• Journal of Korean Neurosurgical Society
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• v.49 no.1
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• pp.26-30
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• 2011

Objective: The primary objective of this study was to perform a retrospective evaluation of the radiological and pathological features influencing the formation of peritumoral brain edema (PTBE) in meningiomas. Methods: The magnetic resonance imaging (MRI) and pathology data for 86 patients with meningiomas, who underwent surgery at our institution between September 2003 and March 2009, were examined. We evaluated predictive factors related to peritumoral edema including gender, tumor volume, shape of tumor margin, presence of arachnoid plane, the signal intensity (SI) of the tumor in T2-weighted image (T2WI), the WHO histological classification (GI, GII/GIII) and the Ki-67 antigen labeling index (LI). The edema-tumor volume ratio was calculated as the edema index (EI) and was used to evaluate peritumoral edema. Results: Gender (p=0.809) and pathological finding (p=0.084) were not statistically significantly associated with peritumoral edema by univariate analysis. Tumor volume was not correlated with the volume of peritumoral edema. By univariate analysis, three radiological features, and one pathological finding, were associated with PTBE of statistical significance: shape of tumor margin (p=0.001), presence of arachnoid plane (p=0.001), high SI of tumor in T2WI (p=0.001), and Ki-67 antigen LI (p=0.049). These results suggest that irregular tumor margins, hyperintensity in T2WI, absence of arachnoid plane on the MRI, and high Ki-67 LI can be important predictive factors that influence the formation of peritumoral edema in meningiomas. By multivariate analysis, only SI of the tumor in T2WI was statistically significantly associated with peritumoral edema. Conclusion: Results of this study indicate that irregular tumor margin, hyperintensity in T2WI, absence of arachnoid plane on the MRI, and high Ki-67 LI may be important predictive factors influencing the formation of peritumoral edema in meningiomas.

• Journal of Trauma and Injury
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• v.33 no.2
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• pp.96-103
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• 2020

Purpose: In patients with trauma, rhabdomyolysis (RM) can lead to fatal complications resulting from muscle damage. Thus, RM must be immediately diagnosed and treated to prevent complications. Creatine kinase (CK) is the most sensitive marker for diagnosing RM. However, relying on CK tests may result in delayed treatment, as it takes approximately 1 hour to obtain CK blood test results. Hence, this study investigated whether the neutrophil-to-lymphocyte ratio (NLR) could predict RM at an earlier time point in patients with trauma, since NLR results can be obtained within 10 minutes. Methods: This retrospective study included 130 patients with severe trauma who were admitted to the emergency room of a tertiary institution between January 2017 and April 2020. RM was defined as a CK level ≥1,000 U/L at the time of arrival. Patients with severe trauma were categorized into non-RM and RM groups, and their characteristics and blood test results were analyzed. Statistical analysis was performed using SPSS version 26.0 for Windows. Results: Of the 130 patients with severe trauma, 50 presented with RM. In the multivariate analysis, the NLR (odds ratio [OR], 1.252; 95% confidence interval [CI], 1.130-1.386), pH level (OR, 0.006; 95% CI, 0.000-0.198), presence of acute kidney injury (OR, 3.009; 95% CI, 1.140-7.941), and extremity Abbreviated Injury Scale score (OR, 1.819; 95% CI, 1.111-2.980) significantly differed between the non-RM and RM groups. A receiver operating characteristic analysis revealed that a cut-off NLR value of 3.64 was the best for predicting RM. Conclusions: In patients with trauma, the NLR at the time of arrival at the hospital is a useful biochemical marker for predicting RM.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.6285-6288
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• 2012

