancy among women worldwide. Illness perception (IP) and quality of life (QoL) are major issues considering breast cancer management. An attempt was here made to inspect the predictive variables influencing IP and their impact on QoL in cancer patients. The key predictors adapted from previous studies including life satisfaction, perceived social support, self-esteem, hope, optimism, and spiritual well being were taken into account. Our sample included 200 female volunteers suffering from breast cancer applying exclusion criteria. The data were collected using various questionnaires and statistically analyzed by means of path analysis and structural equation modeling. The results revealed that of the six predictors, spiritual well being and social support had direct effects on QoL and IP. The only path with significant indirect correlation with IP was social support. Spiritual well being had the second significant direct effect on IP. Self-esteem occupied the third rank in direct effects on both QoL and IP. In conclusion, here in Iran and most likely in other strongly religious communities, spiritual intervention is an effective strategy to raise QoL. Also social support helps women suffering from breast cancer to experience better conception and coping strategies.
Severe acute respiratory syndrome (SARS) is an emerging infectious disease associated with a novel coronavirus (CoV) that was identified and molecularly characterized in 2003. Previous studies on various coronaviruses indicate that protein-protein interactions amongst various coronavirus proteins are critical for viral assembly and morphogenesis. It is necessary to elucidate the molecular mechanism of SARS-CoV replication and rationalize the anti-SARS therapeutic intervention. In this study, we employed an in vitro GST pull-down assay to investigate the interaction between the membrane (M) and the nucleocapsid (N) proteins. Our results show that the interaction between the M and N proteins does take place in vitro. Moreover, we provide an evidence that 12 amino acids domain (194-205) in the M protein is responsible for binding to N protein. Our work will help shed light on the molecular mechanism of the virus assembly and provide valuable information pertaining to rationalization of future anti-viral strategies.
Lee, Kyung Eun;Kim, Gook Tae;Ryu, Ah-Jin;Shim, Eun Bo
Journal of computational fluids engineering
/
v.22
no.1
/
pp.15-25
/
2017
Swirl flow is often found in proximal coronary arteries, because the aortic valves can induce swirl flows in the coronary artery due to vortex formation. In addition, the curvature and tortuosity of arterial configurations can also produce swirl flows. The present study was performed to investigate fractional flow reserve alterations in a post-stenotic distal part due to the presence of pre-stenotic swirl flow by computational fluid dynamics analysis for virtual stenotic models by quantifying fractional flow reserve(FFR). Simplified stenotic coronary models were divided into those with and without pre-stenotic swirl flow. Various degrees of virtual stenosis were grouped into three grades: mild, moderate, and severe, with degree of stenosis of 0 ~ 40%, 50 ~ 60%, and 70 ~ 90%, respectively. In this study, three-dimensional computational hemodynamic simulations were performed under hyperemic conditions in virtual stenotic coronary models by coupling with a zero-dimensional lumped parameter model. The results showed that the influence of pre-stenotic swirl inflow is dominant on FFR alteration in mild stenosis, whereas stenosis is dominant on FFR alteration in moderate/severe stenosis. The decrease in FFR caused by swirl flow is more significant in mild stenosis than moderate/severe stenosis. Biomechanical modeling is useful for clinicians to provide insight for medical intervention strategies. This hemodynamic-based parameter study could play a critical role in the development of a non-invasive imaging-based strategy-support system for percutaneous transluminal angioplasty in cases of mild/moderate stenosis.
Purpose: The aims of current study were to assess the inhaler competency and medication adherence, and to identify association of inhaler competency with medication adherence in patients with obstructive lung disease. Methods: We did a secondary analysis of the Hanyang Obstructive Pulmonary Evaluation data in a single institution from June 2014 to April 2015 after an approval of Institutional Review Board. A total of 150 patients with asthma or chronic obstructive lung disease participated in the study. Inhaler competency was evaluated accuracy in each step for using metered dose inhaler. Medication adherence was calculated using actually dispensed doses based on the prescribed inhaler doses. Results: Older adults (${\geq}65$) had lower competency in using inhaler (66.7 vs 83.3, z=-4.52, p<.001) and poorer medication adherence (67.7 vs 91.8, $x^2=14.06$, p<.001) than adults (<65). Inhaler competency was associated with medication adherence (p=.26, p=.001). Surprisingly, more than 50% of patients were current smokers. Conclusion: Inhaler competency and medication adherence were lower in older adults with obstructive lung disease than those in adult-age patients. Therefore, an individual education program for older patients should be developed to improve the rates of proper use of inhalers. Nursing management for obstructive lung disease should focus on developing behavioral intervention strategies for smoking cessation.
