• Title/Summary/Keyword: One-year mortality

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Outcomes of Local Excision for Early Rectal Cancer: a 6-year Experience from the Largest University Hospital in Thailand

  • Lohsiriwat, Varut;Anubhonganant, Worabhong;Prapasrivorakul, Siriluck;Iramaneerat, Cherdsak;Riansuwan, Woramin;Boonnuch, Wiroon;Lohsiriwat, Darin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5141-5144
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    • 2013
  • Background: This study aimed to determine clinical outcomes of local excision for early rectal cancer from a University Hospital in Thailand. Materials and Methods: We performed a retrospective review of 22 consecutive patients undergoing local excision for early rectal cancer (clinical and radiological T1/T2) from 2005-2010 at the Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok. Data were collected from patients' medical records, including demographic and clinical characteristics, pathological report and surgical outcomes. Results: This study included 10 males and 12 females, with average age of 68 years. Nineteen patients (86%) underwent transanal excision and the others had trans-sacral excision. Median operative time was 45 minutes. Postoperative complications occurred in 2 patients (9%); 1 fecal fistula and 1 wound infection following trans-sacral excision. There was no 30-day postoperative mortality. Median hospital stay was 5 days. Pathological reports revealed T1 lesion in 12 cases (55%), T2 lesion in 8 cases (36%) and T3 lesion in 2 cases (9%). Eight patients received additional treatment; one re-do transanal excision, two proctectomies, and five adjuvant chemoradiation. During the median follow-up period of 25 months, local recurrence was detected in 4 patients (18%); two cases of T2 lesions with close or positive margins, and two cases of T3 lesions. Three patients with local recurrence underwent salvage abdominoperineal resection. No local recurrence was found in T1/T2 lesions with free surgical margins. Conclusions: Local excision is a feasible and acceptable alternative to radical resection only in early rectal cancer with free resection margins and favorable histopathology.

Culture of the Ark Shell, Anadara broughtonii in Yoja Bay (여자만에서의 피조개 양성)

  • KWON Woo-Seop;CHO Chang-Hwan
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.19 no.4
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    • pp.375-379
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    • 1986
  • A culture experiment of the ark shell, Anadara broughtonii, one of the edible clams, was carried out in Yoja Bay located at the south ern coast of Korea to find the state of growth and any problems which influence them. Seed shells at an average length of 2.5cm and a weight of 2.5g were planted on bottom mud with a density 20 to 40 shells per square meter on March 10 and 11, 1982. Shell length, shell height, shell breadth, meat weight (wet weight), and total weight for six months from August 1982 to February 1983 were measured to find their state of growth. At the same time, the survival rate was investigated during the whole culture period through December 1983 when they were harvested. Growth, on the whole, was fast when water temperature was high. For a year, an average shell length and total weight attained to 6.1 cm and 63.0g respectively and meat weight was gained to 19.5g. It showed that the state of growth was favourable. Shell shape became round from the oval ana meat weight increase was faster than shell growth as time goes by regardless of water temperature while both shells and total weight increased faster during high temperature. A month after seed shells were planted, about $30\%$ of them was dead and a high mortality, say $5\%\;to\;8\%$ per month, was kept till September. It dropped to around $2\%$ aften divers eliminated starfish, Asterias spp., in August. Thereafter, the rate maintained through December. In all, the final survival rate was about $10\%$ at the time of harvest in December 1983. It was caused mainly by starfish predation. Therefore, a best way for satisifactory culture is seemed to find a way to get rid of the starfish.

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Mid- to Long-term Results of Surgical Treatment of ASD in Patients over 60 Years Old

  • Jeong, In-Seok;Ahn, Byoung-Hee;Kim, Soon-Jin;Oh, Sang-Gi;Oh, Bong-Suk;Kim, Sang-Hyung
    • Journal of Chest Surgery
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    • v.44 no.2
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    • pp.137-141
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    • 2011
  • Background: There is controversy about the benefit of surgical correction of an atrial septal defect (ASD) in patients over 60 years old. The purpose of this study was to determine whether surgical treatment is beneficial in those 60 years of age or older. Materials and Methods: We reviewed the clinical course of 57 patients (mean age: $63.54{\pm}5.59$ years) diagnosed with an isolated secundum ASD after the age of 60. The 24 patients (group A) who underwent surgical repair were compared with the 33 patients (group B) who were treated non-surgically. The mean follow-up period was $6.8{\pm}4.5$ years. Results: One operative death, 5 late deaths (20.8%) in group A, and 9 deaths (27.3%) in group B occurred in the study period. Symptomatic improvement was noted in 18 patients (75%) of group A after surgery. However 13 patients (39.4%) of group B showed symptomatic improvement during the follow-up period (p=0.012). The incidence of new atrial arrhythmia of the two groups was significantly different (16.7% vs 36.7%, p=0.038). The actuarial 10 year survival rate was 79% in group A and 73% in group B. Conclusion: Although surgical correction of ASD did not increase survival in patients over 60 years old, the surgical outcomes of ASD showed low operative mortality and resulted in symptomatic improvement in the majority of these patients. This study has shown the benefits of surgical closure of ASD even in advanced age in comparison to medical treatment.

