• Title/Summary/Keyword: Risk-Free Rate

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Clinical Analysis of 51 Cases of Free Flap Reconstruction after Ablative Surgery of Head and Neck Cancer (두경부암종 수술 후 결손부위 재건에 사용된 유리피판술 51예의 고찰)

  • Lee, Seung-Won;Kim, Jae-Wook;Kim, Yong-Bae;Tak, Min-Sung;Shi, Ho-Sung;Chang, Hyuck-Soon;Oh, Cheon-Hwan;Park, Jin-Gyu;Koh, Yoon-Woo
    • Korean Journal of Head & Neck Oncology
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    • v.23 no.1
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    • pp.26-31
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    • 2007
  • Background and Objectives:Microvascular free flap reconstruction has been revolutionized in last two decades, and became a standard option in the reconstruction of head and neck defects. We intended to review our experiences of 51 microvascular free flap for head and neck defects during 5-year period and to analyze the types of flaps according to primary sites, success and complication rates. Subjects and Methods:From Oct. 2001 through Dec. 2005, fifty one free flap reconstructions were performed in forty nine patients at ENT department of Soonchunhyang university bucheon hospital. Primary sites, pathology, T-stage, operative time, time interval of oral feeding, and various reconstructive factors such as recipient and donor vessels, free flap related complications, failure rates and salvage rates were retrospectively analyzed. The relation between complication rates and preoperative risk factors were statistically analyzed. Results:Methods of reconstruction were radial forearm free flap(RFFF)(n=28, 54.9%), anterolateral thigh free flaps(n=9, ALTFF)(17.6%), rectus abdominis free flap(n=7, RAFF)(13.7%), jejunal free flap(n=5, JFF)(9.8%), and miscellanous(n=2, 4.0%) in order. In free flap related complications, failure of free flap occurred in seven cases(13.7%) and pharyngocutaneous fistula occurred in five cases(9.8%) among fifty one free flaps. The overall success rate of free flaps was 86.3%. Salvage of free flaps was possible only one among eight cases(12.5%). In positive preoperative risk factor groups, failure of free flap was higher than in negative risk factor group. However, it was not statistically significant. Conclusion:We confirmed that free flap reconstructions are highly versatile and reliable options for use in the reconstruction of various soft tissue defects of the head and neck. Free flaps have gained great popularity given its versatility, ability for a two-team approach, and minimal donor site morbidity. However, complications related to microvascular surgery may be overcome by increased surgical experience and by intensive flap monitoring in early postoperative period.

The Analysis on the Change of Behaviors of Exchange Rate between Two Countries related to FTA and the Prospects (FTA체결 전.후의 환율행태 변화 분석과 전망)

  • Khoe, Kyung-Il;Sul, Won-Sik
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.5
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    • pp.1043-1051
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    • 2009
  • This study intends to discuss the influence on behaviors of won/dollar exchange rate after a FTA between Korea and US come into effect. The change of behaviors of won/dollar exchange rate has been looked into concerning other countries who have signed a FTA pact with the US, and these examples were compared with that of Korea so as to find similarities and differences. As a result of analyses, behaviors of exchange rate between FTA-pact countries were showed differently. Volatility and risk premium somewhat decreased after the FTA took effect except for Chile. As for Chile, showing intense volatility, foreign exchange risk premium rather increased. It can be concluded that the relationship between volatility and risk premium of individual exchange rate is established and FTA can influence change of these behaviors of exchange rate depending on the situation of individual country. This study will contribute to offer informations to Korea trading companies related to IT that will have to prepare for the uncertainties of change of exchange rate due to FTA between Korea and US.

Risk Factors of Recurrence after Gross Total Excision in Pediatric Craniopharyngioma (전적출후 재발한 소아 두개인두종의 재발인자에 대한 분석)

