• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1105-1109
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• 2012

Breast cancer is the second most common cancer in women in India and the disease burden is increasing annually. The lack of awareness initiatives, structured screening, and affordable treatment facilities continue to result in poor survival. We present a breast cancer survival scenario, in urban population in India, where standardised care is distributed equitably and free of charge through an employees' healthcare scheme. We studied 99 patients who were treated at our hospital during the period 2005 to 2010 and our follow-up rates were 95.95%. Patients received evidence-based standardised care in line with the tertiary cancer centre in Mumbai. One-, three- and five-year survival rates were calculated using Kaplan-Meier method. Socio-demographic, reproductive and tumor factors, relevant to survival, were analysed. Mortality hazard ratios (HR) were calculated using Cox proportional hazard method. Survival in this series was compared to that in registries across India and discrepancies were discussed. Patients mean age was 56 years, mean tumor size was 3.2 cms, 85% of the tumors belonged to T1 and T2 stages, and 45% of the patients belonged to the composite stages I and IIA. Overall 5-year survival was 74.9%. Patients who presented with large-sized tumors (HR 3.06; 95% CI 0.4-9.0), higher composite stage (HR 1.91; 0.55-6.58) and undergone mastectomy (HR 2.94; 0.63-13.62) had a higher risk of mortality than women who had higher levels of education (HR 0.25; 0.05-1.16), although none of these results reached the significant statistical level. We observed 25% better survival compared to other Indian populations. Our results are comparable to those from the European Union and North America, owing to early presentation, equitable access to standardised free healthcare and complete follow-up ensured under the scheme. This emphasises that equitable and affordable delivery of standardised healthcare can translate into early presentation and better survival in India.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4395-4399
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• 2016

The FLT3-ITD mutation is one of the most frequent genetic abnormalities in acute myeloid leukemia (AML) where it is associated with a poor prognosis. The FLT3-ITD mutation could, therefore, be a potential molecular prognostic marker important for risk-stratified treatment options. We amplified the FLT3 gene at exon 14 and 15 in 52 AML patients (aged between 2 months and 74 years) from 4 referral centers (a university hospital and 3 regional hospitals in Northeast Thailand), using a simple PCR method. FLT3-ITD mutations were found in 10 patients (19.2%), being more common in adults than in children (21.1% vs. 14.3%) and more prevalent in patients with acute promyelocytic leukemia (AML-M3) than AML-non M3 (4 of 10 AML-M3 vs. 6 of 42 AML-non M3 patients). Duplication sequences varied in size-between 27 and 171 nucleotides (median=63.5) and in their location. FLT3-ITD mutations with common duplication sequences accounted for a significant percentage in AML patients in northeastern Thailand. This simple PCR method is feasible for routine laboratory practice and these data could help tailor use of the national protocol for AML.

• The Korean Journal of Emergency Medical Services
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• v.15 no.3
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• pp.31-44
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• 2011

Purpose : The purpose of emergency medical services(EMS) is to save human lives and assure the completeness of the body in emergency situations. Those who have been qualified on medical practice to perform such treatment as there is the risk of human life and possibility of major physical and mental injuries that could result from the urgency of time and invasiveness inflicted upon the body. In the emergency medical activities, 119 emergency medical technicians mainly perform the task but they are not able to perform such task independently and they are mandatory to receive medical direction. The purpose of this study is to examine the recognition and request for medical direction by 119 emergency medical technicians in order to provide basic information on the development of medical direction program suitable to the characteristics of EMS as well as for the studies on EMS for the sake of efficient operation of pre-hospital EMS. Method : Questionnaire via e-mail was conducted during July 1-31, 2010 for 675 participants who are emergency medical technicians, nurses and other emergency crews in Gyeongbuk. The effective 171 responses were used for the final analysis. In regards to the emergency medical technicians' scope of responsibilities defined in Attached Form 14, Enforcement regulations of EMS, t-test analysis was conducted by using the means and standard deviation of the level of request for medical direction on the scope of responsibilities of Level 1 & Level 2 emergency medical technicians as the scale of medical direction request. The general characteristics, experience result, the reason for necessity, emergency medical technicians & medical director request level, medical direction method, the place of work of the medical director, feedback content and improvement plan request level were analyzed through frequency and percentage. The level of experience in medical direction and necessity were analyzed through ${\chi}^2$ test. Results : In regards to the medical direction experience per qualification, the experience was the highest with 53.3% for Level 1 emergency medical technicians and 80.3% responded that experience was helpful. As for the recognition on the necessity of medical direction, 71.3% responded as "necessary" and it turned out to be the highest of 76.9% in nurses. As for the reason for responding "necessary", the reason for reducing the risk and side-effects from EMS for patients was the largest(75.4%), and the reason of EMS delay due to the request of medical direction was the highest(71.4%) for the reason for responding "not necessary". In regards to the request level of the task scope of emergency medical technicians, injection of certain amount of solution during a state of shock was the highest($3.10{\pm}.96$) for Level 1 emergency rescuers, and the endotracheal intubation was the highest($3.12{\pm}1.03$) for nurses, and the sublingual administration of nitroglycerine(NTG) during chest pain was the highest($2.62{\pm}1.02$) for Level 2 emergency medical technicians, and regulation of heartbeat using AED was the highest($2.76{\pm}.99$) for other emergency crews. For the revitalization of medical direction, the improvement in the capability of EMS(78.9%) was requested from emergency crew, and the ability to evaluate the medical state of patient was the highest(80.1%) in the level of request for medical director. The prehospital and direct medical direction was the highest(60.8%) for medical direction method, and the emergency medical facility was the highest(52.0%) for the placement of medical director, and the evaluation of appropriateness of EMS was the highest(66.1%) for the feedback content, and the reinforcement of emergency crew(emergency medical technicians) personnel was the highest(69.0%) for the improvement plan. Conclusion : The medical direction is an important policy in the prehospital EMS activity because 119 emergency medical technicians agreed the necessity of medical direction and over 80% of those who experienced medical direction said it was helpful. In addition, the simulation training program using algorithm and case study through feedback are necessary in order to enhance the technical capability of ambulance teams on the item of professional EMS with high level of request in the task scope of emergency medical technicians, and recognition of medical direction is the essence of the EMS field. In regards to revitalizing medical direction, the improvement of the task performance capability of 119 emergency medical technicians and medical directors, reinforcement of emergency medical activity personnel, assurance of trust between emergency medical technicians and the emergency physician, and search for professional operation plan of medical direction center are needed to expand the direct medical direction method for possible treatment beforehand through the participation by medical director even at the step in which emergency situation report is received.