Purpose: The objective of this study was to identify the predictors of self-care behaviors among elderly patients with hypertension using quantile regression method. Methods: A total of 253 elderly patients diagnosed with hypertension was recruited via 3 different medical clinics for the study. The quantile regression and a liner regression was conducted using Stata 12.0 program by analyzing predictors of self-care behaviors. Results: In the ordinary least square, self-efficacy, period of disease, and education level explained 42% of the variance in self-care activities. In the quantile regression, affecting predictors of self-care behaviors were self-efficacy for all quantiles, the period of disease for from 60% quantile to 90% quantile, education level for 20%, 30%, and 50% quantiles, economic status for 10%, 50%, and 60% quantiles, age for 10%, 70% quantiles, fatigue for 10% quantile, knowledge about hypertension for 10% and 20% quantiles, and depression for 30% and 40% quantiles. Conclusion: The affecting predictors of self-care behaviors among elderly with hypertension were different from the level of self-care behaviors. These results indicated the significance in assessing predictors according to the level of self-care behaviors when clinical nurses examine the patients' health behaviors and plan any intervention strategies. Specially, education level and knowledge about hypertension were the significant predictors of self-care activities for low quantiles. Clinical nurses may promote self-care activities of the given population though health education programs.
Context: Genuine community participation does not denote taking part in an action planned by health care professionals in a medical or top-down approach. Further, community participation and health education on breast cancer prevention are not similar to other activities incorporated in primary health care services in Iran. Objective: To propose a model that provides a methodological tool to increase women's participation in the decision making process towards breast cancer prevention. To address this, an evaluation framework was developed that includes a typology of community participation approaches (models) in health, as well as five levels of participation in health programs proposed by Rifkin (1985&1991). Method: This model explains the community participation approaches in breast cancer prevention in Iran. In a 'medical approach', participation occurs in the form of women's adherence to mammography recommendations. As a 'health services approach', women get the benefits of a health project or participate in the available program activities related to breast cancer prevention. The model provides the five levels of participation in health programs along with the 'health services approach' and explains how to implement those levels for women's participation in available breast cancer prevention programs at the local level. Conclusion: It is hoped that a focus on the 'medical approach' (top-down) and the 'health services approach' (top-down) will bring sustainable changes in breast cancer prevention and will consequently produce the 'community development approach' (bottom-up). This could be achieved using a comprehensive approach to breast cancer prevention by combining the individual and community strategies in designing an intervention program for breast cancer prevention.
Kobeissi, Loulou Hassan;Yassine, Ibrahim Adnan;Jabbour, Michel Elias;Moussa, Mohamad Ahmad;Dhaini, Hassan Rida
Asian Pacific Journal of Cancer Prevention
/
v.14
no.5
/
pp.3205-3211
/
2013
Background: Bladder cancer is the second most incident malignancy among Lebanese men. The purpose of this study was to investigate potential risk factors associated with this observed high incidence. Methods: A case-control study (54 cases and 105 hospital-based controls) was conducted in two major hospitals in Beirut. Cases were randomly selected from patients diagnosed in the period of 2002-2008. Controls were conveniently selected from the same settings. Data were collected using interview questionnaire and blood analysis. Exposure data were collected using a structured face-to-face interview questionnaire. Blood samples were collected to determine N-acetyltransferase1 (NAT1) genotype by PCR-RFLP. Analyses revolved around univariate, bivariate and multivariate logistic regression, along with checks for effect modification. Results: The odds of having bladder cancer among smokers was 1.02 times significantly higher in cases vs. controls. The odds of exposure to occupational diesel or fuel combustion fumes were 4.1 times significantly higher in cases vs controls. The odds of prostate-related morbidity were 5.6 times significantly higher in cases vs controls. Cases and controls showed different clustering patterns of NAT1 alleles. No significant differences between cases and controls were found for consumption of alcohol, coffee, tea, or artificial sweeteners. Conclusions: This is the first case-control study investigating bladder cancer risk factors in the Lebanese context. Results confirmed established risk factors in the literature, particularly smoking and occupational exposure to diesel. The herein observed associations should be used to develop appropriate prevention policies and intervention strategies, in order to control this alarming disease in Lebanon.
Purpose: This study was performed to identify the factors which affected exercise and the perceived exercise behaviors in women according to Q-methodology and to provide basic strategies for health promotion of middle-aged women in Korea. Method: Q-methodology provides a scientific method for identifying perception structures that exist within certain individuals or groups. Thirty subjects in Seoul, Incheon, Chung-buk classified 35 selected Q-statements in to 9 points standard. The collected data was analyzed by using a QUANL pc program. Result: Principal component analysis identified 3 types of exercise behavior of middle-aged women in Korea and named by the researcher. They are called persistent activity preference type, living-exercise preference type, exercise mania type. In persistent activity preference type, the middle-aged women thought activity was very helpful to achieving health and releasing stress or fatigue. Also, they recognized the relationship between physical health and psychological health. In living-exercise preference type, the middle-aged women preferred maintaining stability or nonactivity to intended exercise or activity for health. In exercise mania type, the middle-aged women thought there was no other way to keep her health than to exercise. Conclusion: The findings of this study will provide the health care provider including nurse with useful information. It's very important to offer appropriate exercise intervention to the middle-aged women of each type by taking into consideration the characteristics of individual types.
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