A Case of Primary Pulmonary Hypertension in Pregnancy Presented as Massive Hemoptysis (임신 중 대량객혈로 발현된 원발성 폐고혈압 1예)

  • Kim, Myung Sook;Kim, Hyoung Doo;Kim, Seok Chan;Kwan, Soon Suk;Kim, Young Kyoon;Kim, Kwan Hyoung;Moon, Hwa Sik;Song, Jeong Sup;Park, Sung Hak
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.1
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    • pp.66-71
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    • 2004
  • Primary pulmonary hypertension (PPH) is a rare, progressive and incurable disease, which is characterized by an increase in the pulmonary artery pressure without a demonstrable cause. The most common presenting symptom is dyspnea on exertion, with other symptoms comprising of chest pain, syncope and hemoptysis. The diagnosis is one of exclusion of any of the known causes of pulmonary hypertension. When associated with pregnancy, the maternal mortality ranges from 30 to 50%. Because pregnancy and labor are very serious problems for patients with PPH, the available evidence suggests that pregnancy when afflicted with PPH should be avoided. In account the case of a 33-year old patient, reporting with massive hemoptysis, and diagnosed with PPH during her twenty seventh week of gestation, is presented. She was treated with conservative management, including oxygen and a vasodilator, and underwent a pregnancy termination. However, due to aggravation of right heart failure, she presented with severe systemic hypotension and hypoxemia, and eventually died. This case is reported, with brief review of the literature.

Research Areas and Trends in Articles on Pediatric and Adolescent Tuberculosis in Korea (국내 소아청소년 결핵 관련 논문의 연구 영역과 동향)

  • Lim, Ho Yoon;Lee, Jung Hyun;Jung, Yu Jin;Oh, Chi Eun
    • Pediatric Infection and Vaccine
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    • v.26 no.2
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    • pp.89-98
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    • 2019
  • Purpose: Despite the decline in tuberculosis (TB) incidence and mortality rates in the Republic of Korea through a national TB control program, TB remains one of the most critical infectious diseases in Korean children. We investigated the trends and research areas of published articles on TB in Korean children and adolescents. Methods: In 6 Korean and overseas databases, we searched titles and abstracts including "tuberculo*" or "TB," "child*" or "adolescen*" or "neonat*" or "infant*" or "pediatric*," and "korea*." The publication type, publication year, research areas, journal title, and research subjects were analyzed. Results: Out of the 257 searched documents, 120 papers were included in the analysis. Of these, 82 were original articles (68.3%), 33 case reports (27.5%), 4 review articles (3.3%), and 1 guideline (0.8%). In the original articles, the most common subject of studies was the clinical characteristics of patients with TB (36.6%), followed by diagnostics (29.3%), contact investigations (9.8%), epidemiology (6.1%), treatment (4.9%), vaccine (3.6%), latent TB infection (3.6%), complications (3.6%), and surveys on perception of TB (2.4%). From 1962, 4 articles were published in the 1960s, 10 articles in the 1970s, 11 articles in the 1980s, 22 articles in the 1990s, 26 articles in the 2000s, and 47 articles since 2010. Conclusions: The amount of research on TB in Korean children has increased over the past 5 decades; however, it has mainly focused on the clinical characteristics and diagnostics. Research in different areas, such as treatment and vaccine, is needed in the future.