  • Kim, Seung-Ki;Wang, Kyu-Chang;Chung, Young Seob;Sim, Ki-Bum;Cho, Byung-Kyu
    • Journal of Korean Neurosurgical Society
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    • v.30 no.1
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    • pp.20-25
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    • 2001
  • Objectives : A substantial number of craniopharyngiomas recur despite gross total excision. The purpose of our study was to investigate pattern of recurrence and to verify prognostic factors for recurrence after gross total excision of craniopharyngiomas in children. Methods : A series of 36 patients with craniopharyngiomas were reviewed. All patients had undergone gross total excision and none of them received radiotherapy after initial surgery. Fifteen were girls and twenty-one were boys, with a mean age of 7.3 years(range, one to 15 years). The mean follow-up period was 52 months(range, one to 149 months). Recurrence was noted in 14 patients within 83 months(mean 31.4 months). Results : The overall three-year recurrence free survival rate was 65%, and the five-year recurrence-free survival rate was 55%. Regular neuroimaging follow-up at six to 12-month intervals detected tumor recurrence of a smaller size before symptoms developed(p<0.05). At the first surgical procedure, the optic nerve/chiasm(n=23) was the most common adhesion site. The most frequent sites of recurrence were the optic nerve/chiasm(n=6) and the pitiutary fossa(n=6). Tumor location was the single significant clinical predictor of recurrence. The five-year recurrence-free survival rate was 39% for those who had an intrasellar tumor component and 81% for those who did not (p<0.05). Conclusion : Craniopharyngiomas with intrasellar components should be followed cautiously and regular followup of patients should be emphasized, even when the tumors are totally resected.

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Relapse-free Rate with Childhood Acute Lymphoblastic Leukemia Treated under the Thai National Protocol

  • Tharnprisan, Piangjit;Khiewyoo, Jiraporn;Sripraya, Piporn;Wiangnon, Surapon
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.1127-1130
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    • 2013
  • Background: The standard national protocol for treatment of acute lymphoblastic leukemia (ALL) in children was implemented in 2006. A systematic evaluation of the treatment outcome is needed. This study examined the relapse-free survival among childhood ALL cases treated with this protocol and related factors. Materials and Methods: A descriptive study was conducted in children aged between 0-15 years, newly diagnosed with ALL between March 2006 and March 2011 at Srinagarind Hospital, Department of Pediatrics, Faculty of Medicine, Khon Kaen University. The patients were treated on the basis of stratified risk as per the Thai national protocol. Data were compiled from the hospital records. The Kaplan-Meier method was used to describe relapse-free survival and the Cox proportional hazard model to investigate the associated factors. Results: Of the 103 children recruited, 86 (83.5%) achieved complete remission. The total follow-up time was 3132.5 person-months. Eighteen (20.9%) relapsed. The incidence density was 0.6 per 100 person-months (95%CI: 0.4, 0.9). The respective relapse-free rates at 1, 3 and 5 years were 93.0% (95%CI: 85.1, 96.8), 84.5% (95%CI: 74.0, 90.9) and 64.1% (95%CI: 45.6, 77.8). A factor associated with the relapse-free rate was age under 1 year (HR=6.0; 95%CI: 1.1, 33.8). Conclusions: The rate of being relapse-free in ALL children treated under the Thai national protocol at Srinagarind Hospital was better than with former protocols; however, it is still not as good as in developed countries. Further review of the treatment approach of ALL is needed.

Postoperative Radiotherapy for the Early Stage Carcinoma of the Uterine Cervix (초기 자궁경부암의 수술후 방사선 치료)

  • Kim, Jin-Hee;Kim, Ok-Bge;Lee, Tae-Sung
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.337-346
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    • 1993
  • This is a retrospective cohort analysis of 58 patients who treated with postoperative radiation therapy following radical hysterectomy and bilateral pelvic adenectomy for early stage carcinoma of uterine cervix between January 1988 and December 1990 at department of radiation oncology, Keimyoung University Hospital. Sixteen percent of patients (9/58) had chemotherapy. Most patients were FIGO I b (47 patients), and FIGO I a and II a were one and ten patients, respectively. The median follow-up periods were 48.5 months. The indications for radiation therapy included pelvic lymph node metastasis, large tumor size, deep stromal invasion, lymphovascular invasion, positive surgical margin, endometrial invasion and parametrial invasion. Eighty five percent of the patients had more than one risk factor. The actuarial overall five year survival rate (5 YSR) and five year disease free survival rate (5 YDFSR) were $89.5\%,\;and\;87.8\%,$ respectively. Their overall recurrence rate was $12.1\%,$(758). Distant metastasis was the most common cause of treatment failure $(71.4\%:5/7).$ The univariate analysis of prognostic factors affecting to five year survival rate disclosed pelvic lymph node status (negative: $95.5\%,\;positive:69.2\%,$ p=0.006) and hemoglobin level $(\le11 :75\%,>11g/dl:93.3\%,p=0.05)$ as significant factor. The age status was marginally significant $(\le40:96.0\%,\;>\;40:84.3\%p=0.15).$ Multivariate analysis clarified three independent prognostic factors: pelvic lymph node metastasis (p=p.006), hemoglobin level (p=0.015) and age (p=0.035). Multivariate analysis of prognostic factor affecting to five year disease free survival rate disclosed pelvic lymph node status (p=0.0078) and status of surgical margin (p=0.008). Complications relating to radiotherapy were $10.3\%,(6/58).$ There were no severe major complication requiring surgical intervention or a long hospital stay. It is our opinion that the benefit of postoperative pelvic radiotherapy may be gained in such a high risk patient population with acceptible morbidity.