Background: The aim of this study was to outline the trend in the incidence of colorectal cancer (CRC) in the city of Jeddah, Kingdom of Saudi Arabia (KSA), for comparison with previously published national CRC data. Materials and Methods: A retrospective data analysis was performed on all cases of CRC diagnosed between January 2000 and December 2006 amongst Saudi patients in Jeddah using data retrieved from the Saudi Cancer Registry (SCR). Descriptive analysis was performed and results were compared to national CRC data from the SCR. Results: In Jeddah, 644 cases of CRC were diagnosed during the time period, accounting for 15% of all CRC cases in KSA. Males were more commonly affected than females (58% versus 42%). The male preponderance of CRC was similar to that observed at a national level. In Jeddah, the incidence was higher among those >45 years (77.0%), and the mean age at diagnosis was 57 years. At diagnosis, 10% of patients presented with localized disease; 25% presented with distant metastasis and the remaining patients had various stages of regional extension. Adenocarcinomas accounted for 72% of cases. Statistical analysis did not reveal any clinically significant differences between cases diagnosed in Jeddah and those diagnosed throughout KSA. Conclusions: The increased trend in the incidence of CRC in Jeddah between 2000 and 2006 mirrors the recent trend in KSA. This highlights the magnitude of this healthcare hazard, not only in Jeddah, but also across the country and supports the need for preventive measures and early detection of the disease.

• Safety and Health at Work
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• v.8 no.2
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• pp.162-168
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• 2017

Background: Pelvic ring fractures (PRFs) may influence the daily activities and quality of life of the injured. The aim of this retrospective study was to explore the functional outcomes and factors related to return to work (RTW) after PRF. Methods: During the years 2003-2012, 282 injured individuals aged 20-55 years on the date of the accident, were hospitalized and treated for PRFs in a large tertiary hospital in Athens, Greece. One hundred and three patients were traced and contacted; 77 who were on paid employment prior to the accident gave their informed consent to participate in the survey, which was conducted in early 2015 through telephone interviews. The questionnaire included variables related to injury, treatment and activities, and the Majeed pelvic score. Univariate and multiple regression analyses were used for statistical assessment. Results: Almost half of the injured (46.7%) fully RTW, and earning losses were reported to be 35% after PRF. The univariate analysis confirmed that RTW was significantly related to accident site (labor or not), the magnitude of the accident's force, concomitant injuries, duration of hospitalization, time to RTW, engagement to the same sport, Majeed score, and complications such as limp and pain as well as urologic and sexual complaints (p < 0.05 for all). On multiple logistic regression analysis, the accident sustained out of work (odds ratio: 6.472, 95% confidence interval: 1.626-25.769) and Majeed score (odds ratio: 3.749, 95% confidence interval: 2.092-6.720) were identified as independent predictive factors of full RTW. Conclusion: PRFs have severe socioeconomic consequences. Possible predictors of RTW should be taken into account for health management and policies.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.3
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• pp.211-219
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• 2022

Backgrounds/Aims: Historically, incidence and survival analysis and annual traits for primary liver cancer (LC) has not been investigated in a population-based study in Korea. The purpose of the current study is to determine incidence, survival rate of patients with primary LC in Korea. Methods: We conducted a retrospective cohort study using Korea Central Cancer Registry based on the Korea National Cancer Incidence Database. Statistical analysis including crude rate and age-standadized rate (ASR) of incidence and mortality was performed for LC patients registered with C22 code in International Classification of Diseases, tenth revision from 1999 to 2019. Subgroup analysis was performed for hepatocellular carcinoma (HCC, C22.0) and intrahepatic cholangiocarcinoma (IHCC, C22.1). Results: The crude incidence rate of HCC (21.0 to 22.8 per 100,000) and IHCC (2.3 to 5.6 per 100,000) increased in the observed period from 1999 to 2019. The ASR decreased in HCC (20.7 to 11.9 per 100,000) but remained unchanged in IHCC (2.4 to 2.7 per 100,000). The proportion of HCC patients diagnosed in early stages (localized or regional Surveillance, Epidemiology, and End Results or SEER stage) increased significantly over time. As expected, 5-yeat survival rate of HCC was greatly improved, reaching 42.4% in the period between 2013 and 2019. This trait was more prominent in localized SEER stage. On the other hand, the proportion of IHCC patients diagnosed in localized stage remained unchanged (22.9% between 2013 and 2019), although ASR and 5-year survival rate showed minor improvements. Conclusions: A great improvement in survival rate was observed in patients with newly diagnosed HCCs. It was estimated to be due to an increase in early detection rate. On the contrary, detection rate of an early IHCC was stagnant with a minor improvement in prognosis.