Adjuvant Chemotherapy in Patients with Node-Negative Non-Small Cell Lung Cancer with Satellite Pulmonary Nodules in the Same Lobe

  • Park, Jiyoun;Lee, Junghee;Jeon, Yeong Jeong;Shin, Sumin;Cho, Jong Ho;Kim, Hong-Kwan;Choi, Yong Soo;Kim, Jhingook;Zo, Jae Ill;Shim, Young Mog
    • Journal of Chest Surgery
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    • v.55 no.1
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    • pp.10-19
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    • 2022
  • Background: According to the eighth TNM (tumor-node-metastasis) staging system, the presence of separate tumor nodules in the same lobe is designated as a T3 descriptor. However, it remains unclear whether adjuvant chemotherapy confers survival advantages in this setting. Methods: We retrospectively identified 142 pathologic T3N0M0 patients with additional pulmonary nodules in the same lobe from a single-institutional database from 2004 to 2019. The main outcomes were overall survival and recurrence-free survival. Multivariable Cox regression was used to identify the benefit of adjuvant chemotherapy while adjusting for other variables. Results: Sixty-one patients received adjuvant chemotherapy (adjuvant group) and 81 patients did not receive adjuvant therapy after surgery (surgery-only group). There were no demonstrable differences between the 2 groups regarding hospital mortality and postoperative complications, indicating that treatment selection had not significantly occurred. However, the use of adjuvant chemotherapy was associated with improved 5-year overall survival (70% vs. 59%, p=0.006) and disease-free survival (60% vs. 46%, p=0.040). A multivariable Cox model demonstrated that adjuvant chemotherapy was associated with a survival advantage (adjusted hazard ratio, 0.54; p<0.001). In exploratory analyses of subgroups, the effect of adjuvant chemotherapy seemed to be insufficient in those with small main tumors (<4 cm). Conclusion: Adjuvant chemotherapy was associated with better survival in T3 cancers with an additional tumor nodule in the same lobe. However, the role of adjuvant chemotherapy in patient subgroups with small tumors or those without risk factors should be determined via large studies.

Protein kinase A activation by β-Lapachone is associated with apoptotic cell death in NQO1-overexpressing breast cancer cells

  • SAHIB ZADA;JIN SEOK HWANG;MAHMOUD AHMED;TRANG HUYEN LAI;TRANG MINH PHAM;DONG-HEE KIM;DEOK RYONG KIM
    • Oncology Letters
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    • v.42 no.4
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    • pp.1621-1630
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    • 2019
  • One million females are diagnosed worldwide every year with breast cancer, and the mortality rate of these patients remains high. Several treatments, including surgery, are available for breast cancer. β-Lapachone (β-Lap), a natural quinone compound, has been developed for cancer treatment due to its strong cytotoxic effect through its action on NAD(P)H:quinone oxidoreductase 1 (NQO1)-dependent activity. However, the mechanism in regards to how β-Lap induces cytotoxicity in breast cancer cells is still elusive. In the present study, we showed that β-Lap induced apoptotic cell death via activation of protein kinase A (PKA) in NQO1-overexpressing MDA-MB-231 human breast cancer cells. This PKA-dependent cell death was observed solely in NQO1-overexpressing 231 cells via the high production of reactive oxygen species (ROS). Cell survival of antioxidant [N-acetylcysteine (NAC)]-treated NQO1-overexpressing 231 cells was significantly recovered, and NQO1-negative 231 cells did not respond to β-Lap. Antiapoptotic proteins such as Bcl2 and Bcl-xL were decreased, while proapoptotic proteins, including cytochrome c, activation of caspase-3, and cleavage of PARP were increased after β-Lap treatment of NQO1-overexpressing 231 cells. Furthermore, PKA activators, forskolin or dibutyryl-cAMP, an analog of cAMP, aggravated the β-Lap-induced apoptotic cell death by decreasing antiapoptotic proteins and further activating proapoptotic proteins in NQO1-positive 231 cells. Treatment with a PKA inhibiter, H89, significantly increased cell viability even in NQO1-overexpressing cells treated with β-Lap. These data showed that β-Lap activated PKA via ROS accumulation, subsequently leading to apoptotic cell death in NQO1-positive breast cancer cells.

Polyculture of Fleshy Shrimp Fenneropenaeus chinensis and White Shrimp Litopenaeus vannamei with River Puffer Takifugu obscurus in Shrimp Ponds (축제식 양식장에서의 대하, 흰다리새우와 황복의 복합양식)

