Background: Inflammatory breast cancer (IBC) is an aggressive form of locally advanced breast cancer characterized by rapidly progressive breast erythema, pain and tenderness, oedema and paeu d'orange appearance. It accounts for 1-3% of all newly diagnosed cases of breast cancer in the west. Data on IBC from India are lacking. The aim of our study was to assess the clinical-pathological parameters and outcome of IBC at, All India Institute of Medical Sciences, a large tertiary care centre. Materials and Methods: We screened 3,650 breast cancer cases registered from January 2004 to December 2012 and found 41 cases of IBC. Data included demographics as well as clinical, radiological and histopathological characteristics, and were collected from clinical case records using the International Classification of Diseases code (C-50). Patients who presented with IBC as a recurrence, or who had a neglected and advanced breast cancer that simulated an IBC were excluded from this study. Results: The median age was 45 years (range 23-66). The median duration of symptoms was 5 months. The American Joint Committee on Cancer stage (AJCC) distribution was Stage III - 26 and IV - 15 patients. Estrogen receptor (ER), progesterone receptor (PR) positivity and human epidermal growth factor receptor 2 (HER2/neu) positivity were 50%, 46% and 60%, respectively. Triple negativity was found in 15% of the cases. All the non metastatic IBC patients received anthracycline and/ or taxane based chemotherapy followed by modified radical mastectomy, radiotherapy and hormonal therapy as indicated. Pathological complete remission rate was 15%. At a median follow-up of 30 months, the 3 year relapse free survival and overall survival were 30% and 40%respectively. Conclusion: IBC constituted 1.1% of all breast cancer patients at our centre. One third of these had metastatic disease at presentation. Hormone positivity and Her2 neu positivity were found in 50% and 60% of the cases, respectively.
Somali, Isil;Ustaoglu, Bahar Yakut;Tarhan, Mustafa Oktay;Yigit, Seyran Ceri;Demir, Lutfiye;Ellidokuz, Hulya;Erten, Cigdem;Alacacioglu, Ahmet
Asian Pacific Journal of Cancer Prevention
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v.14
no.10
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pp.6013-6017
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2013
Background: To evaluate the clinicopathologic and demographic characteristics of triple-negative breast cancer (TNBC) patients and to determine differences from non-triple-negative cases. Materials and Methods: A detailed review of the medical records of 882 breast cancer (BC) patients was conducted to obtain information regarding age, menopausal status, height and weight at the time of diagnosis, presence of diabetes or hypertension, and pathologic characteristics of the tumor (tumor size, lymph node status, histologic grade, ER status, PR status, HER2 status, p53 mutation). Body mass index (BMI) was calculated and a value of ${\geq}30$ was considered as indicative of obesity. Results: 14.9% (n=132) of the patients had TNBC. There was no difference among the patients in terms of median age, comorbid conditions and menopausal status. The proportion of medullary, tubular and mucinous carcinomas was significantly higher (15.9%) in the triple-negative (TN) group, while invasive lobular histology was more frequent (8.2%) among non-triple negative (NTN) cases (p<0.001). Grade 3 (G3) tumors were more frequent in the triple-negative group (p<0.001). The rate of p53 mutation was 44.3% in TN tumors versus 28.2% in the NTN group (p<0.001). The two groups were similar in terms of LN metastasis. In the NTN group, the rate of patients with BMI ${\geq}30$ was 53% among postmenopausal patients, while it was 36% among premenopausal women, and the difference was statistically significant (p<0.001). No significant difference was observed in terms of BMI between postmenopausal and premenopausal patients in the TN group (p=0.08). Conclusions: TNBC rates and clinicopathologic characteristics of the Turkish patient population were consistent with the data from Europe and America. However, no relationship between obesity and TNBC was observed in our study. The association between TNBC and obesity needs to be evaluated in a larger patient population.