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Mariner's Information Processing Characteristics in Ship-to-Ship Collision Situation (선박간 충돌 위험상황에서의 항해사 정보처리 특성에 관한 연구)

  • Kim, Bi-A;Oh, Jin-Seok;Lee, Se-Won;Lee, Jae-Sik
    • Journal of the Korean Society of Safety
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    • v.23 no.1
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    • pp.46-50
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    • 2008
  • The purpose of the present study was to investigate the mariner's information characteristics in ship-ta-ship collision situation using the full mission ship-handling simulator. Risk levels of ship-to-ship collision were manipulated by whether the target ship complies with the naval regulations and by movement patterns of target ship. Dependent variables reflecting mariner's information characteristics in ship-ta-ship collision situation were measured in terms of radar detection reaction time, free recall performance of past navigation situation, and subjective ratings for the task difficulty. The results showed that, in general, the mariners appeared to be deteriorated in their radar detection reaction time and free recall performance as the risk of ship-ta-ship collision increased. Also, the mariners tended to rate required tasks more difficult in the high risk ship-ta-ship collision situation.

Comparative Analysis of Food Habits and Bone Density Risk Factors between Normal and Risk Women Living in the Seoul Area (서울지역 성인여성의 골밀도 정상군.위험군의 식습관과 식품섭취 관련요인의 비교분석)

  • Kim, Myung-Suk;Koo, Jae-Ok
    • Korean Journal of Community Nutrition
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    • v.13 no.1
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    • pp.125-133
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    • 2008
  • This study was carried out to compare bone density risk factors affecting women's BMD, and to examine the relationship age, lifestyle and dietary habits for bone health by physical measurement and questionnaires. The subjects of this study were 194 women living in the Seoul area. When the subjects were divided into normal and risk groups, BMD, height, weight, BMI, total body water, soft lean mass, fat free mass, protein, mineral, body-fat of normal group were much higher than those of the risk group. The breakfast eating rate of the normal group was much higher than that of the risk group, walking time was significantly longer and exercise was more (p < 0.05). The normal group had more frequent intakes of tunas, squid, radishes, the green parts of radish, cucumbers, carrots and Iucchinis, tomatoes, and grapes than the risk group (p < 0.01 or p < 0.05). In conclusion, breakfast eating, exercise, intakes of some foods such as anchovies, radishes, carrots, zucchinis and tomatoes were significantly important factor to prevent bone density risk.

Lung cancer and insurance medicine (폐암과 보험의학)

  • Lee, Sin-Hyung
    • The Journal of the Korean life insurance medical association
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    • v.31 no.1
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    • pp.34-36
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    • 2012
  • Lung cancer such as small cell lung cancer(SCLC) and non small cell lung cancer(NSCLC) have high mortality rate, so, we insurance doctors have little interest in their risk. But nowadays there's a lot of development in targeted therapy of NSCLC. Screening by CT scanning and early resection strategy also shows better prognosis. It is helpful for underwriters and insurance doctors to review the current development of targeted therapy of NSCLC and estimation of extra-risk of early lung cancer. The preferred treatment option for patients whose tumors contain EGFR-activating mutations are one of the EGFR-directed tyrosine kinase inhibitors, such as gefitinib or erlotinib. In patients with NSCLC whose tumors harboured an ALK rearrangement, there was 61% objective response rate to crizotinib in the phase 1 study. The median survival progression-free survival was 10 months. Mortality analysis of early lung cancer who were detected by CT screening, MR of 105% and EDR of 1‰ were calculated.

