• Title/Summary/Keyword: Site Risk

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Solitary Keratoacanthoma at the Recipient Site of a Full-Thickness Skin Graft: A Case Report and Review of the Literature

  • Jeong Ho Kim;Sang-Hoon Lee;Seung-Phil Hong;Jiye Kim;Sug Won Kim
    • Archives of Plastic Surgery
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    • v.50 no.1
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    • pp.59-62
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    • 2023
  • A 57-year-old man presented with a pigmented papule, 0.4 cm in diameter, on the left lower eyelid. Skin biopsy revealed a basal cell carcinoma, which was excised through a wide excision followed by a full-thickness skin graft (FTSG). Two weeks after the surgery, an erythematous nodule developed in the lower margin of the graft recipient site. The nodule size increased rapidly over 2 weeks, becoming dome-shaped with a central hyperkeratotic plug. A diagnosis of keratoacanthoma (KA) was made, and surgical excision was performed. Histological findings revealed a large, well-differentiated squamous tumor with a central keratin-filled crater and buttress. The human papilloma virus (HPV) genotyping results were negative. Risk factors for KA include trauma, old age, exposure to ultraviolet (UV) radiation, immunosuppression, and HPV infection. KA has most often been reported to develop at the donor site. Although the pathogenesis of KA is unclear, trauma is believed to act as a second insult to a preceding oncogenic insult, such as exposure to UV radiation, resulting in a koebnerization. Herein, we report a case of solitary KA at a FTSG recipient site. This report presents information that may provide guidance during dermatologic surgeries.

Scheme on Environmental Risk Assessment and Management for Carbon Dioxide Sequestration in Sub-seabed Geological Structures in Korea (이산화탄소 해양 지중저장사업의 환경위해성평가관리 방안)

  • Choi, Tae-Seob;Lee, Jung-Suk;Lee, Kyu-Tae;Park, Young-Gyu;Hwang, Jin-Hwan;Kang, Seong-Gil
    • Journal of the Korean Society for Marine Environment & Energy
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    • v.12 no.4
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    • pp.307-319
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    • 2009
  • Carbon dioxide capture and storage (CCS) technology has been regarded as one of the most possible and practical option to reduce the emission of carbon dioxide ($CO_2$) and consequently to mitigate the climate change. Korean government also have started a 10-year R&D project on $CO_2$ storage in sea-bed geological structure including gas field and deep saline aquifer since 2005. Various relevant researches are carried out to cover the initial survey of suitable geological structure storage site, monitoring of the stored $CO_2$ behavior, basic design of $CO_2$ transport and storage process and the risk assessment and management related to $CO_2$ leakage from engineered and geological processes. Leakage of $CO_2$ to the marine environment can change the chemistry of seawater including the pH and carbonate composition and also influence adversely on the diverse living organisms in ecosystems. Recently, IMO (International Maritime Organization) have developed the risk assessment and management framework for the $CO_2$ sequestration in sub-seabed geological structures (CS-SSGS) and considered the sequestration as a waste management option to mitigate greenhouse gas emissions. This framework for CS-SSGS aims to provide generic guidance to the Contracting Parties to the London Convention and Protocol, in order to characterize the risks to the marine environment from CS-SSGS on a site-specific basis and also to collect the necessary information to develop a management strategy to address uncertainties and any residual risks. The environmental risk assessment (ERA) plan for $CO_2$ storage work should include site selection and characterization, exposure assessment with probable leak scenario, risk assessment from direct and in-direct impact to the living organisms and risk management strategy. Domestic trial of the $CO_2$ capture and sequestration in to the marine geologic formation also should be accomplished through risk management with specified ERA approaches based on the IMO framework. The risk assessment procedure for $CO_2$ marine storage should contain the following components; 1) prediction of leakage probabilities with the reliable leakage scenarios from both engineered and geological part, 2) understanding on physio-chemical fate of $CO_2$ in marine environment especially for the candidate sites, 3) exposure assessment methods for various receptors in marine environments, 4) database production on the toxic effect of $CO_2$ to the ecologically and economically important species, and finally 5) development of surveillance procedures on the environmental changes with adequate monitoring techniques.