• Tuberculosis and Respiratory Diseases
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• v.49 no.2
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• pp.169-178
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• 2000

Background : Usually fever subsides within one week in over 90% of pulmonary tuberculosis (TBp) patients after the start of short-course anti-tuberculosis therapy, but occasionally it persists over two weeks after treatment. When the fever persists, drug resistance, combined infection, or drug fever, and so on, are considered as an etiology and, in some cases, drugs are changed. But inadvertent discontinuation of a short-course regimen inevitably will extend the duration of treatment, and the treatment completion may be delayed. This study was performed to investigate the causes of prolonged fever (PF) and to identify the predictors of PF in drug-susceptible TBp patients in Korea. Method : Five hundred-ninety-eight patients, who were admitted to Asan Medical Center from January 1996 to March 1999, diagnosed with TBp and prescribed short-course, anti-tuberculosis treatment, were reviewed. PF was defined as having fever over two weeks despite treatment. The causes of PF were analyzed. Drug-sus-ceptible TBp patients who presented no causes for PF, except turberculosis itself, were selected(n=22), and they were compared with those who had no fever at diagnosis (n=22) and those who had fever at diagnosis, which had subsided within two weeks after treatment (n=22). Clinical, laboratory, and radiological parameters were compared among the three groups. Results : Twenty-eight (4.8%) of 598 patients showed PF over two weeks despite short-course treatment. The causes of PF were drug fever (n=2), multi-drug resistant tuberculosis (n=3), disseminated Mycobacterium kansasii infection (n=1), and drug-susceptible tuberculosis itself (n=22). The patients with PF had more risk factors for tuberculosis, long duration of symptoms before treatment, night sweats, weight long, numerous acid fast bacilli on sputum smear, anemia, hyponatremia, hypoalbuminemia, over three lung cavity numbers and extensive infiltration, indicating that they had prolonged and extensive lung diseases. Conclusion : The main cause of PF in TBp despite short-course regimen seems to be drug-susceptible but extensive disease in Korea. Any changes to the drug regiment provided for TBp patients with prolonged fever despite treatment should be carefully considered.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.1601-1607
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• 2013

