• Title/Summary/Keyword: Risk grade

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Risk and protective factors affecting sensory recovery after breast reconstruction

  • Bae, Jae Young;Shin, Ha Young;Song, Seung Yong;Lee, Dong Won
    • Archives of Plastic Surgery
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    • v.48 no.1
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    • pp.26-32
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    • 2021
  • Background Although loss of sensation in patients with breast cancer after mastectomy followed by breast reconstruction is an important factor affecting patients' quality of life, the mechanism of sensory recovery is still unclear. Our study aimed to identify variables that affect sensory recovery, especially pain, in reconstructed breasts. Methods All patients with breast cancer who underwent mastectomy followed by immediate breast reconstruction, including nipple reconstruction or areolar tattooing, were included in this study. Sensation was evaluated in the nipple as an endpoint of sensation recovery of the whole breast. Patients rated pain severity using a 3-point verbal rating scale (VRS): grade 0, no pain; grade 1, mild to moderate pain; and grade 2, severe pain. The VRS was assessed by a single experienced plastic surgeon. Results In the univariate analysis, the odds ratio (OR) for sensation recovery was 0.951 for age (P=0.014), 0.803 for body mass index (P=0.001), 0.996 for breast volume before surgery (P=0.001), 0.998 for specimen weight after mastectomy (P=0.040), and 1.066 for the period between mastectomy and sensory assessment (P=0.003). In the multivariate analysis, the variables that showed a significant effect were age (OR, 0.953; P=0.034), the period between mastectomy and sensory assessment (OR, 1.071; P=0.006), and reconstruction using abdominal tissue instead of prosthetic reconstruction (OR, 0.270; P=0.004). Conclusions Based on our results, it can be inferred that aging has a negative impact on the recovery of sensation, breast sensation improves with time after surgery, and the recovery of sensation is better in prosthetic reconstruction.

The Metabolic Syndrome is Associated with More Aggressive Prostate Cancer

  • Ozbek, Emin;Otunctemur, Alper;Dursun, Murat;Sahin, Suleyman;Besiroglu, Huseyin;Koklu, Ismail;Erkoc, Mustafa;Danis, Eyyup;Bozkurt, Muammer
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.9
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    • pp.4029-4032
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    • 2014
  • Purpose: The aim of this study was to analyze any association between the metabolic syndrome (MetS) and risk of prostate cancer (PCa) and cancer grade among men undergoing radical prostatectomy for PCa. Materials and Methods: 50 patients with MetS and 50 patients without MetS who undervent radical prostatectomy (RP) were included in the study. Age at biopsy, height, weight, digital rectal examination (DRE), pre-biopsy PSA levels, prostate volume, histopathologic diagnosis after surgery and gleason scores were collected data from all patients. Histologic material obtained at biopsy was given a Gleason score; tumours with a Gleason score ${\geq}7$ were considered high grade and <7 were considered low grade. Results: The mean age at the time of biopsy was $63.7{\pm}5.94$ in patients with MetS and $61.6{\pm}6.14$ in patients without MetS. Men with MetS had significantly lower PSA levels (p=0.01) ($7.21{\pm}2.74$ and $8.81{\pm}2.72$, respectively). Also, the men with MetS had higher RP tumor grade (p=0.04). Conclusions: Men with MetS undergoing RP have lower PSA levels and have significantly higher grade PCa. We must be careful for screening PCa in patients with MetS. Although the patients had lower PSA levels, they may have high grade disease.