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Diabetes Mellitus and Site-specific Colorectal Cancer Risk in Korea: A Case-control Study

  • Woo, Hyeongtaek;Lee, Jeeyoo;Lee, Jeonghee;Park, Ji Won;Park, Sungchan;Kim, Jeongseon;Oh, Jae Hwan;Shin, Aesun
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.1
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    • pp.45-52
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    • 2016
  • Objectives: Previous large-scale cohort studies conducted in Korea have found a positive association between diabetes mellitus (DM) and colorectal cancer (CRC) in men only, in contrast to studies of other populations that have found significant associations in both men and women. Methods: A total of 1070 CRC cases and 2775 controls were recruited from the National Cancer Center, Korea between August 2010 and June 2013. Self-reported DM history and the duration of DM were compared between cases and controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by binary and polytomous logistic regression models. Results: DM was associated with an elevated risk of CRC in both men (OR, 1.47; 95% CI, 1.13 to 1.90) and women (OR, 1.92; 95% CI, 1.24 to 2.98). This association remained when we controlled for age, body mass index, alcohol consumption, and physical activity level. In sub-site analyses, DM was associated with distal colon cancer risk in both men (multivariate OR, 2.04; 95% CI, 1.39 to 3.00) and women (multivariate ORs, 1.99; 95% CI, 1.05 to 3.79), while DM was only associated with rectal cancer risk in women (multivariate OR, 2.05; 95% CI, 1.10 to 3.82). No significant association was found between DM and proximal colon cancer risk in either men (multivariate OR, 1.45; 95% CI, 0.88 to 2.41) or women (multivariate OR, 1.79; 95% CI, 0.78 to 4.08). Conclusions: Overall, DM was associated with an increased risk of CRC in Koreans. However, potential over-estimation of the ORs should be considered due to potential biases from the case-control design.

Health Impact Assessment on Construction of Landfill Site - Focused on Human Risk Assessment due to Inhalation Exposure to Landfill Gas - (매립장 조성사업에 대한 건강영향평가 - 매립가스의 호흡노출로 인한 인체위해성평가를 중심으로 -)

  • Kim, Young-Ha;Lee, Young-Soo
    • Journal of Environmental Policy
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    • v.7 no.1
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    • pp.1-29
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    • 2008
  • The Ministry of Environment(MoE) of Korea has recently established the Environmental Health Act. This Act contains a clause related to implementation of Health Impact Assessment(HIA). So, selecting a landfill which was expected to have an influence on human health among major development projects, this study carried out the human risk assessment due to inhalation exposure to landfill gas emission and attempted to measure the possibility of domestic application of HIA in the future. The process for HIA on landfill site extension focusing on human risk assessment is as follows: The first step is to presume and calculate the amount of landfill gas emissions using LandGEM, The second step is to carry out exposure assessment using K-SCREEN Model which is used for predicting the concentration in a conservative method. The last step is to carry out human risk assessment of carcinogenic and non-carcinogenic substances. It is considered that it is likely to apply a technique for human risk assessment due to inhalation exposure to landfill gas emission performed here more specifically in the case of implementing HIA. In addition, it is also believed that more systematic studies are needed to overcome some weak points and limits found in this study and if these weak points and limits are improved more reliable outcomes will be produced.

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Risk-based Safety Impact Assessment for Construction Projects (위험도 접근방법에 의한 건설사업 안전영향평가방안에 관한 연구)

  • Choi Hyun-Ho;Jung Pyung-Ki;Seo Jong-Won;Choi Ook
    • Proceedings of the Korean Institute Of Construction Engineering and Management
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    • 2004.11a
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    • pp.504-509
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    • 2004
  • Safety assessment of construction projects may be affected by various factors such as types and scale of projects, construction methods, procedure, climactic, and site conditions etc. Presently, in planning and design phases, designers are still often uncertain of their responsibilities, l3i]I information and training of safety. Therefore, designers are still failing to exploit the potential that have to eliminate and reduce risks on site. In this study, the concepts of safety impact assessment is introduced in order to derive the performing design for safety in design phase. For this purpose, a framework for safety impact assessment model using risk-based approach for construction projects is suggested. The suggested model includes of information survey and scenarios, classification of safety impact factors occurred by design and construction, and quantitative estimation of magnitude and frequency. Moreover, the checklist which is enable to identify relationship between safety impact factors and design factors is developed and the methodology of safety impact assessment model using risk-based approach is also proposed.