A determination of circulating tumor cell (CTC) effectiveness for prediction of progression-free survival (PFS) and overall survival (OS) was conducted as an adjunct to standard treatment of care in breast cancer management. Between November 2008 and March 2009, 22 metastatic and 12 early stage breast carcinoma patients, admitted to Ankara Oncology Training and Research Hospital, were included in this prospective trial. Patients' characteristics, treatment schedules and survival data were evaluated. CTC was detected twice by CellSearch method before and 9-12 weeks after the initiation of chemotherapy. A cut-off value equal or greater than 5 cells per 7.5 ml blood sample was considered positive. All patients were female. Median ages were 48.0 (range: 29-65) and 52.5 (range: 35-66) in early stage and metastatic subgroups, respectively. CTC was positive in 3 (13.6%) patients before chemotherapy and 6 (27.3%) patients during chemotherapy in the metastatic subgroup whereas positive in only one patient in the early stage subgroup before and during chemotherapy. The median follow-up was 22.0 (range: 21-23) and 19.0 (range: 5-23) months in the early stage and metastatic groups, respectively. In the metastatic group, both median PFS and OS were significantly shorter in any time CTC positive patients compared to CTC negative patients (PFS: 4.0 vs 14.0 months, Log-Rank p=0.013; and OS: 8.0 months vs. 20.5 months, Log-Rank p<0.001). OS was affected from multiple visceral metastatic sites (p=0.055) and higher grade (p=0.044) besides CTC positivity (log rank p<0.001). Radiological response of chemotherapy was also correlated with better survival (p<0.001). As a result, CTC positivity was confirmed as a prospective marker even in a small patient population, in this single center study. Measurement of CTC by CellSearch method in metastatic breast carcinoma cases may allow indications of early risk of relapse or death with even as few as two measurements during a chemotherapy program, but this finding should be confirmed with prospective trials in larger study populations.

• Journal of Veterinary Clinics
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• v.27 no.6
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• pp.740-745
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• 2010

Patent ductus arteiosus (PDA) is the persistent opening of ductus arterious located between pulmonary artery and descending aorta after birth. Although PDA can be occluded by surgical ligation, interventional closure of PDA using various devices is being rapidly replaced to surgical ligation, because of its non-invasive nature of treatment and minimal post-care after treatment. Main problem encountering in interventional treatment in toy breed dogs is vascular inaccessibility due to small size of artery. Although transvenous approach using jugular veins has been developed, this technique requires experienced skill to locate occlude devices into PDA and has high risk of accidental dislodgement of occluding devices (i.e. embolization coils or vascular plugs). Therefore, in this study, we developed a modified technique for coil embolization using mini-angiocatheter with trans-femoral approach in toy breed dogs (< 3.0 kg of body weight). With this modified method, we were successfully treated two toy breed (Maltese) dogs with the left to right shunted PDA.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.9
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• pp.3595-3604
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• 2015

Hepatocellular carcinoma (HCC) has been one of the most fatal malignant tumors worldwide and its associated morbidity and mortality remain of significant concern. Based on in-depth reviews of serological diagnosis of HCC, in addition to AFP, there are other biomarkers: Lens culinaris agglutinin-reactive AFP (AFP-L3), descarboxyprothrombin (DCP), tyrosine kinase with Ig and eprdermal growth factor (EGF) homology domains 2 (TIE2)-espressing monocytes (TEMs), glypican-3 (GPC3), Golgi protein 73 (GP73), interleukin-6 (IL-6), and squamous cell carcinoma antigen (SCCA) have been proposed as biomarkers for the early detection of HCC. The diagnosis of HCC is primarily based on noninvasive standard imaging methods, such as ultrasound (US), dynamic multiphasic multidetector-row CT (MDCT) and magnetic resonance imaging (MRI). Some experts advocate gadolinium diethyl-enetriamine pentaacetic acid (Gd-EOB-DTPA) MRI and contrast-enhanced US as the promising imaging madalities of choice. With regard to recent advancements in tissue markers, many cuting-edge technologies using genome-wide DNA microarrays, qRT-PCR, and proteomic and inmunostaining studies have been implemented in an attempt to identify markers for early diagnosis of HCC. Only less than half of HCC patients at initial diagnosis are at an early stage treatable with curative options: local ablation, surgical resection, or liver transplant. Transarterial chemoembolization (TACE) is considered the standard of care with palliation for intermediate stage HCC. Recent innovative procedures using drug-eluting-beads and radioembolization using Yttrium-90 may exhibit beneficial effects in HCC treatment. During the past few years, several molecular targeted agents have been evaluated in clinical trials in advanced HCC. Sorafenib is currently the only approved systemic treatment for HCC. It has been approved for the therapy of asymptomatic HCC patients with well-preserved liver function who are not candidates for potentially curative treatments, such as surgical resection or liver transplantation. In the USA, Europe and particularly Japan, hepatitis C virus (HCV) related HCC accounts for most liver cancer, as compared with Asia-Pacific regions, where hepatitis B virus (HBV) may play a more important role in HCC development. HBV vaccination, while a vaccine is not yet available against HCV, has been recognized as a best primary prevention method for HBV-related HCC, although in patients already infected with HBV or HCV, secondary prevention with antiviral therapy is still a reasonable strategy. In addition to HBV and HCV, attention should be paid to other relevant HCC risk factors, including nonalcoholic fatty liver disease due to obesity and diabetes, heavy alcohol consumption, and prolonged aflatoxin exposure. Interestingly, coffee and vitamin K2 have been proven to provide protective effects against HCC. Regarding tertiary prevention of HCC recurrence after surgical resection, addition of antiviral treatment has proven to be a rational strategy.