  • Jang, In-Kwon;Jun, Je-Cheon;Jo, Gook-Jin;Cho, Yeong-Rok;Seo, Hyung-Chul;Kim, Bong-Lae;Kim, Jong-Sheek
    • Journal of Aquaculture
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    • v.20 no.4
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    • pp.278-288
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    • 2007
  • Shrimp culture in Korea had been rapidly developed during 1990's and the production of farmed shrimp reached 3,268 mt from 2,605 ha in 2001. However the shrimp production decreased to 2,368 mt in 2004 because of the mass mortality due to outbreak of white spot syndrome virus (WSSV). WSSV which is one of the most serious threats associated with cultured shrimp around the world has given the economic damages to shrimp culture industry every year since it was found from the shrimp ponds in the west coast of the South Korea in 1993. Various polyculture technologies of shrimp with shellfish, finfish or seaweeds have been implemented to reduce economic damages by mass mortalities of shrimp. Among them, the polyculture of shrimp with carnivorous fish can suppress or delay the viral outbreak of shrimp ponds because the fish may selectively eat the moribund shrimps infected by virus. To determine the selective predatory effect of river puffer Takifugu obscures on WSSV infected shrimp, postlarvae of Litopenaeus vannamei and Fenneropenaeus chinensis. One-year old river puffers were stocked to four earthen ponds of $1,616-1,848\;m^2$ in surface area as followings: polyculture LvP, L. vannamei ($43.4/m^2$)+puffer ($0.22/m^2$); control Lv, L. vannamei ($46.9/m^2$); polyculture FcP, F. chinensis ($30.3/m^2$)+puffer ($0.25/m^2$); control Fc, F. chinensis ($24.6/m^2$). Ponds of control Fc and polyculture FcP had mass mortalities by WSSV outbreak on the $51^{st}$ and $57^{th}$ days of culture respectively. The shrimps of polyculture LvP and control Lv were harvested on the $95^{th}\;day$. Shrimp survival rates of polyculture LvP and control Lv were 32.4% and 18.2% respectively and shrimp productivity of polyculture LvP was 69.2% higher than that of control Lv. Concentration of nutrients (TAN, $NO_2-N$, $NO_3-N$) was maintained within optimal ranges for shrimp growth although that of polyculture ponds showed at least two times higher than that of control ponds. The results suggest that polyculture of L. vannamei with river puffer is higher than monoculture in survival rate and productivity. In addition, F. chinensis should be carefully cultured because this species shows much higher susceptibility to WSSV than L. vannamei.

On Pattern of Birth and Death in Seoul City (서울시인구(市人口)의 출생(出生).사망(死亡) 양상(樣相)에 관(關)한 연구(硏究))

  • Kwon, E-Hyock;Kim, Tae-Ryong;Park, Hyung-Jong;Koo, Do-Suo;Lee, Yong-Wook;Park, Soon-Young
    • Journal of Preventive Medicine and Public Health
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    • v.1 no.1
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    • pp.9-23
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    • 1968
  • A survey was conducted by the staff of the College of Medicine and School of Public Health, Seoul National University in cooperation with Seoul Special City from 1 December 1967 through 28 February 1968, on such events as delivery, death, abortion and pregnancy. The survey directed to a total population of 47,811 residing in 9,157 households led us to the following findings: 1. Two year averages of crude birth rate, crude death rate and natural increase rate were 30.1, 5.6 and 24.5, respectively. 2. Of all deliveries, home and hospital deliveries constituted 61.1 per cent and 35.5 per cent, respectively. 3. Deliveries other than hospital deliveries were found to be attended more often by mother-in-laws (26.5 per cent) than by doctors or midwives(23.4 per cent). 4. About 51 per cent of all women having experiences in pregnancy during the last two years had an experience of consulting a doctor at least one time throughout whole period of pregnancy. 5. In most cases scissors were used to cut umbilical cords, of which 71.0 per cent were not sterilized and only 20.3 per cent sterilized. 6. In many cases placenta was incinerated(48.2 per cent) and on many other occasions it was thrown away into water(28.3 per cent). 7. Cement bags(37.4 per cent), gauze and absorbent cotton(29.8 per cent) were found to be most frequently used to receive new-born babies. 8. In 1966 8. 8 per cent of the women had at least one abortion induced and in 1967 the percentage was 9.2 per cent. 9. Nearly all(95.8 per cent) of the induced abortions reportedly were done at doctor's clinics. 10. Of all the abortions induced 65.3 per cent were done by specialists in obstetrics, 30.3 per cent by general practitioners and 2.7 per cent by midwives. 11. Those who experienced spontaneous abortions were 1.9 per cent of all women both in 1966 and 1967. 12. About 9.2 per cent of women investigated were found to be currently pregnant. 13. Age specific death rate turned out to be highest among those under 1 year of age. 14. Ten major causes of death in their order of frequency were: 15. Places of death can be classified into homes(75.3 per cent) and hospitals(13.2 per cent). 16. Method of disposing of corpses comprised burials(54.2 per cent) and cremations(44.6 per cent). 17. Infant, neonatal and hebdomadal mortality rates have been computed at 32.2, 18.9 and 13.7, respectively. 18. Infants were found to have died either at homes(81.5 per cent) or at hospitals(18.5 per cent). 19. Birth registrations had been done for about 18.5 per cent of the dead infants.

