• Journal of Korean Neurosurgical Society
• /
• 제54권3호
• /
• pp.211-219
• /
• 2013

Objective : The objectives of the present study were to characterize the natural course of initially non-operated traumatic acute subdural hematoma (ASDH) and to identify the risk factors of hematoma progression. Methods : Retrospective analysis was performed using sequential computed tomography (CT) images maintained in a prospective observational database containing 177 ASDH cases treated from 2005 to 2011. Patients were allocated to four groups as followings; 136 (76.8%) patients to the spontaneous resolution group, 12 (6.8%) who underwent operation between 4 hours and 7 days to the rapid worsening group (RWG), 24 (13.6%) who experienced an increase of hematoma and that underwent operation between 7 and 28 days to the subacute worsening group (SWG), and 5 (2.8%) who developed delayed aggravation requiring surgery from one month after onset to the delayed worsening group (DWG). Groups were compared with respect to various factors. Results : No significant intergroup difference was found with respect to age, mechanism of injury, or initial Glasgow Coma Scale. The presence of combined cerebral contusion or subarachnoid hemorrhage was found to be a significant prognostic factor. Regarding CT findings, mixed density was common in the RWG and the SWG. Midline shifting, hematoma thickness, and numbers of CT slices containing hematoma were significant prognostic factors of the RWG and the SWG. Brain atrophy was more severe in the SWG and the DWG. Conclusion : A large proportion of initially non-operated ASDHs worsen in the acute or subacute phase. Patients with risk factors should be monitored carefully for progression by repeat CT imaging.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권5호
• /
• pp.2369-2374
• /
• 2014

Background and Aim: Selumetinib is a promising and interesting targeted therapy agent as it may reverse radioiodine uptake in patients with radioiodine-refractory differentiated thyroid cancer. We conduct this metaanalysis to compare the efficacy and safety of selumetinib with current therapies in patients with advanced cancer. Methods: An electronic search was conducted using PubMed/ Medicine, EMBASE and Cochrane library databases. Statistical analyses were carried out using either random-effects or fixed-effects models according to the heterogeneity of eligible studies. Results: Six eligible trials involved 601 patients were identified. Compared with current therapies, treatment schedules with selumetinib did not improve progression free survival (hazard ratio, 0.91; 95%CI 0.70-1.17, P= 0.448), but did identify better clinical benefits (odds ratio, 1.24; 95%CI 0.69-2.24, P = 0.472) and less disease progression (hazard ratio, 0.72; 95%CI 0.51-1.00, P = 0.052) though its impact was not statistically significant. Sub-group analysis resulted in significantly improved progression free survival (hazard ratio, 0.61; 95%CI 0.49-0.57, P = 0.00), clinical benefits (odds ratio, 3.04; 95%CI 1.60-5.77, P = 0.001) and reduced disease progression (hazard ratio, 0.35; 95%CI 0.18-0.67, P = 0.001) in patients administrated selumetinib. Dermatitis acneiform (risk ratio, 9.775; 95%CI 3.143-30.395, P = 0.00) and peripheral edema (risk ratio, 2.371; 95%CI 1.690-3.327, P = 0.00) are the most frequently observed adverse effects associated with selumetinib. Conclusions: Compared with current chemotherapy, selumetinib has modest clinical activity as monotherapy in patients with advanced cancer, but combinations of selumetinib with cytotoxic agents in patients with BRAF or KRAS mutations hold great promise for cancer treatment. Dermatitis acneiform and peripheral edema are the most frequently observed adverse effects in patients with selumetinib.

• 한국건강관리협회지
• /
• 제2권2호
• /
• pp.149-153
• /
• 2004

Dementia prevention is mainly aimed to the people who have various risk factors for developing dementia or who have mild cognitive impairments. The possible methods for this prevention may include the control of dementiarisk factors and the administration of drugs which may suppress the dementia progression. It is noteworthy that people with milc cognitive impairments (MCI) have 10 times higher risk for developing dementia compared to healthy aged people. Thus 25-50% of them may be progressed to dementia within 2-4 years. Here I describe various factors related to Alzheimer dementia, and possible way to control these factors.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권2호
• /
• pp.815-821
• /
• 2016

Background: Development of chronic myeloid leukemia (CML) involves formation of double strand breaks (DSBs) which are initially sensed by the ataxia telangiectasia mutated (ATM) signal kinase to induce a DNA damage response (DDR). Mutations or single nucleotide polymorphisms in ATM gene are known to influence the signaling capacity resulting in susceptibility to certain genetic diseases such as cancers. Materials and Methods: In the present study, we have analyzed -5144A>T (rs228589) and C4138T (rs3092856) polymorphisms of theATM gene through polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in 925 subjects (476 CML cases and 449 controls). Results: The A allele of -5144A>T polymorphism and T allele of C4138T polymorphism which were known to be influencing ATM signaling capacity are significantly associated with enhanced risk for CML independently and also in combination (evident from the haplotype and diplotype analyses). Significant elevation in the frequencies of both the risk alleles among high risk groups under European Treatment and Outcome Study (EUTOS) score suggests the possible role of these polymorphisms in predicting the prognosis of CML patients. Conclusions: This study provides the first evidence of association of functional ATM gene polymorphisms with the increased risk of CML development as well as progression.