• Journal of Acupuncture Research
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• v.32 no.2
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• pp.87-96
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• 2015

Objectives : The purpose of this study was to investigate the clinical effects of Dong-qi acupuncture on piriformis for herniated intervertebral disc(HIVD) of lumbar spine patients with piriformis muscles tenderness. Methods : This research was carried out on the 60 inpatients who received treatment for their HIVD of lumbar spine from January 1 to May 31, 2014 in DaeJeon Jaseng Hospital of Korean Medicine. We divided them into two groups ; group A(n=30) : common treatment on HIVD of L-spine without Dong-qi acupuncture on piriformis(acupuncture, pharmacopuncture, herb medication, Chuna and physiotherapy), and group B(n=30) : common treatment on HIVD of L-spine with Dong-qi acupuncture on piriformis. We evaluated the treatment effect of each group on tenderness(checked by Algometer pressure), and with a numeric rating scale(NRS), and oswestry disability index(ODI). The evaluations of tenderness were performed 8 times : admission day, and on the 3rd, 6th, 9th, 12th, 15th, 18th and 21st day after admission. The evaluations of NRS and ODI were performed 3 times : admission day, and on the 12th and 21st day after admission. The statistical significance was evaluated by SPSS 18.0 for Windows. Results : In group B, tenderness was significantly decreased compared with group A. The difference of tenderness from admission day to the 12th day showed significant reduction compared with group A. Conclusions : Dong-qi acupuncture is more effective in reducing piriformis muscle tenderness in the early stages of treatment. We expect that patients who receive Dong-qi acupuncture will be satisfied with Korean medical treatment and trust their doctor.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7445-7449
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• 2013

Background: Breast cancer (BC) is the one of the most common cancers in women. It is also a leading cause of death. Unfortunately, some patients initially present with distant metastases and are diagnosed with stage IV disease that is nearly always, by then, incurable. This retrospective analysis investigated the risk factors for stage IV BC that may underlie such late presentation. Materials and Methods: In all, 916 patients with BC who visited the medical oncology polyclinic of eight different centres in Turkeybetween December 2011 and January 2013 were analysed. Results: A total of 115 patients (12.6%) presented with stage IV disease. In univariate analysis; to comparing these with patients at other stages, no statistical difference was found for median diagnosis age or age at menarche (p=0.611 and p=0.820), whereas age at menopause and age at first live birth were significant (p=0.018 and p=0.003). No difference was detected in terms of accompanying diseases, use of oral contraceptives and hormone replacement therapy, smoking, alcohol consumption and the rate of family history of BC between the patients (p=0.655, p=0.389, p=0.762, p=0.813, p=0.229, p=0.737). However, screening methods were employed less often, the rate of illiteracy was higher, and the rate of other cancers was higher in patients with stage IV BC (p=0.022, p=0.022, p=0.018). No statistical difference was observed between the patients in terms of tumour histopathology, and status of oestrogen receptor, progesterone receptor, or human epidermal growth factor-2 receptor (p=0.389, p=0.326, p=0.949, p=0.326). Grade 3 tumours were more frequent in patients with stage IV disease (p<0.001). On multivariate analysis, risk factors for stage IV breast cancer at the time of presentation were found to be age at first live birth and educational level (p=0.003 and p=0.047). Conclusions: Efforts should be made to perform mammography scans, in particular, at regular intervals through national training programs for all women, particularly those with family histories of breast and other types of cancer, and to establish early diagnosis of BC long before it proceeds to stage IV. Additionally, women's education had better be upgraded. In order to make women aware of BC, national education-programmes must be organised.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.31.1-31.7
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• 2016

