• Title/Summary/Keyword: Risk-Factor

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Microsurgical Reconstruction in Elderly Patients (노인에서의 미세수술에 의한 재건술)

  • Jun, Myung Gon;Park, Bong Kweon;Ahn, Hee Chang
    • Archives of Reconstructive Microsurgery
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    • v.9 no.1
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    • pp.1-5
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    • 2000
  • The microsurgical reconstruction is necessary for elderly patients to treat severe trauma and head and neck tumor. The aim of this study is to analyze the risks of microvascular surgery and whether or not happening of more complication in elderly patients who are older than 60 years old and to suggest the solution of the complication. The retrospective study included 41 elderly patients who underwent treatment of 44 microsurgical reconstructions among total 271 cases of microsurgical reconstruction from July, 1988 to December, 1998. Their ages ranged from 61 years to 79 years. There were 26 males and 15 females. The involved sites were 23 head and necks, 13 upper gastrointestinal tracts, 3 lower extremities, 1 chest and 1 sacral region. The causes of microsurgical reconstruction were 36 head and neck tumors, 2 radionecrosis, 2 traumas and 1 melanoma in lower limb. The used flaps were 14 radial forearm flaps, 13 jejunal flaps, 10 latissimus dorsi muscle flaps, 3 rectus abdominis muscle flaps, 2 lateral arm flaps, 1 scapular flap, and 1 iliac osteocutaneous flap. They had medical problems which were 29 tobacco abuse, 14 hypertensions, 13 alcohol abuse, 10 chronic obstructive pulmonary diseases, 7 diabetes mellituses, 3 ischemic heart diseases. All patients have had successful results without specific complications except 3 cases of free flap failure and 3 perioperative death. The causes of 3 flap failures were 2 flap necrosis due to arterial insufficiency and 1 flap loss due to secondary infection. All of these cases were treated with secondary free flap surgery. However 3 patients died perioperatively due to 2 respiratory arrests and 1 sepsis. It was not related to operate microsurgical reconstruction itself, but was correlated with the complication of postoperative care after head and neck surgery. We conclude that plastic surgeons consider the importance of prevention of expected complication as thorough analysis of operative risk factor and appropriate treatment. We had to select the donor and recipient vessel appropriately to perform successful microsurgery in elderly patients and consider vein graft and end-to-side anastomosis to reduce complication if necessary. In addition, we emphasize the importance of pre, peri and postoperative care in head and neck cancer patients to reduce postoperative complication and morbidity.

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A Improvement Plans for Anchorage at Masan Port (마산항 정박지 개선방안에 관한 연구)

  • Park, Jun-Mo;Kim, Seungyeon
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.24 no.6
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    • pp.637-645
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    • 2018
  • This study analyzes the problem of lack of anchorage caused by some anchorage closed and suggests ways to improve Masan anchorage. For this, we established the evaluation criteria, and analysed the anchorage operating rate during 5 years after estimating the capacity of barge, and suggested improvement plan after appropriateness assessment of anchorage capacity, finally verified the anchorage improvement plan. As a result of study, it is analyzed that the Masan A-2, A-4, A-6 anchorage needs to expand the anchorage due to excess the anchorage assessment criteria of 60 %. So, in order to improve the Masan anchorage, we suggested the improvement plan that extended 1.8 times by the group designated anchorage, according to integrating the A-2, A-4, A-6 anchorage and anchorage dwell time and ship type. And, the result of verification improvement plan, it is analyzed that meet the assessment criteria since decreasing the anchorage operating rate by 1/2 compared to the existing one, does not act as a risk factor in terms of maritime traffic.

Current Trends and Recent Advances in Diagnosis, Therapy, and Prevention of Hepatocellular Carcinoma

  • Wang, Chun-Hsiang;Wey, Keh-Cherng;Mo, Lein-Ray;Chang, Kuo-Kwan;Lin, Ruey-Chang;Kuo, Jen-Juan
    • 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.