• Journal of Trauma and Injury
• /
• 제23권2호
• /
• pp.142-150
• /
• 2010

Purpose: In this study, patients in whom two computed tomography (CT) scans had been obtained within 24 hours of injury were analyzed to determine the incidence, risk factors and clinical significance of a progressive intracerebral hematoma (PIH). Methods: Participants were 182 patients with a traumatic intracerebral hematoma and contusion who underwent a repeat CT scan within 24 hours of injury. Univarite and multivariate statistics were used to define growth (volume increase) and to examine the relationship between the risk factors and hemorrhage expansion. Results: Fifty-four percent of the patients experienced progression in the size of the lesion in the initial 24 hours postinjury. A PIH was independently associated with worsened Glasgow coma scale (GCS) score (2.99, 1.04~8.60), the presence of subarachnoid hemorrhage (6.29, 2.48~16.00), the presence of a subdural hematoma (6.18, 2.13~17.98), the presence of an epidural hematoma (5.73, 1.18~27.76), and the presence of a basal cistern effacement (10.93, 1.19~99.57). Conclusion: For patients undergoing scanning within 2 hours of injury, the rate of PIH approaches 61%. Early repeated CT scanning is indicated in patients with a nonsurgically-treated hemorrhage revealed on the first CT scan. Worsened GCS score, significant hematoma growth and effacement of the basal cisterns on the initial CT scan are powerful predictors of which patients will require surgery. These findings should be important factors in understanding and managing of PIH.

• 한국철도학회:학술대회논문집
• /
• 한국철도학회 2006년도 추계학술대회 논문집
• /
• pp.1132-1139
• /
• 2006

Railway risk is evaluated by a method of linking event trees and fault trees as the general PSA(Probabilistic Safety Assessment) model for the risk assessment of complex systems. Accident scenarios causing undesirable events are modeled by event trees comprised of several accident sequences. Each branch located in the accident progression of the event tree is modeled by an fault tree or can be represented by some value too simply. We usually evaluate the frequency of the whole sequence by adding them after calculating the frequency of each sequence at a time. However, since there are quite a number of event trees and fault trees in the railway risk assessment model, the number of sequence to evaluate increases and preparation for the risk assessment costs much time all the more. Also, it may induce errors when analysts perform the work of quantification. Therefore, the systematic maintenance and control of event trees and fault trees will be essential for the railway risk assessment. In this paper we introduce an integrated assessment method using one-top model and develop a risk assessment tool for the maintenance and control of the railway risk model.

• Nuclear Engineering and Technology
• /
• 제23권3호
• /
• pp.285-298
• /
• 1991

전형적인 정성적 퍼지형태의 입력데이타를 가진, 주어진 사고진행사건수목의 일부분에 대하여 퍼지집합이론(fuzzy set theory)의 응용 예를 먼저 보여주고, 이 예를 통해서 퍼지집합이론을 사고 진행사건수목에 적용하기 위해 적절한 계산알고리즘을 찾아내고 또 예를 들어 설명하였다. 그리고, 간단한 예제에 사용한 계산절차를 많은 현상학적 불확실성 인자를 포함한 아주 복잡한 사고진행사건수목 즉, 최근 Zion 발전소 위험도평가(PRA)에 사용된 전형적인 발전소 손상군의 하나인‘SEC’에 응용해서 적용하였다. 퍼지집합이론으로 평가한 계산값들의 퍼지평균치들은 최근 통계적 PRA 평가 방법론으로 얻는 값들의 평균치와 거의 같은 결과를 보여주고 있다. 본 논문의 주요목적은 부정확하고 또 정성적인 분기점확률이나 또는 많은 현상학적 불확실성 인자들을 가진 사고진행사건수목들에 이 퍼지집합이론을 적용하기 위한 공식적 계산절차를 제공하는데 있다.