Background: The objective of this retrospective study was to show results from platform-switched narrow-diameter implants in the posterior edentulous region, which we followed up for more than 1 year after functional loading. Methods: Ninety-eight narrow implants were inserted into 66 patients. After healing, fixed implant-supported prostheses were delivered to the patients, and Periotest and radiographic examinations were performed. After the first year of loading, the implant outcome was again evaluated clinically and radiographically using the Periotest analysis. Crestal bone loss and Periotest values (PTVs) were used to evaluate the effect of surgery, prosthesis, implant, and a host-related factor. A general linear model was used to statistically detect variables statistically associated with crestal bone loss and Periotest value. Results: We followed up on the implants over 1 to 4 years after loading; their survival rate was 100 %, and pronounced differences from PTVs were noted among jaw location, bone quality, and loading period. No difference was detected in bone loss among the variables studied. Bone loss after functional loading was $0.14{\pm}0.39mm$. The stability value from the Periotest was $-3.29{\pm}0.50$. Conclusions: Within the limitations of this study, judicious use of platform-switched narrow implants with a conical connection must be considered an alternative for wide-diameter implants to restore a posterior edentulous region.

• Neonatal Medicine
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• v.25 no.3
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• pp.102-108
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• 2018

Purpose: Congenital diaphragmatic hernia (CDH) is rare but potentially fatal. The overall outcome is highly variable. This study aimed to identify a simple and dynamic parameter that helps predict the mortality of CDH patients in real time, without invasive tests. Methods: We conducted a retrospective chart review of 59 CDH cases. Maternal and fetal information included the gestational age at diagnosis, site of defect, presence of liver herniation, and lung-to-head ratio (LHR) at 20 to 29 weeks of gestational age. Information regarding postnatal treatment, including the number of days until surgery, the need for inhaled nitric oxide (iNO), the need for extracorporeal membrane oxygenation (ECMO), and survival, was collected. The highest respiratory severity score (RSS) within 24 hours after birth was also calculated. Results: Statistical analysis showed that a younger gestational age at the initial diagnosis (P<0.001), a lower LHR (P=0.001), and the presence of liver herniation (P=0.003) were prenatal risk factors for CDH mortality. The RSS and use of iNO and ECMO were significant factors affecting survival. In the multivariate analysis, the only remaining significant risk factor was the highest preoperative RSS within 24 hours after birth (P=0.002). The area under the receiver operating characteristic curve was 0.9375, with a sensitivity of 91.67% and specificity of 83.87% at the RSS cut-off value of 5.2. The positive and negative predictive values were 82.14% and 92.86%, respectively. Conclusion: Using the RSS as a prognostic predictor with simple calculations will help clinicians plan CDH management.

• Radiation Oncology Journal
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• v.37 no.4
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• pp.279-285
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• 2019

Purpose: This study was conducted to compare the outcome of three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) for the postoperative treatment of biliary tract cancer. Materials and Methods: From February 2008 to June 2016, 57 patients of biliary tract cancer treated with curative surgery followed by postoperative 3D-CRT (n = 27) or IMRT (n = 30) were retrospectively enrolled. Results: Median follow-up time was 23.6 months (range, 5.2 to 97.6 months) for all patients and 38.4 months (range, 27.0 to 89.2 months) for survivors. Two-year recurrence-free survival is higher in IMRT arm than 3D-CRT arm with a marginal significance (25.9% vs. 47.4%; p = 0.088). Locoregional recurrence-free survival (64.3% vs. 81.7%; p = 0.122) and distant metastasis-free survival (40.3% vs. 55.8%; p = 0.234) at two years did not show any statistical difference between two radiation modalities. In the multivariate analysis, extrahepatic cholangiocarcinoma, poorly-differentiated histologic grade, and higher stage were significant poor prognostic factors for survival. Severe treatment-related toxicity was not significantly different between two arms. Conclusions: IMRT showed comparable results with 3D-CRT in terms of recurrence, and survival, and radiotherapy toxicity for the postoperative treatment of biliary tract cancer.