• Title/Summary/Keyword: Progression risk

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Risk Assessment and Pharmacogenetics in Molecular and Genomic Epidemiology

  • Park, Sue-K.;Choi, Ji-Yeob
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.6
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    • pp.371-376
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    • 2009
  • In this article, we reviewed the literature on risk assessment (RA) models with and without molecular genomic markers and the current utility of the markers in the pharmacogenetic field. Epidemiological risk assessment is applied using statistical models and equations established from current scientific knowledge of risk and disease. Several papers have reported that traditional RA tools have significant limitations in decision-making in management strategies for individuals as predictions of diseases and disease progression are inaccurate. Recently, the model added information on the genetic susceptibility factors that are expected to be most responsible for differences in individual risk. On the continuum of health care, from diagnosis to treatment, pharmacogenetics has been developed based on the accumulated knowledge of human genomic variation involving drug distribution and metabolism and the target of action, which has the potential to facilitate personalized medicine that can avoid therapeutic failure and serious side effects. There are many challenges for the applicability of genomic information in a clinical setting. Current uses of genetic markers for managing drug therapy and issues in the development of a valid biomarker in pharmacogenetics are discussed.

Factors Related to High Risk Drinking in Adult Drinkers by Age Group (연령군별 성인 음주자의 고위험음주 관련 요인)

  • Lee, Eun Sook;Seo, Yeong-Mi
    • Journal of East-West Nursing Research
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    • v.27 no.1
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    • pp.51-60
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    • 2021
  • Purpose: The purpose of this study was to identify factors associated with high risk drinking in adults. Methods: Multi-variate logistic regression was used to analyze the data of 15,949 adults age 19 years or older from the sixth (2013-2015) Korea National Health and Nutrition Examination Survey. Results: Factors associated with high risk drinking included education level, employment and smoking status among the age group of 19-39. In the 40-59 year age group, the associated factors were gender, employment, smoking, obesity, and depressive mood. In the over 60 year age group, related factors included gender, employment, smoking, abdominal obesity, and subjective health status. Conclusion: The result of this study suggests that early risk factor screening may be helpful to avoid the progression to high-risk drinking. An individualized approach for each age group can be used as a preventive measure.

Current Advancement of Oral Cancer Research and its Clinical Implications (구강암의 연구동향 및 임상적 의의)

  • Kwon, Tae-Geon;Kim, Chin-Soo
    • The Journal of the Korean dental association
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    • v.48 no.8
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    • pp.576-586
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    • 2010
  • Recent advancement in molocular biology enhanced further understanding of the carcinogenesis of oral cancer and its relation with various genetic backgrounds. Familial risk factors includes similar habits of the family and polymorphic variations of the genes. Recently, human papilloma virus has been suggested to be linked with oral cancer progression. Enhancement of understanding of the damage or alteration in molecular pathway in various cellular response of oral cancer progression would lead the targeted therapy or precise early diagnosis of the oral cancer.

The latest development in Dementia (치매에 관한 최근의 연구 동향)

  • Na, Chang-Su;Kim, Jeong-Sang;Chae, U-Seok;Park, Seok-Cheon
    • The Journal of Internal Korean Medicine
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    • v.19 no.1
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    • pp.291-300
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    • 1998
  • Dementia is the neurodegenerative process that affects cognition, behavior and function and one of the most prominent diseases of dementia is Alzheimer's disease(AD). AD is a dementing illness characterized clinically by the progressive and irreversible deafferentation of the limbic system, association neocortex and basal forebrain. A number of conditions are known to be predisposing risk factors for AD. In several of these, initiation of glial-mediated inflammatory pathways as a mechanism of AD is getting a lot of attention. On the other hand, a biochemical marker for monitoring the onset and progression of the disease would be a valuable tool for disease management. Also such a marker might be used as an end point in clinical intervention protocols. This biochemical marker will have the potential for identifying subjects afflicted with the disease and possibly for monitoring the onset and longitudinal progression of the disease. Here we have reviewed the latest papers of different approaches to AD. Of course, there is a section of PET which is very useful clinically nowadays.