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National Survey of Injury and Poisoning on a Representative Sample Population of Koreans (우리나라 대표적(代表的) 표본인구(標本人口)의 연간(年間) 손상(損傷) 및 중독발생율(中毒發生率)과 역학적(疫學的) 특성(特性))

  • Kim, Joung-Soon;Kim, Sung-Soo;Chang, Sung-Chill
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.3 s.47
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    • pp.447-463
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    • 1994
  • Despite the public health importance of injury and poisoning in terms of its high mortality and incidence, epidemiologic information to be utilized are scarce in Korea. This study was carried out in 1990 on a representative sample population (about 55,000 persons) along with the 6th National Tuberculosis Prevalence Survey in order to estimate the magnitude of injury and poisoning occurrence and to identify its epidemiologic characteristics which can be aided for establishing preventive strategy. Pre-tested and structured Questionnaire was used by trained interviewer to collect data including general information of the person, various information on the injury and poisoning during the past one year such as time and place of its occurrence, its nature and external causes, type of medical institute attended, duration of treatment and outcome of the accident occured. In analysis of the data collected incidence rates per 1000 persons by sex, age group and its nature as well as external causes, and relative frequencies were calculated. The result obtained are as followings; 1. The incidence rate per 1000 was 30 for both sexes, 39 for male and 22 for female, male being 1.8 times more frequent than female. Age adjusted incidences were not much different from the crude rates. Age group specific rate curve showed bimodal shape in both sexes, small peaks in preschool children and higher peaks in older ages. The incidence rate per 1000 people by area was highest in Jeon-bug province (57/1000) and the lowest in Daegu city(11/1000). 2. The place where the injuries occured were road in 46%, within the boundary of house in 25%, and working place in 12% The injuries and poisoning had occured more frequently during the months from March to August of the year than other months. 3. The relatively frequent injuries by its nature were contusion with intact skin surface (19%), fracture of upper limb (13%), open wound of head, neck and trunk (12%) and fracture of lower limb (11%) among males; contusion with intact skin surface (28%), sprains and strains of joints and adjacent muscle (14%), fracture of upper limb (10%) and fracture of lower limb (9%) among females. Higher incidence rate among males than females were fracture of skull (4.5 times), open wound and fractures of limbs ($2{\sim}3$ times). Age specific rate of injuries and poisoning by its nature showed increasing pattern by age in fractures of upper and lower limbs and sprains & strains of joints whereas the age group of 30's showed highest incidence in open wounds of upper limb. Fractures of radius and ulna in upper limb, fractures of tibia & fibula and ankle in lower limb were most frequent among fractures of upper and lower limbs. The frequent injuries among sprains and strains of joints and adjacent muscles were that of ankle, foot and back, and among open wound were that of head and fingers. 4. Relative frequency of injuries and poisoning by external causes showed following order : other accidents (25%), accidental falls (23%), motor vehicle accident (22%) and other road vehicle accident (14%) among males and accidental falls (37%), motor vehicle accident (24%) and other accident (18%) among females. The external causes revealing higher incidences among males than females, were other road vehicle accident (4.8 times), vehicle accident not elsewhere classifiable (4.4 times), accidental poisoning (4.4 times), accidents due to natural and environmental factors (2.8 times), and sucide & self-inflicted injuries (2.8 times). Age specific incidence by external causes for frequent injuries showed that incidence of other accident steadily increased from 10's till age 50's; motor vehicle traffic accident increased from age 20's and dropped after age 60's; on the other hand accidental fall increased strikingly by age. The most frequent external causes among motor vehicle traffic accidents was motor vehicle traffic accident involving collision with pedstrain (69%), pedal cycle accident (30%) and other road vehicle accident (71%) among other road vehicle accidents; falls on same level from slipping, tripping or standing (44%) and other falls from one level to another among accidental falls; accidents caused by machinary (32%) for male and striking against or struck accidentally by objects or person for female among other accidents. 5. Seventy nine percent of the injuries and poisonings were treated in general hospital or hospital/clinic. The duration of treatment ranged from a few days to 123 weeks; the majority(52%) took under 2 weeks, 36% for $3{\sim}8$ weeks and 4% over 21 weeks. 6. The accident resulted in full recovery of normal healthy state in 62%, residual functional defects in 21% and on process of treatment in 16%.

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