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Risk factors of osteonecrosis of the jaw after tooth extraction in osteoporotic patients on oral bisphosphonates

  • Jeong, Ho-Gul;Hwang, Jae Joon;Lee, Jeong-Hee;Kim, Young Hyun;Na, Ji Yeon;Han, Sang-Sun
    • Imaging Science in Dentistry
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    • v.47 no.1
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    • pp.45-50
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    • 2017
  • Purpose: The aim of this study was to investigate the incidence of bisphosphonate-related osteonecrosis of the jaw (BRONJ) after tooth extraction in patients with osteoporosis on oral bisphosphonates in Korea and to evaluate local factors affecting the development of BRONJ. Materials and Methods: The clinical records of 320 patients who underwent dental extraction while receiving oral bisphosphonates were reviewed. All patients had a healing period of more than 6 months following the extractions. Each patient's clinical record was used to assess the incidence of BRONJ; if BRONJ occurred, a further radiographic investigation was carried out to obtain a more definitive diagnosis. Various local factors including age, gender, extraction site, drug type, duration of administration, and C-terminal telopeptide (CTx) level were retrieved from the patients' clinical records for evaluating their effect on the incidence of BRONJ. Results: Among the 320 osteoporotic patients who underwent tooth extraction, 11 developed BRONJ, reflecting an incidence rate of 3.44%. Out of the local factors that may affect the incidence of BRONJ, gender, drug type, and CTx level showed no statistically significant effects, while statistically significant associations were found for age, extraction site, and duration of administration. The incidence of BRONJ increased with age, was greater in the mandible than the maxilla, and was associated with a duration of administration of more than 3 years. Conclusion: Tooth extraction in patients on oral bisphosphonates requires careful consideration of their age, the extraction site, and the duration of administration, and close postoperative follow-up should be carried out to facilitate effective early management.

Prediction of Time to Recurrence and Influencing Factors for Gastric Cancer in Iran

  • Roshanaei, Ghodratollah;Ghannad, Masoud Sabouri;Safari, Maliheh;Sadighi, Sanambar
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.6
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    • pp.2639-2642
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    • 2012
  • Background: The patterns of gastric cancer recurrence vary across societies. We designed the current study in an attempt to evaluate and reveal the outbreak of the recurrence patterns of gastric cancer and also prediction of time to recurrence and its effected factors in Iran. Materials and Methods: This research was performed from March 2003 to February 2007. Demographic characteristics, clinical and pathological diagnosis and classification including pathologic stage, tumor grade, tumor site and tumor size in of patients with GC recurrent were collected from patients' data files. To evaluate of factors affected on the relapse of the GC patients, gender, age at diagnosis, treatment type and Hgb were included in the research. Data were analyzed using Kaplan-Meier and logistic regression models. Results: After treatment, 82 patients suffered recurrence, 42, 33 and 17 by the ends of first, second and third years. The mean ( SD) and median ( IQR) time to recurrence in patients with GC were 25.5 (20.6-30.1) and 21.5 (15.6-27.1) months, respectively. The results of multivariate analysis logistic regression showed that only pathologic stage, tumor grade and tumor site significantly affected the recurrence. Conclusions: We found that pathologic stage, tumor grade and tumor site significantly affect on the recurrence of GC which has a high positive prognostic value and might be functional for better follow-up and selecting the patients at risk. We also showed time to recurrence to be an important factor for follow-up of patients.

Epidemiology and Histopathological Spectrum of Head and Neck Cancers in Bihar, a State of Eastern India

  • Siddiqui, Md. Salahuddin;Chandra, Rajeev;Aziz, Abdul;Suman, Saurav
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3949-3953
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    • 2012
  • Head and neck cancers are amongst the commonest malignancies, accounting for approximately 20% of the cancer burden in India. The major risk factors are tobacco chewing, smoking and alcohol consumption, which are all preventable. This retrospective study presents data from the histopathology register for a five year period from 2002-2006 at Patna Medical College and Hospital, a tertiary care hospital drawing patients from the entire Bihar state, the 3rd most populous state of India with the majority of the population residing in rural areas. Incidence rates based on sex, age, site of lesion, including age standardized incidence rates for males and females, with mean age of presentation, distribution of histological variants and year wise trend were calculated. Out of 455 head and neck neoplasias, 241 were benign while 214 were malignant. The most common age group for all malignant biopsies was 7th decade for males and the 5th decade for females. Malignant cases were commoner in males than females with the male:female ratio of 3.1:1, which was found to be statistically significant by the chi-square (${\chi}^2$) test. The crude rate and age standardized incidence rate was 0.05 and 0.06 per 100,000 population respectively. Squamous cell carcinoma (SCC) contributed about 96% of all cases, with grade I being the most common. Larynx was the most common site for malignancy, the supraglottic region being its most commonly affected sub-site. This observed incidence patterns in the region are a reminder of widespread unawareness, low healthcare utilization with virtually non-existent cancer programs. It also underlines the need to advocate for reliable cost-effective programs to create awareness, for early detection and plan appropriate management strategies. There is a compelling demand for a cancer registry in this region as well as proper implementation of preventive measures to combat this growing threat of cancer, many of whose risk factors are preventable.