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Review of Bladder cancer (방광암의 이해)

  • You, Hyun Wook
    • The Journal of the Korean life insurance medical association
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    • v.33 no.2
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    • pp.18-24
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    • 2014
  • Bladder cancer is one of the most common cancers affecting men and women and thus has a profound impact on health care. The majority of patients (75%) with newly diagnosed urothelial tumors have non-muscle invasive disease confined to the bladder mucosa or the lamina propria. The most important risk factors for the development of bladder cancer are smoking and occupational exposure to toxic chemicals. Painless visible hematuria is the most common presenting symptom of bladder cancer. Cystoscopy and urine cytology are currently the recommended tools for diagnosis of bladder cancer. Excluding muscle invasion is an important diagnostic step, as outcomes for patients with muscle invasive bladder cancer (MIBC) are less favorable. For non-muscle invasive bladder cancer (NMIBC), the high rate and frequency of recurrence and the concern for disease progression - especially in patients with high-risk tumors - mandate careful strategies for tumor surveillance. The surveillance strategies should be based on available prognostic factors and in particular data from the EORTC risk tables.

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Examining the Role of Psychosocial Stressors in Hypertension

  • Komal, Marwaha
    • Journal of Preventive Medicine and Public Health
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    • v.55 no.6
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    • pp.499-505
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    • 2022
  • Despite advances in medicine and preventive strategies, fewer than 1 in 5 people with hypertension have the problem under control. This could partly be due to gaps in fully elucidating the etiology of hypertension. Genetics and conventional lifestyle risk factors, such as the lack of exercise, unhealthy diet, excess salt intake, and alcohol consumption, do not fully explain the pathogenesis of hypertension. Thus, it is necessary to revisit other suggested risk factors that have not been paid due attention. One such factor is psychosocial stress. This paper explores the evidence for the association of psychosocial stressors with hypertension and shows that robust evidence supports the role of a chronic stressful environment at work or in marriage, low socioeconomic status, lack of social support, depression, anxiety, post-traumatic stress, childhood psychological trauma, and racial discrimination in the development or progression of hypertension. Furthermore, the potential pathophysiological mechanisms that link psychosocial stress to hypertension are explained to address the ambiguity in this area and set the stage for further research.

Long Term Proton Pump Inhibitor Use and Gastric Cancer (장기간 양성자펌프억제제의 사용과 위암)

  • Seung In Seo
    • Journal of Digestive Cancer Research
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    • v.10 no.1
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    • pp.9-15
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    • 2022
  • Proton pump inhibitors (PPIs), a potent gastric acid inhibitor, are widely used in gastric acid-related diseases such as gastroesophageal reflux disease and peptic ulcer, and are known as the most frequently used drugs worldwide. However, as the frequency of use increases, the number of cases of long-term PPI therapy without clear indications is increasing. Recently, there have been concerns about the risk of gastric cancer in patients with long-term PPI users. Potential mechanisms for the association between PPI and gastric cancer include enterochromaffin-like cell proliferation due to hypergastrinemia caused by gastric acid suppression, progression of atrophic gastritis, and corpus-predominant type through interaction with Helicobacter pylori (H. pylori) infection. Several epidemiologic studies showed controversial results on the issue, and it is difficult to prove a causal relationship between PPI and gastric cancer. Nevertheless, long-term PPI should be administered cautiously based on individual risk-benefit profile, specifically among those with history of H. pylori infection, in high-risk region of gastric cancer.

Is Routine Repeated Head CT Necessary for All Pediatric Traumatic Brain Injury?