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Relationship between Osteoporosis and Cardiovascular Risk Factors according to Sasang Constitution in Rural Wonju Cohort (원주농촌코호트에서 사상체질별 심혈관위험인자와 골다공증의 관계)

  • Song, Hak-Soo;Choi, Jae-Wan;Yu, Jun-Sang;Park, Jong-Ku
    • Journal of Sasang Constitutional Medicine
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    • v.25 no.2
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    • pp.81-97
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    • 2013
  • Objectives The purpose of this study was to investigate the relationship between osteoporosis and cardiovascular risk factors according to Sasang constitution. Methods A total of 1773 participants, over 40 years old, were examined as part of a community-based cohort in Wonju city in Gangwon province of South Korea, from June 2006 to August 2009. We measured bone mineral density by Achilles ultrasonometer, serum levels of lipids, fasting blood sugar, insulin and other cardiovascular risk factors like blood pressure and waist circumference. Constitution was verified by a Sasang constitution specialist using the results of PSSC(Phonetic System for Sasang Constitution), facial photos and a simplified Sasang constitutional questionnaire. Results The prevalence rate was 11.2% in total participants, and 10.6% in Soyangin, 10.4% in Taeeumin and 13.9% in Soeumin. In general characteristics, educational and economic property and exercise were concerned with osteoporosis. Systolic blood pressure, pulse rate and total cholesterol were significantly high in osteoporosis group. Age and menopause were the key risk factors for osteoporosis. There was a significantly high prevalence in Soeumin for osteoporosis in men alone. Low physical activity was a major risk factor for osteoporosis. Waist circumference and hip circumference had significantly high odds ratio and weight had significantly low odds ratio. By Sasang constitution, Soyangin has the negative correlation with free fatty acid, Taeeumin has the negative correlation with waist circumference, pulse rate, systolic blood pressure, total cholesterol and low density lipoprotein and Soeumin has the positive correlation with body fat amount. Conclusions Regimens on osteoporosis should be considered according to Sasang constitution. Cardiovascular diseases should be considered according to Sasang constitution. Soeumin should be cautious of osteoporosis and gain weights and reasonable amount of fat food. Soyangin had better do exercise lower body and eat little food containing triglyceride. Taeeumin had better lose weights and eat little cholesterol food.

The Results and Prognostic Factors of Postoperative Radiation Therapy in the Early Stages of Endometrial Cancer (초기 자궁내막암의 수술 후 방사선치료의 결과와 예후인자)

  • Lee, Kyung-Ja
    • Radiation Oncology Journal
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    • v.26 no.3
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    • pp.149-159
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    • 2008
  • Purpose: To evaluate the results and prognostic factors for postoperative adjuvant radiation therapy in patients at stages I and II of endometrial cancer. Materials and Methods: Between January 1991 and December 2006, 35 patients with FIGO stages I and II disease, who received adjuvant radiation therapy following surgery for endometrial cancer at Ewha Womans University Hospital, were enrolled in this study. A total of 17 patients received postoperative pelvic external beam radiation therapy; whereas, 12 patients received vaginal brachytherapy alone, and 6 patients received both pelvic radiation therapy and vaginal brachytherapy. Results: The median follow-up period for all patients was 54 months. The 5-yr overall survival and disease-free survival rates for all patients were 91.4% and 81.7%, respectively. The 5-yr overall survival rates for low-risk, intermediate-risk, and high-risk groups were 100%, 100% and 55.6%, respectively. In addition, the 5-yr disease-free survival rates were 100%, 70.0%, and 45.7%, respectively. Although no locoregional relapses were identified, distant metastases were observed in 5 patients (14%). The most common site of distant metastases was the lung, followed by bone, liver, adrenal gland, and peritoneum. A univariate analysis revealed a significant correlation between distant metastases and risk-group (p=0.018), pathology type (p=0.001), and grade (p=0.019). A multivariate analysis also revealed that distant metastases were correlated with pathology type (p=0.009). Papillary, serous and clear cell carcinoma cases demonstrated a poor patient survival rate compared to cases of endometrioid adenocarcinoma or adenosquamous carcinoma. The most common complication of pelvic external beam radiation therapy was enteritis (30%), followed by proctitis, leucopenia, and lymphedema. All these complications were of RTOG grades 1 and 2; no grades 3 and 4 were observed. Conclusion: For the low-risk and intermediate-risk groups (stages 1 and 2) endometrial cancer, pelvic control, and overall survival rate was free of severe toxicity when pelvic radiation therapy or vaginal brachytherapy was performed. In the high-risk group, pelvic control rate was excellent, but the survival rate was poor due to distant metastases, in spite of the pelvic radiation therapy. The combined modality of chemotherapy and radiation therapy is recommended for high-risk groups. For the intermediate-risk group, a prospective randomized study is required to compare the efficacy between whole pelvic radiation therapy and vaginal brachytherapy.