Evaluation of Hemoglobin A1c Levels in Endometrial Cancer Patients: a Retrospective Study in Turkey

  • Karaman, Erbil;Karaman, Yasemin;Numanoglu, Ceyhun;Ark, Hasan Cemal
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.1817-1820
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    • 2015
  • Background: Hemoglobin A1c(HgA1c) is a marker of poor gylcemic control and elevation HgA1c is associated with increased risk of many cancers. We aimed to determine the HgA1c levels in endometrial cancer cases and any relationship with stage and grade of disease. Materials and Methods: A retrospective data review was performed between June 2011 and October 2012 at a tertiary referral center in Turkey. The study included 35 surgically staged endometrial cancer patients and 40 healthy controls. Preoperative HgA1c levels drawn within 3 months before surgery were compared. Also the relationships between HgA1c levels and stage, grade and hystologic type of cancer cases were evaluated. Results: The mean HgA1c levels were statistically significantly higher at $6.19{\pm}1.44$ in endometrial cancer cases than the $5.61{\pm}0.58$ in controls (p=0.027). With endometrial cancer cases, the mean HgA1c level was found to be $6.62{\pm}1.40$ for stage I and $6.88{\pm}1.15$ for stages II-IV (p=0.07). The figures were $6.74{\pm}1.65$ for endometrioid and $6.63{\pm}1.41$ for non-endometrioid type tumors (p=0.56). Mean HgA1c levels of $6.72{\pm}1.14$ for grade 1 and $6.62{\pm}1.42$ for grade 2-3 were observed (p=0.57). Conclusions: HgA1c levels in endometrial cancer patients were statistically higher than healthy controls. However, HgA1c did not show any significant correlation with stage, grade and histologic type in endometrial cancer cases.

Surgical Outcome of Spinal Canal Meningiomas

  • Yoon, Sang-Hoon;Chung, Chun-Kee;Jahng, Tae-Ahn
    • Journal of Korean Neurosurgical Society
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    • v.42 no.4
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    • pp.300-304
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    • 2007
  • Objective : We report experiences and clinical outcomes of 61 cases with spinal canal meningiomas from January 1970 through January 2005. Methods : Thirty-eight patients were enrolled with follow-up duration of more than one year after surgery. There were 7 male and 31 female patients. The mean age was 52 years (range, 19 to 80 years). All patients underwent microsurgical resection using a posterior approach. Results : Twenty-nine (79.4%) cases experienced clinical improvement after surgery. The extent of tumor resection at the first operation was Simpson Grade I in 10 patients, Grade II in 17, Grade III in 4, Grade IV in 6, and unknown in one. We did not experience recurrent cases with Simpson grade I, II, or III resection. There were 6 recurrent cases, consisting of 5 cases with an extent of Simpson grade IV and one with an unknown extent. The mean duration of recurrence was 100 months after surgery. Radiation therapy was administered as a surgical adjunct in four patients (10.5%). Two cases were recurrent lesions that could not be completely resected. The other two cases were malignant meningiomas. No immediate postoperative death occurred in the patient group. Conclusion : We experienced no recurrent cases of intraspinal meningiomas once gross total resection has been achieved, regardless of the control of the dural origin. Surgeons do not have to take the risk of causing complication to the control dural origin after achieving gross total resectioning of spinal canal meningioma.

Longitudinal Effects of Preschool Children's Media Exposure and Maternal Depression on School Adjustment during First Grade: Mediating Effect of Attention Problem (취학 전 미디어 노출과 어머니의 우울이 초등학교 1학년의 학교 적응에 미치는 종단적 영향: 주의집중문제의 매개효과)

  • Suh, Bo Lim;Han, Heesoo;Kim, Tae Ryun;Jo, Jinsil;Kang, Min Ju
    • Human Ecology Research
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    • v.58 no.2
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    • pp.267-278
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    • 2020
  • This study examined the longitudinal effect of preschool children's media exposure and maternal depression on first-grade children's school adjustment and the mediating effect of attention problem. Longitudinal data from the Panel Study of Korean Children (PSKC) collected by the Korea Institute of Child Care and Education (KICCE) was used to examine this hypothetical model. The subjects of the study included 2,150 children (1,091 boys and 1,059 girls) and their mothers across 2013 (5 yrs.) through 2015 (7 yrs.). The Structural Equation Model (SEM) was estimated using SPSS 25.0 and Amos 25. The results of this study were as follows. First, higher level of preschool children's media exposure and maternal depression were related to higher attention problems after a year and lower level of children's school adjustment during first-grade. Second, preschool children's media exposure and maternal depression had an indirect effect on first-grade children's school adjustment via attention problem. The results of this study will provide supporting evidence to many educators and parents for the implementation of effective practices for first-grade children to enhance their school adjustment. Furthermore, this study emphasizes the importance of maternal psychological wellbeing and the risk of indiscriminate media exposure during early childhood on first-grade's school adjustment.