  • Kim, Won-Hyung;Lim, Dong-Jun;Kim, Se-Hoon;Ha, Sung-Kon;Choi, Jong-Il;Kim, Sang-Dae
    • Journal of Korean Neurosurgical Society
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    • v.58 no.2
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    • pp.125-130
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    • 2015
  • Objective : Repeated computed tomography (CT) follow up for traumatic brain injury (TBI) patients is often performed. But there is debate the indication for repeated CT scans, especially in pediatric patients. Purpose of our study is to find risk factors of progression on repeated CT and delayed surgical intervention based on the repeated head CT. Methods : Between March, 2007 and December, 2013, 269 pediatric patients (age 0-18 years) had admitted to our hospital for head trauma. Patients were classified into 8 subgroups according to mechanisms of injury. Types, amount of hemorrhage and amount changes on repeated CT were analyzed as well as initial Glasgow Coma Scale (GCS) scores. Results : Within our cohort of 269 patients, 174 patients received repeat CT. There were progression in the amount of hemorrhage in 48 (27.6%) patients. Among various hemorrhage types, epidural hemorrhage (EDH) more than 10 cc measured in initial CT was found to be at risk of delayed surgical intervention significantly after routine repeated CT with or without neurological deterioration than other types of hemorrhage. Based on initial GCS, severe head trauma group (GCS 3-8) was at risk of delayed surgical intervention after routine repeated CT without change of clinical neurologic status. Conclusion : We suggest that the patients with EDH more than 10 cc or GCS below 9 should receive repeated head CT even though absence of significant clinical deterioration.

Columnar variant of papillary carcinoma in the thyroglossal duct cyst with progression to lung metastasis

  • Yun, Yujung;Park, Hye Jung;Lee, Young Ki;Cho, Yongin;Kang, Beoduel;Kim, Hyun Ju;Lee, Jung-Hee;Jin, Moo-Nyun;Shin, Dong Yeob
    • Journal of Yeungnam Medical Science
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    • v.31 no.2
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    • pp.103-108
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    • 2014
  • Thyroglossal duct cyst (TGDC) carcinoma generally shows a favorable prognosis. If metastasis is present latently, it may not threaten the patient's life immediately. It has been shown, however, that larger than 1 cm papillary carcinoma (PC), level VI metastasis to the lymph node (LN), which is the nearest to the thyroid, independently predicts a worse prognosis. In the case presented herein, a 61-year-old female patient was diagnosed with an about 3 cm PC in the TGDC, particularly the columnar variant subtype, one of the aggressive variants. She had occult papillary thyroid microcarcinoma, but no LN metastasis. Even though she underwent the Sistrunk procedure and total thyroidectomy with central compartment neck dissection followed by high-dose radioactive iodine remnant ablation, however, the cancer cells spread to level IV neck LN, and finally to the lung. Therefore, when a patient is diagnosed with an aggressive histologic variant of PC in the TGDC, even without LN metastasis, the invasive surgical approach and close postoperative surveillance are necessary, with consideration of the risk of disease progression. Therefore, if it is possible to stratify the risk for patients, higher-risk patients can be offered a more invasive therapeutic approach.

Categorizing accident sequences in the external radiotherapy for risk analysis

  • Kim, Jonghyun
    • Radiation Oncology Journal
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    • v.31 no.2
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    • pp.88-96
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    • 2013
  • Purpose: This study identifies accident sequences from the past accidents in order to help the risk analysis application to the external radiotherapy. Materials and Methods: This study reviews 59 accidental cases in two retrospective safety analyses that have collected the incidents in the external radiotherapy extensively. Two accident analysis reports that accumulated past incidents are investigated to identify accident sequences including initiating events, failure of safety measures, and consequences. This study classifies the accidents by the treatments stages and sources of errors for initiating events, types of failures in the safety measures, and types of undesirable consequences and the number of affected patients. Then, the accident sequences are grouped into several categories on the basis of similarity of progression. As a result, these cases can be categorized into 14 groups of accident sequence. Results: The result indicates that risk analysis needs to pay attention to not only the planning stage, but also the calibration stage that is committed prior to the main treatment process. It also shows that human error is the largest contributor to initiating events as well as to the failure of safety measures. This study also illustrates an event tree analysis for an accident sequence initiated in the calibration. Conclusion: This study is expected to provide sights into the accident sequences for the prospective risk analysis through the review of experiences.