Objective: This study aimed to investigate the effect of multimodality treatment of advanced paediatric hepatoblastoma (HB) and the factors affecting prognosis. Methods: A total of 35 children underwent multimodality treatments consisting of chemotherapy, surgery, interventional therapy, and autologous peripheral blood stem cell transplantation. The patients were followed up every month. Results: Serum AFP levels in 33 out of 35 patients in this study were significantly increased (P = 0.0002). According to the statistical scatter plot, the values of serum AFP on the 25th, 50th, and 75th percentages were 1,210, 1,210 and 28,318 ng/dl, respectively. Of the 35 cases, 21 were stage IV. 18 cases were treated with systemic chemotherapy before surgery, and 3 cases with locally interventional chemotherapy before surgery. Statistical analysis showed that the preferred interventional treatment affected prognosis, and that there was a statistically significant difference (P = 0.024). Some 33 patients completed the follow-up, of which 17 were in complete remission (CR), 5 were in partial remission (PR), 1 became disease progressive (DP), and 10 died. The remission and overall survival rates were 66.7% (22/33) and 69.7% (23/33), respectively. Patients with the mixed HB phenotypes had worse prognoses than the epithelial phenotype (P < 0.001), and patients in stage IV had a lower survival rate than those in stage III (P < 0.001). Conclusion: Multimodality treatment can effectively improve remission rate and prolong the survival of children with advanced HB. In addition, alpha-fetoprotein (AFP), a tumor marker of liver malignant tumors, HB pathological classification, and staging are highly useful in predicting prognosis.
Asia-Pacific Journal of Business Venturing and Entrepreneurship
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v.10
no.4
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pp.157-165
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2015
The purpose of this study is to suggest a successful operating strategy of co-working space. Therefore, the operating elements were identified through a literature research. And then, verified through site investigation and interview of operation managers. We found out that the high level operating elements are 'Co-working management', 'Membership management' and 'Supporting management' And the low level elements of Co-working management are 'Relationship facilitation', 'Networking event & Party' and 'Community & Communication', Membership management's are 'Service diversity & Price plan', 'Promotion & PR' and 'Alliance & Partnership', Supporting management's are 'Space & Interior', 'Facility & Device, Solution' and 'Mentoring & Education'. And the questionnaire was designed and conducted to Co-working space operators through the AHP method. As a result of the collected data analyzing, the highest priority was the operational element 'Community & Communication', and 'space and interior' is next, 'Service diversity & Price plan' is the third. The results were discussed with the relevant experts and it presents the following operating strategies. First, to create an environment suitable to voluntary coworking is the most important element. In particular, good management of 'Community & Communication' should be considered as a high priority operations strategy in a coworking space. Second, interior and space utilization helps in making the environment and atmosphere conducive to coworking. Office devices and facilities such as IT infra, printer, fax, scan, paper...etc are also important elements. But the reason why these necessary items are given a low priority is that these items don't need any special strategy. Third, in order to create a stable profit, 'Service diversity & Price plan' should be the characteristics of each coworking space because it will attract and secure enough customers. This study is valuable, it could be a great guideline for coworking space in an early stage to adopt operating model and strategy
Purpose: The aim of this retrospective study was to determine response rates, progression-free survival (PFS), overall survival (OS) and toxicity of gemcitabine and paclitaxel combinations with advanced or metastatic non-small cell lung cancer patients (NSCLC) who have progressive disease after platinum-based first-line chemotherapy. Methods: We retrospectively evaluated the file records of patients treated with gemcitabine plus paclitaxel in advanced or metastatic NSCLC cases in a second-line setting. The chemotherapy schedule was as follows: gemcitabine $1500mg/m^2$ and paclitaxel 150 mg/m2 administered every two weeks. Results: Forty-eight patients (45 male, 3 female) were evaluated; stage IIIB/IV 6/42; PS0, 8.3%, PS1, 72.9%, PS2, 18.8%; median age, 56 years old (range 38-76). Six (12.5%) patients showed a partial response (PR), 13 (27.1%) stable disease (SD), and 27 (56.3%) progressive disease (PD). The median OS was 6.63 months (95% CI 4.0-9.2); the median PFS was 2.7 months (95% CI 1.8-3.6). Grade 3 and 4 hematologic toxicities, including neutropenia (n=4, 8.4%), and anemia (n=3, 6.3%) were encountered, but no grade 3 or 4 thrombocytopenia. One patient developed febrile neutropenia. There were no interruption for reasons of toxicity and no exitus related to therapy. Conclusion: The combination of two-weekly gemcitabine plus paclitaxel was an effective and well-tolerated second-line chemotherapy regimen for advanced or metastatic NSCLC patients previously treated with platinum-containing chemotherapy. Although the most common and dose limiting toxicities were neutropenia and neuropathy, this regimen was tolerated well by the patients.