Anterior Choroidal Artery Aneurysm Surgery : Ischemic Complications and Clinical Outcomes Revisited

  • Lee, Young-Sup;Park, Jaechan
    • Journal of Korean Neurosurgical Society
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    • v.54 no.2
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    • pp.86-92
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    • 2013
  • Objective : Surgical results for anterior choroidal artery (AChA) aneurysms have previously been reported as unsatisfactory due to inadvertent occlusion of the AChA, while the low incidence of AChA aneurysms hampers the accumulation of surgical experience. The authors reviewed their related surgical experience to document the ischemic complications and surgical outcomes. Methods : Identification of the AChA at its origin by rigorous visual scrutiny, careful microdissection, and meticulous clip placement to avoid the AChA origin are all crucial surgical maneuvers. A retrospective review of a surgical series of 62 consecutive cases of an AChA aneurysm between 2004 and 2012 was performed. Results : All patients, except for five (8.1%) with a small residual neck, showed complete aneurysm obliteration in postoperative angiographic evaluations. There was no incidence of procedure-related permanent AChA syndrome or oculomotor nerve palsy, while three (4.8%) patients suffered from transient AChA syndrome. The clinical outcomes [the 3-month modified Rankin Scale (mRS)] of the patients were related to their preoperative World Federation of Neurologic Surgeons (WFNS) grade. As regards the 3-month mRS, significant differences were found between patients with an unruptured aneurysm (WFNS grade 0; n=20), good-grade subarachnoid hemorrhage (WFNS grade 1-3; n=30), and poor-grade subarachnoid hemorrhage (WFNS grade 4-5; n=4). Conclusion : In surgical treatment of AChA aneurysms, a risk of AChA insufficiency can be minimized by taking every precaution to preserve the AChA patency and intraoperative monitoring. In addition, the surgical outcome is primarily determined by the preoperative clinical state.

Trends in the Prevalence of Health Risk Behaviors among Korean Adolescents, 2005-2009: The Korea Youth Risk Behavior Web-based Survey (청소년건강행태온라인조사 자료를 활용한 국내 청소년 건강행태 동향 분석)

  • Kim, Keon-Yeop;Park, Soon-Woo;Kim, Jong-Yeon;Bae, Ji-Suk;Lee, Won-Kee;Jeong, Seong-Hwa;Kim, Ki-Su;Kim, Yeon-Hee;Park, Sun-Min
    • Korean Journal of Health Education and Promotion
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    • v.29 no.1
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    • pp.13-25
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    • 2012
  • Objectives: The aim of this study was to measure secular trends in health risk behaviors among middle and high school students in Korea between 2005 and 2009 by using data from the Korea Youth Risk Behavior Web-based Survey(KYRBS). Methods: The analyses were performed using data from the 2005, 2006, 2007, 2008, and 2009 KYRBS, which included a nationally representative sample of middle and high school students. A total of 34 health behavior indices were used for the assessment of secular trends in health risk behaviors. Logistic regression models were used to identify statistically significant secular trends in health risk behaviors, after adjusting for gender and grade. Linear and higher-order time variables were simultaneously entered into the statistical models. Results: There was evidence of small, but statistically significant increasing or decreasing trends in certain health risk behaviors. Secular trends in health risk behaviors varied by gender. Conclusions: This study indicates that between 2005 and 2009, changes in health risk behaviors among Korean adolescents were generally small, but represented statistically significant increases or decreases. Further research should explore why certain health risk behaviors are increasing or decreasing and what types of interventions are most effective.