Pretreatment Thrombocytosis as a Prognostic Factor in Women with Gynecologic Malignancies: a Meta-analysis

  • Yu, Min;Liu, Lei;Zhang, Bing-Lan;Chen, Qi;Ma, Xue-Lei;Wu, Yu-Ke;Liang, Chun-Shui;Niu, Zhi-Min;Qin, Xin;Niu, Ting
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.6077-6081
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    • 2012
  • Background: This study was performed to analyze the prognostic implications of pretreatment or preoperative thrombocytosis in women with gynecologic malignancies. Material and Methods: We surveyed 2 medical databases, PubMed and EMBASE, to identified all relevant studies. A total of 14 (n=3,490) that evaluated the link between thrombocytosis and 5-year survival were included. REVMAN version 5.1 was used for our analysis and publication bias was evaluated using the Begg's funnel plot and tested by STATA 11.0. Risk ratios (RRs) with 95% confidence intervals (CIs) generated by the random effect model were used to assess the strength of any association. Results: 709(20.3%) of the 3,490 patients exhibited thrombocytosis (platelet counts > $400{\times}10^9/L$) at primary diagnosis, and their mortality was 1.62-fold higher compared with the others (RR=1.62, 95%CI=[1.28-2.05], p<0.0001). Thrombocytosis failed to have a stronger effect on the survival of advanced patients of stages III to IV in our study (n=478, RR=1.29, 95% CI=[1.13-1.48], p=0.0003), nor in women with cervical cancer in stage IB (n=1371, RR=1.73, 95% CI=[1.71-2.58], p=0.007). In addition, when adjusted for different carcinoma, it was associated with worse prognosis for all except the ones with vulvar cancer (n=201, RR=0.43, 95% CI=[0.14-1.29], p=0.13). Conclusions: This meta-analysis indicated that thrombocytosis might be associated with a worse prognosis for patients with gynecologic malignancies but without specificity or sensitivity for the ones in advanced stage. When adjusted for different gynecologic malignancies, it showed a significant effect on survival of all except vulvar cancers.

Suppressive Effect of Pioglitazone, a PPAR Gamma Ligand, on Azoxymethane-induced Colon Aberrant Crypt Foci in KK-Aу Mice

  • Ueno, Toshiya;Teraoka, Naoya;Takasu, Shinji;Nakano, Katsuya;Takahashi, Mami;Yamamoto, Masafumi;Fujii, Gen;Komiya, Masami;Yanaka, Akinori;Wakabayashi, Keiji;Mutoh, Michihiro
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.4067-4073
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    • 2012
  • Obesity is an established risk factor for colorectal cancer. Pioglitazone is a peroxisome proliferator activated receptor$receptor{\gamma}$ ($PPAR{\gamma}$) agonist that induces differentiation in adipocytes and induces growth arrest and/or apoptosis in vitro in several cancer cell lines. In the present study, we investigated the effect of pioglitazone on the development of azoxymethane-induced colon aberrant crypt foci (ACF) in KK-$A^{\mathcal{Y}}$ obesity and diabetes model mice, and tried to clarify mechanisms by which the $PPAR{\gamma}$ ligand inhibits ACF development. Administration of 800 ppm pioglitazone reduced the number of colon ACF/mouse to 30% of those in untreated mice and improved hypertrophic changes of adipocytes in KK-$A^{\mathcal{Y}}$ mice with significant reduction of serum triglyceride and insulin levels. Moreover, mRNA levels of adipocytokines, such as leptin, monocyte chemoattractant protein-1 and plasminogen activator inhibitor-1, in the visceral fat were decreased. PCNA immunohistochemistry revealed that pioglitazone treatment suppressed cell proliferation in the colorectal epithelium with elevation of p27 and p53 gene expression. These results suggest that pioglitazone prevented obesity-associated colon carcinogenesis through improvement of dysregulated adipocytokine levels and high serum levels of triglyceride and insulin, and increase of p27 and p53 mRNA levels in the colorectal mucosa. These data indicate that pioglitazone warrants attention as a potential chemopreventive agent against obesity-associated colorectal cancer.

CD4+, IL17 and Foxp3 Expression in Different pTNM Stages of Operable Non-small Cell Lung Cancer and Effects on Disease Prognosis