A Study on the Simplified Estimating Method of Off-site Consequence Analysis by Concentration of Hydrochloric Acid (염산수용액의 농도별 간이 영향 평가 방법 연구)

  • Jung, Y.k.;Kim, B.;Heo, H.;Yoo, B.;Sin, C.;Yoon, Y.;Yoon, J.;Ma, B.
    • Journal of the Korean Society of Safety
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    • v.32 no.2
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    • pp.52-58
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    • 2017
  • One of the most important elements of the management of chemical accident is threat zone estimation of fires, explosions and toxic gas dispersion based on chemical releases. The threat zone estimation is going to be standard of emergency response for the first defender and base line data of off-site risk assesment (hereinafter referred to as "ORA") and risk management plan (hereinafter referred to as "RMP"). Generally, ALOHA form EPA(U.S.) and Kora(from KOREA MINISTRY OF ENVIRONMENT) has been used for the off-site consequence analysis in Korea. However it is hard to predict accurate consequences rapidly in case of emergency. Hydrochloric acid is a multipurpose raw material used in many industrial applications such as chemical, metal and food industries. It is usually treated in concentrations from 10 ~ 35 %, and release accident have occurred frequently. In this study, we have developed a simplified estimating method and equation to calculate threat zone easily in case of emergency due to release accident of hydrochloric acid.

The Incidences of Catheter Colonization and Central Line-Associated Bloodstream Infection According to Tegaderm vs. Chlorhexidine Gluconate (CHG)-Tegaderm Dressing (중심정맥관 번들이행에 따른 중심정맥관 균집락과 중심정맥관 관련 혈류감염: CHG테가덤과 일반테가덤 드레싱비교연구)

  • Kim, Eunji;Lee, Haejung
    • Journal of Korean Academy of Nursing
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    • v.50 no.4
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    • pp.541-553
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    • 2020
  • Purpose: In spite of the recent application of a general infection control method, central line-associated infections is still relatively high in Korea. Central line bundle with Chlorhexidine gluconate (CHG) tegaderm dressing was reported to be effective in reducing catheter colonization and central line-associated bloodstream infections (CLABSI). Therefore, this study aimed to examine the incidences of catheter colonization occurrence and CLABSI while using Tegaderm vs. CHG Tegaderm dressings. Methods: We used a descriptive design. 400 patients who had central venous catheters were selected from four hospitals in the Korean National Healthcare-associated Infections Surveillance System. Of all subjects, 200 used Tegaderm™ (Tegaderm group), and the remaining 200 used CHG Tegaderm (CHG Tegaderm group) dressing at the catheter insertion site. Data were analyzed using the χ2 test or Fisher's exact test, t-test, and logistic regression analysis using SPSS WIN 21.0. Results: In the Tegaderm and CHG Tegaderm groups, CLABSI incidences were 5.89 and 1.79 per 1,000 catheter-days, catheter colonization incidences were 3.93 and 1.43 per 1,000 catheter-days, and central line bundle compliance rates were 26.0% and 49.0%, respectively. Catheter colonization risk factors were 'reinsertion after failure' and 'Tegaderm dressing' at the central line insertion site. CLABSI risk factors were 'incomplete performance of 7 central line bundle items' and 'Tegaderm dressing' at the central line insertion site. Conclusion: A further prospective study is needed to examine the effects of central line bundle with CHG Tegaderm dressing, avoiding central line reinsertion after failure, and improving the bundle compliance in reducing catheter colonization and CLABSI.