• Journal of the Korean Society of School Health
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• v.24 no.2
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• pp.141-154
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• 2011

Purpose: The purpose is to provide basic information for establishing improvements on performance-based pay's evaluation method of health teachers. Methods: For subjects, 200 teachers at public elementary schools and 200 health teachers at public elementary schools in Gyeonggi-do were conveniently sampled, and then surveyed through a questionnaire. The questionnaire was to recognize recognition of teachers working under the teacher's performance-based pay system, which was quoted in the questionnaire of Choi ji-hye (2005) and Lee mi-gyeong (2008). Inquiry for the recognition of teachers on evaluation of health teacher's performance-based pay system and improvements on the performance-based pay's evaluation method of health teachers were used after consultation with five incumbent health teachers and a review with the thesis director. Results: The performance-based pay's evaluation method of health teachers has the same method with general teachers in schools, so it is not fair to evaluate the performance of health teachers. The ways to improve the performance-based pay evaluation method of health teachers is as follows: first, the approval on improving 'the number of class hours' which is a detailed item of a teacher's performance evaluation criterion to 'the number of health lesson hours per week and the number of students visiting the school infirmary per week'; second, improving 'life guidance' into 'counseling results of medically-treated students, parents of students and personal hygiene guidance'; third, improving 'a teacher in charge' into 'awarding of points by being recognized as a health teacher in charge of all students and considering the economic situation of the region,; forth, improving 'difficulty of position' into 'the number of health-teacher's annual promotion task items and the treatment number of issuing and receiving of official documents', and improving the 'task difficulty' into 'importance and urgency of emergency patient management, risk level and urgency of infectious diseases and avoiding work in charge' appeared to be more than 90% respectively. Conclusion: The performance-based pay system of teachers being carried out every year should be executed by preparing fair evaluation criteria suitable for task properties and the role of health teachers with different evaluation criteria compared to general teachers.

• Journal of Food Hygiene and Safety
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• v.38 no.3
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• pp.123-130
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• 2023

Salmonella spp. are prevalent foodborne pathogens that are infective at relatively low concentrations, thus posing a serious health threat, especially to young children and the elderly. In several countries, the management and regulation of Salmonella spp. in food, including seafood, adhere to a negative detection standard. The risk of infection is particularly high when seafood is consumed raw, which underscores the importance of timely detection of pathogenic microorganisms, such as Salmonella. Accordingly, this study aimed to develop a combined pre-treatment and detection method that includes pre-culture and DNA extraction in order to detect five species of Salmonella at concentrations below 10 CFU/mL in seafood. The effectiveness of the proposed method was assessed in terms of the composition of the enrichment (pre-culture) medium, minimum incubation time, and minimum cell concentration for pathogen detection. Furthermore, a practical DNA extraction method capable of effectively handling high salt conditions was tested and found to be successful. Through polymerase chain reaction, Salmonella spp. Were detected and positively identified in shellfish samples at cell concentrations below 10 CFU/g. Thus, the proposed method, combining sample pre-treatment and cell culture with DNA extraction, was shown to be an effective strategy for detecting low cellular concentrations of harmful bacteria. The proposed methodology is suitable as an economical and practical in situ pre-treatment for effective detection of Salmonella spp. in seafood.

• Journal of the Korean Applied Science and Technology
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• v.36 no.3
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• pp.915-929
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• 2019

This study attempted to investigate the effects of natural henna-treated permanent wave on degree of damage and morphological changes of hair. For this, amino acid was analyzed, and hair thickness and surface were observed through SEM. In addition, hair curl formation & retention, methylene blue coloring, tensile strength and elongation were measured. The results found the followings: Total amino acid contents rose as the number of natural henna treatment increased, hair protection effects are expected. In terms of curl formation, in an experimental group hair became more elastic as the number of natural henna treatment increased, compared to a control group. In both control and experimental groups, hair retention decreased as shampooing frequency increased because of extension of (C) and (C)', According to analysis of hair thickness using SEM, hair became thick in an experimental group after natural henna treatment, compared to a control group. In morphological observation of hair surface, it was mostly clean, and cuticle was tidy and healthy. In methylene blue coloring, as the number of natural henna treatment increased, absorbance went up. In addition, tensile strength declined in an experimental group, compared to a control group. As the number of natural henna treatment increased, elongation in an experimental group increased, compared to a control group. The above results show that as the number of natural henna treatment increased, hair became thicker, and curl formation and retention improved. In addition, hair elasticity and flexibility were enhanced, reducing a risk of hair damage. Therefore, the study results would be available as basic data in reducing scalp and hair damage, proposing the natural henna treatment as a method to reduce hair damage from chemical perm in cosmetology industry.