  • Zhang, Guo-Qing;Han, Feng;Fang, Xin-Zhi;Ma, Xiao-Mei
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3955-3960
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    • 2012
  • Objective: To investigate the effects of $CD4^+$, IL17 and Foxp3 expression on prognosis of operable non-small cell lung cancer (NSCLC) with different pTNM stages. Methods: Expression of $CD4^+$, IL17 and Foxp3 in 102 cases of NSCLC tissues and adjacent cancer tissues was detected by immunohistochemistry and associations with prognosis with different pTNM stages were analyzed. The Chi-square test was used to compare count data. Survival differences were evaluated by Kaplan-Meier single factor analysis and the COX regression model was used to analyze the relationship between influential factors and the disease prognosis. The significance level was ${\alpha}$=0.05. Results: Expression of CD4, IL-17 and Foxp3 significantly varied in different pTNM stages of NSCLC tissues (P < 0.05). The same was true for CD4 expression (P < 0.05). The median survival time (MST) in the positive CD4 expression group was evidently higher than that in the negative group (25.8/23.9 months). Compared with stage III, the MST difference of stages I and II in the positive CD4 expression group were statistically significant (P < 0.05). The MST in positive IL-17 and Foxp3 expression groups was obviously lower than that in the corresponding negative group (P < 0.05) (25.6/35.1 months and 24/35.3 months, respectively). There was a significant difference of MST between any two of three stages of positive IL-17 expression group (P < 0.05), and it was the same with positive Foxp3 expression group. TNM stage, negative CD4 expression, and positive IL-17 and Foxp3 expression were the main risk factors for the prognosis of NSCLC. Conclusion: Surgical prognosis of NSCLC can be better assessed by the combination of clinical staging and expression of IL17 and Foxp3.

Cumulative Probability of Prostate Cancer Detection Using the International Prostate Symptom Score in a Prostate-specific Antigen-based Population Screening Program in Japan

  • Kitagawa, Yasuhide;Urata, Satoko;Narimoto, Kazutaka;Nakagawa, Tomomi;Izumi, Kouji;Kadono, Yoshifumi;Konaka, Hiroyuki;Mizokami, Atsushi;Namiki, Mikio
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.7079-7083
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    • 2014
  • The International Prostate Symptom Score (IPSS) is often used as an interview sheet for assessing lower urinary tract symptoms (LUTS) at the time of prostate-specific antigen (PSA) testing during population-based screening for prostate cancer. However, the relationship between prostate cancer detection and LUTS status remains controversial. To elucidate this relationship, the cumulative probability of prostate cancer detection using IPSS in biopsy samples from patients categorized by serum PSA levels was investigated. The clinical characteristics of prostate cancer detected using IPSS during screening were also investigated. A total of 1,739 men aged 54-75 years with elevated serum PSA levels who completed the IPSS questionnaire during the initial population screening in Kanazawa City, Japan and underwent systematic transrectal ultrasonography-guided prostate biopsy between 2000 and 2013 were enrolled in the present study. Of the 1,739 men, 544 (31.3%) were diagnosed with prostate cancer during the observation period. The probability of cancer detection at 3 years in the entire study population was 27.4% and 32.7% for men with $IPSS{\leq}7$ and those with $IPSS{\geq}8$, respectively; there was no statistically significant difference between groups. In men with serum PSA levels of 6.1 to 12.0ng/mL at initial screening, the probability of cancer detection was significantly higher in men with $IPSS{\leq}7$ than in those with $IPSS{\geq}8$. There were no significant differences in clinical characteristics between groups of patients stratified by IPSS. These findings indicate that the use of IPSS for LUTS status evaluation may be useful for prostate cancer detection in the limited range of serum PSA levels.

Reduction of Intestinal Polyp Formation in Min Mice Fed a High-Fat Diet with Aloe Vera Gel Extract