A Study on the Risk Evaluation of Construction Management Based on Risk Identification (위험도 기반 건설경영 리스크 평가에 관한 연구)

  • Lee, Hyun-Chul;Lee, Gun;Yeo, Sang-Ku;Go, Seong-Seok
    • Korean Journal of Construction Engineering and Management
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    • v.10 no.3
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    • pp.83-91
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    • 2009
  • Construction industry is a complex industry which should be invested with plenty capital, manpower and resources. Investment factors and inner and outer environmental factors should be managed systemically in terms with risk factors possible to occur. It maximizes the profit to establish construction management by managing risk systemically. While previous studies were executed with risk related to some special progress lively, studies about risk in managing construction company leave much to be desired. Therefore, this study examined risk in the whole construction management, showed the checklist and deduced the quantitative factors through questionnaire analysis from specialists. Also, priority and grade of construction management factors were evaluated by analyzing weight of construction risk factors.

Urinary Tract Infection Following Voiding Cystourethrography (배뇨 방광 요도 조영술 시행 후 발생하는 요로 감염에 대한 고찰)

  • Ryu, Jung-Min;Ahn, Yo-Han;Lee, So-Hee;Choi, Hyun-Jin;Lee, Beom-Hee;Kang, Hee-Gyung;Ha, Il-Soo;Cheong, Hae-Il;Choi, Yong
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.194-201
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    • 2008
  • Purpose : Voiding cystourethrography(VCUG) is required to detect vesicoureteral reflux(VUR), which may manifest as urinary tract infection(UTI) in children. It is well known that VCUG can cause UTI(post-VCUG UTI). In this study, risk factors for post-VCUG UTI and the preventive effect of antibiotics against this complication of VCUG were explored. Methods : Medical records of 284 patients who underwent VCUG at our hospital in 2007 were reviewed retrospectively. The incidence of post-VCUG UTI and risk factors for post-VCUG UTI, and the impact of antibiotic use on prevention of post-VCUG UTI were evaluated. According to antibiotics usage, we divided the enrolled patients into 4 groups of noantibiotics group, prophylactic antibiotics group(prophylactic antibiotics having been used before), antibiotics-for-VCUG group(antibiotics added for VCUG) and antibiotics-for-treatment group(treatment dose of antibiotics). Results : Seven of 284 children(2.5%) developed UTI after they underwent VCUG. Highgrade(grade$\geq$III) VUR was the only statistically significant risk factor(odds ratio[OR] 6.266, P=0.026) for post-VCUG UTI, while sex, age, and other anomalies of urinary system were not significant. Five post-VCUG UTI cases belonged to prophylactic antibiotics group. Antibiotics use (three groups using antibiotics vs. no-antibiotics group) or addition of antibiotics for VCUG (antibiotics-for-VCUG vs. other groups) did not have any effect on prevention of post-VCUG UTI. Conclusion : The risk factor for post-VCUG UTI was high-grade VUR. Antibiotics use did not prevent post-VCUG UTI in this study.

Scheduling Risk Management at the Preconstruction Phase (공사 착공 전 단계의 공정리스크 대응방안)

  • Park Ji-Hoon;Kim Sun-Kuk;Han Choong-He
    • Proceedings of the Korean Institute Of Construction Engineering and Management
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    • 2004.11a
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    • pp.457-461
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    • 2004
  • The insufficient management o( the risk of preconstruction phase causes the risk of construction phase so it makes bad effects such as the extension of construction time and raising of cost. Therefore, the management of the risk of preconstruction phase is being considered as an important element of success of project and the competitive power of construction companies. This study Is to suggest solution methods for each progress after examining reasons of the risk for the management of the risk of preconstruction phase 1'he progress is limited as earth work, RC work, steel work and curtain wall work. Through the introduction of Knowledge Management system, work flow is made by specialist of each part. The reasons of the risk of progress are chosen through the analysis of work flow and I suggest detailed solutions such as person in charge, the starting point of progress and the information of requirements according to the grade of importance about elements of the risk

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