The aim of this study was to detail characteristics of mammary Paget's disease (PD) representing the whole population in China. A total of 4211 female breast cancer inpatients at seven tertiary hospitals from seven representative geographical regions of China were collected randomly during 1999 to 2008. Data for demography, risk factors, diagnostic imaging test, physical examination and pathologic characters were surveyed and biomarker status was tested by immunohistochemistry. The differences of demography and risk factors between PD with breast cancer and other lesions were compared using Chi-square test or t-test, with attention to physical examination and pathological characters. The percentage of PD was 1.6% (68/4211) in all breast cancers. The mean age at diagnosis was 48.1, and 63.2% (43/68) patients were premenopausal. There is no difference in demography and risk factors between PD with breast cancer and other breast cancer (P > 0.05). The main pattern of PD in physical exam and pathologic pattern were patients presenting with a palpable mass in breast (65/68, 95.6%) and PD with underlying invasive cancer (82.4%, 56/68) respectively. The rate of multifocal disease was 7.4% (5/68). PD with invasive breast cancer showed larger tumor size, more multifocal disease, lower ER and PR expression and higher HER2 overexpression than those in other invasive breast cancer (P < 0.05). These results suggested that PD in China is a concomitant disease of breast cancer, and that PD with underlying invasive cancer has more multiple foci and more aggressive behavior compared with other breast invasive cancer. We address the urgent needs for establishing diagnostic and therapeutic guidelines for mammary PD in China.
Background: To investigate the association between preoperative pathological Ki-67 labeling index and serum tumor marker cancer antigen 15-3 (CA 15-3) with clinic-pathological parameters and treatment outcomes in early breast cancer. Materials and Methods: A retrospective study at 4 cancer centers in Saudi Arabia and Egypt was performed. Data were collected for female patients diagnosed with unilateral early breast cancer between March 2010 and October 2013. Cases treated with neoadjuvant chemotherapy (NACT) followed by surgery and radiotherapy were included. NACT included 6-8 cycles of anthracycline and taxane based regimens. Trastuzumab and hormonal treatments were added according to HER2 and hormone receptor status. Baseline serum CA15.3 and pathological Ki67 levels were evaluated and correlated with disease free survival (DFS) and overall survival (OS). Results: A total of 280 pts was included. The median age was 49 years (38-66 y) and median overall survival was 35 (20-38) months (mo). Estrogen receptors (ER), progesterone receptors (PR) and HER 2 receptors were positive in 233 (83.2%), 198 (70%) and 65 cases (23.2%), respectively. High preoperative Ki67 and CA15.3 were noted in 177 (63.2%) and 131 (46.8%). A total of 45 (16%) patients had distal or local recurrence and 24 (8.6%) died of their disease. Most of the relapsed cases had high preoperative Ki-67 (n=41, 91%) and CA15.3 (n=28, 62%) values. All of the patients who died had a high Ki-67 but CA15.3 was high in 9 (37%) only. Mean DFS/OS in patients with high preoperative Ki-67 was 32 months /32 months as compared to 37 months/35 months in those with normal Ki-67 (p<0.001). Correlation of preoperative CA15.3 and survival was statistically not significant. Conclusions:Preoperative Ki-67 can be a predictive and prognostic marker. Higher levels are associated with poor DFS and OS in patients with early BC.