  • Chihara, Takeshi;Shimpo, Kan;Beppu, Hidehiko;Tomatsu, Akiko;Kaneko, Takaaki;Tanaka, Miyuki;Yamada, Muneo;Abe, Fumiaki;Sonoda, Shigeru
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.7
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    • pp.4435-4440
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    • 2013
  • Aloe vera gel supercritical $CO_2$ extract (AVGE) has been shown to contain five phytosterols, reduce visceral fat accumulation, and influence the metabolism of glucose and lipids in animal model experiments. Recent epidemiologic studies have shown that obesity is an established risk factor for several cancers including colorectal cancer. Therefore, we examined the effects of AVGE on intestinal polyp formation in Apc-deficient Min mice fed a high-fat diet. Male Min mice were divided into normal diet (ND), high fat diet (HFD), low dose AVGE (HFD+LAVGE) and high dose AVGE (HFD+HAVGE) groups. The ND group received AIN-93G diet and the latter 3 groups were given modified high-fat AIN-93G diet (HFD) for 7 weeks. AVGE was suspended in 0.5% carboxymethyl cellulose (CMC) and administered orally to mice in HFD+LAVGE and HFD+HAVGE groups every day (except on Sunday) for 7 weeks at a dose of 3.75 and 12.5 mg/kg body weight, respectively. ND and HFD groups received 0.5% CMC alone. Between weeks 4 and 7, body weights in the HFD and HFD+LAVGE groups were reduced more than those in the ND group. However, body weights were not reduced in the HFD+HAVGE group. Mice were sacrificed at the end of the experiment and their intestines were scored for polyps. No significant differences were observed in either the incidence and multiplicity of intestinal polyps (${\geq}0.5$ mm in a diameter) among the three groups fed HFD. However, when intestinal polyps were categorized by their size into 0.5-1.4, 1.5-2.4, or ${\geq}2.5$ mm, the incidence and multiplicity of large polyps (${\geq}2.5$ mm) in the intestine in the HFD+HAVGE group were significantly lower than those in the HFD group. We measured plasma lipid (triglycerides and total cholesterol) and adipocytokine [interleukin-6 and high molecular weight (HMW) adiponectin] levels as possible indicators of mechanisms of inhibition. The results showed that HMW adiponectin levels in the HFD group were significantly lower than those in the ND group. However, the levels in the HFD+HAVGE group were significantly higher than those in the HFD group. These results indicate that HAVGE reduced large-sized intestinal polyps and ameliorated reduction in plasma HMW adiponectin levels in Min mice fed HFD.

Effects of the Short-Term Weight Control Program on Periodontal Health in the University Students: A Pilot Study (일개 대학생의 단기 체중조절 프로그램이 치주건강에 미치는 영향: 사전연구)

  • Koong, Hwa-Soo;Son, Soo-Jung;Park, Hoo-Seob;Seo, Hyung-Seok;Hwang, Soo-Jeong
    • Journal of dental hygiene science
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    • v.15 no.4
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    • pp.413-418
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    • 2015
  • Recent cross-sectional studies indicate that obesity is a risk factor for periodontal disease. This study was aimed to investigate whether the four-week weight control program including caloric restriction and exercise training could have an effect on periodontal health. Forty-one obese (body mass index [BMI] ${\geq}25.0$) and five overweight ($23.0{\leq}BMI<25.0$) students participated in the weight control program. Anthropometric data and oral examination data were collected at the baseline and at the 27th day. BMI, waist hip ratio (WHR), and percent of body fat (PBF) of the subjects decreased significantly, but gingival index, sites with bleeding on probing (BOP), and sites with shallow pocket depth didn't show the significant changes in paired t-test. There was no difference in the outcomes according to smoking, drinking alcohol, and sex. Nevertheless, PBF and sites with BOP (r=0.777) and WHR and sites with shallow pocket depth (r=0.444) showed positive correlations. PBF accounted for 58.9% of the variance in sites of BOP in regression analysis. We suggested that obesity might relate with periodontal health, although it was not clear whether weight control could influence on periodontal health directly.

Network Moderating Effects between Social Entrepreneurship and Organizational Performance: Focus on Jeju areas Social Enterprise Workers (사회적기업가 정신과 조직성과간의 네트워크 조절효과: 제주지역 사회적기업 근로자를 대상으로)

  • Kang, MoonSil;Kim, YoonSook
    • Journal of Service Research and Studies
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    • v.6 no.4
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    • pp.15-34
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    • 2016
  • The purpose of this study is to examine the effects of social entrepreneurship on organizational performance and to identify network moderating effects on social entrepreneurship and organizational performance. Data collected from 189 employees working in social enterprises were analyzed by using SPSS 18.0 program. Results are as follows: First, innovativeness, proactiveness, and social value orientation which were sub-factors of social entrepreneurship had positive effects on social performance. Second, proactiveness, risk-taking, and social value orientation which were sub-factors of social entrepreneurship had positive effects on economic performance. Third, the network significantly moderated the effects on innovativeness, proactiveness, social value orientation which were sub-factors of social entrepreneurship, and social performance. Fourth, the network significantly moderated the effects on proactiveness which was a sub-factor of social entrepreneurship, and economic performance. These results exhibited that the social entrepreneurship was effective to increase the organizational performance by activating the network and proposed a useful approach for further studies as an investigation method.