• Korean Journal of Ophthalmology
• /
• 제32권6호
• /
• pp.470-477
• /
• 2018

Purpose: To investigate the relationship between the progression of visual field (VF) loss and changes in lamina cribrosa depth (LCD) as determined by spectral-domain optical coherence tomography (SD-OCT) enhanced depth imaging in patients with primary open angle glaucoma (POAG). Methods: Data from 60 POAG patients (mean follow-up, $3.5{\pm}0.7$ years) were included in this retrospective study. The LCD was measured in the optic disc image using SD-OCT enhanced depth imaging scanning at each visit. Change in the LCD was considered to either 'increase' or 'decrease' when the differences between baseline and the latest two consecutive follow-up visits were greater than the corresponding reproducibility coefficient value ($23.08{\mu}m$, as determined in a preliminary reproducibility study). All participants were divided into three groups: increased LCD (ILCD), decreased LCD (DLCD), and no LCD change (NLCD). The Early Manifest Glaucoma Trial criteria were used to define VF deterioration. Kaplan-Meier survival analysis and Cox's proportional hazard models were performed to explore the relationship between VF progression and LCD change. Results: Of the 60 eyes examined, 35.0% (21 eyes), 28.3% (17 eyes), and 36.7% (22 eyes) were classified as the ILCD, DLCD, and NLCD groups, respectively. Kaplan-Meier survival analysis showed a greater cumulative probability of VF progression in the ILCD group than in the NLCD (p < 0.001) or DLCD groups (p = 0.018). Increased LCD was identified as the only risk factor for VF progression in the Cox proportional hazard models (hazard ratio, 1.008; 95% confidence interval, 1.000 to 1.015; p = 0.047). Conclusions: Increased LCD was associated with a greater possibility of VF progression. The quantitative measurement of LCD changes, determined by SD-OCT, is a potential biomarker for the prediction of VF deterioration in patients with POAG.

• Journal of Ginseng Research
• /
• 제43권2호
• /
• pp.312-318
• /
• 2019

Background: To date, no study has described disease progression in Asian patients infected with HIV-1 subtype D. Methods: To determine whether the disease progression differs in patients infected with subtypes D and B prior to starting combination antiretroviral therapy, the annual decline (AD) in $CD^{4+}$ T cell counts over $96{\pm}59months$ was retrospectively analyzed in 163 patients and compared in subtypes D and B based on the nef gene. Results: $CD^{4+}$ T cell AD was significantly higher in the six subtype D-infected patients than in the 157 subtype B-infected patients irrespective of Korean Red Ginseng (KRG) treatment (p < 0.001). Of these, two subtype D-infected patients and 116 subtype B-infected patients had taken KRG. AD was significantly lower in patient in the KRG-treated group than in those in the $KRG-na{\ddot{i}}ve$ group irrespective of subtype (p < 0.05). To control for the effect of KRG, patients not treated with KRG were analyzed, with AD found to be significantly greater in subtype D-infected patients than in subtype B-infected patients (p < 0.01). KRG treatment had a greater effect on AD in subtype D-infected patients than in subtype B-infected patients (4.5-fold vs. 1.6-fold). Mortality rates were significantly higher in both the 45 $KRG-na{\ddot{i}}ve$ (p < 0.001) and all 163 (p < 0.01) patients infected with subtype D than subtype B. Conclusion: Subtype D infection is associated with a >2-fold higher risk of death and a 2.9-fold greater rate of progression than subtype B, regardless of KRG treatment.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권3호
• /
• pp.1313-1320
• /
• 2014

Introduction: Although most prostate cancers initially respond to castration with luteinizing hormonereleasing analogues or bilateral orchiectomy, progression eventually occurs. Based on the exciting results of several randomized controlled trials (RCTs), it seems that patients with metastatic castration-resistant prostate cancer (mCRPC) might benefit more from treatment withabiraterone. Therefore we conducted a systematic review to evaluate the efficacy and toxicity of abiraterone in the treatment of mCRPC. Methods: Literature was searched from Embase, PubMed, Web of Science, and Cochrane Library up to July, 2013. Quality of the study was evaluated according to the Cochrane's risk of bias of randomized controlled trial (RCT) tool, then the Grading of Recommendations Assessment, Development and Evaluation (GRADE) System was used to rate the level of evidence. Stata 12.0 was used for statistical analysis. Summary data from RCTs comparing abiraterone plus prednisone versus placebo plus prednisone for mCRPC were meta-analyzed. Pooled hazard ratios (HRs) for overall survival (OS), radiographic progression-free survival (RPFS) and time to PSA progression (TTPP); Pooled risk ratios (RR) for PSA response rate, objective response rate and adverse event were calculated. Results: Ten trials were included in the systematic review; Data of 2,283 patients (1,343 abiraterone; 940 placebo) from two phase 3 trials: COU-AA-301 and COU-AA-302 were meta-analyzed. Compared with placebo, abiraterone significantly prolonged OS (HR, 0.74; 95% confidence interval [CI], 0.66 to 0.84), RPFS (HR, 0.59; 95% CI, 0.48 to 0.74) and time to PSA progression (HR, 0.55; 95% CI, 0.43 to 0.70); it also significantly increased PSA response rate (RR, 3.63; 95% CI, 1.72 to 7.65) and objective response rate (RR, 3.05; 95% CI, 1.51 to 6.15). This meta-analysis suggested that the adverse events caused by abiraterone are acceptable and can be controlled. Conclutios: Abiraterone significantly prolonged OS, RPFS and time to progression patients with mCRPC, regardless of prior chemotherapy or whether chemotherapy-na$\ddot{i}$ve, and no unexpected toxicity was evident. Abiraterone can serve as a new standard therapy for mCRPC.