Historical, RCP4.5 and RCP8.5 scenarios from HadGEM2-AO are dynamically downscaled over the northeast East Asia with WRFV3.4. The horizontal resolution of the produced data is 12.5 km and the periods of integration are 1979~2010 for historical and 2019~2100 for both RCP4.5 and RCP8.5. We analyze the time series, climatology, EOF and extreme climate in terms of 2 m-temperature and precipitation during 30-year for the Historical (1981~2010) and RCP4.5 and RCP8.5 (2071~2100) scenarios. According to the result, the temperature of the northeast Asia centered at the Korean Peninsula increase 2.9 and $4.6^{\circ}C$ in the RCP4.5 and RCP8.5 scenarios, respectively, by the end of the 21st century. The temperature increases with latitude and the increase is larger in winter rather than in summer. The annual mean precipitation is expected to increase by about $0.3mm\;day^{-1}$ in RCP4.5 scenario and $0.5mm\;day^{-1}$ in RCP8.5 scenario. The EOF analysis is also performed for both temperature and precipitation. For temperature, the EOF $1^{st}$ modes of all scenarios in summer and winter show that temperature increase with latitude. The $2^{nd}$ mode of EOF of each scenario shows the natural variability, exclusive of the global warming. The summer precipitation over the Korean Peninsula projected increases in EOF $1^{st}$ modes of all scenarios. For extreme climate, the increment of the number of days with daily maximum temperature above $30^{\circ}C$ per year ($DAY_{TX30}$) is 25.3 and 49.7 days in RCP4.5 and RCP8.5 respectively over the Korean Peninsula. The number of days with daily precipitation above $20mm\;day^{-1}$ per year ($DAY_{PR20}$) also increases 3.1 and 3.5 days in RCP4.5 and RCP8.5 respectively.
The purpose of this study is to provide basic information for marketing strategy for hospitals in Busan Metropolitan area by investigating of the web-site management and effect on hospital management about the web-sites managers. Survey of 53 web-site managers was taken between May 1st and May 25th 2008. The survey was carried out to gather information about characteristics of web-site managers and creating, managing and operating process of web-sites and web-sites' effect and information sharing abilities. The results of survey are as follows. First, most of hospitals' web-sites were launched between 2001 to 2005 via outsourcing. Most of hospitals spent about one to three million won for their web-sites and renew web-sites every year. Most of these web-sites have hospital PR, Q&A, and on-line support functions. Second, most of whom participated in survey have agreed that a hospital web-site has influence in hospital management in various categories such as introducing hospital to medical examination, making doctor's appointment, providing patient guidance, providing medical information, and patient counselling. This study shows that effects of web-sites are closely related to web-site satisfaction level. Therefore, to raise the hospital satisfaction level, it is necessary for hospitals to put more efforts in creating web-site that provides more medical information and improved on-line services.
Utilization of cultural contents is more and more increasing as it is believed to improve local problems and provide historical values. This kind of business is positive in terms of the fact that it attracts visitors into local areas and activate local commercial areas. Under this trend, the construction of specialized streets is required to be approached with first priority to solve problems of cities. So to speak, it's more important to solve intrinsic problems found in local communities and then approach cultural contents step-by-step rather than constructing new spaces with first priority. Moreover, cultural contents should accompany economic aspects which result in local community-friendly and sympathetically concentrated values. Under this sentiment, the efforts to suggest economic ripple effects for government local government's businesses using cultural contents are very important. This study analyzed how much economic ripple effects is yielded by reflecting cultural contents. As the result of analysis, specialized street with cultural contents applied are proved to be more concentrated on multiplier of expediting employment, income and tax and tourism industry than service industry. On the contrary to this, service industry showed more concentrated multiplier of expediting production, income, added values and chain reaction effect (coefficients for influence and sensitivity for front and rear side of tourism industry. Based on these results, construction of specialized streets with cultural contents applied is proved to help synergy effects for local economy.
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