• Safety and Health at Work
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• 제5권4호
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• pp.169-174
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• 2014

We have been examining the issue of healthcare workers' exposure to antineoplastic drugs for nearly a decade and have observed that there appears to be more publications on the subject matter originating from Europe than from North America. The concern is that findings from Europe may not be generalizable to North America because of differences in handling practices, regulatory requirements, and training. Our objective was to perform a literature review to confirm our observation and, in turn, identify gaps in knowledge that warrants addressing in North America. Using select keywords, we searched for publications in PubMed and Web of Science. All papers were initially classified according to the originating continent and then categorized into one or more subject categories (analytical methods, biological monitoring, occupational exposure, surface contamination, and probability of risk/exposure). Our review identified 16 papers originating from North America and 55 papers from Europe with surface contamination being the subject matter most often studied overall. Based on our results, we are of the opinion that North American researchers need to further conduct dermal and/or urinary drug contamination studies as well as assess the exposure risk faced by healthcare workers who handle antineoplastic drugs. Trends in exposure levels should also be explored.

• Structural Engineering and Mechanics
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• 제71권2호
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• pp.131-138
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• 2019

It is necessary to predict subway induced vibration if a new subway is to be built. To obtain the vibration response reliably, a three-dimensional (3D) FEM model, consisting of the tunnel, the soil, the subway load and the building above, is established in MIDAS GTS NX. For this study, it is a six-story frame structure built above line 3 of Guangzhou metro. The entire modeling process is described in detail, including the simplification of the carriage load and the determination of model parameters. Vibration measurements have been performed on the site of the building and the model is verified with the collected data. The predicted and measured vibration response are used together to assess vibration level due to the subway traffic in the building. The No.1 building can meet work and residence comfort requirement. This study demonstrates the applicability of the numerical train-tunnel-soil-structure model for the serviceability assessment of subway induced vibration and aims to provide practical references for engineering applications.

• Journal of Digestive Cancer Research
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• 제5권1호
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• pp.16-22
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• 2017

A specialist in the medical field is probably one of the most time-consuming professions to train for before one is considered an expert. Inclusive of medical school, it can take as long as 20 or more years of structured training before one graduates as a new specialist in a particular surgical subspecialty or medical field. A fellowship is often the last official phase in this professional marathon, typically defined as a 1 to 2-year full-on clinical subspecialty experience. One would expect this important "finishing school" to be well researched and written about, however, as compared to other professionals and fields, there is scanty literature on how one can get into a good fellowship program. This is a perspective piece on the intricacies of securing a position in a good fellowship program, drawn from the collective experience of the authors, their colleagues and friends. There are several ways to achieve this and many processes one will encounter. A variety of factors one will need to consider, decide and works towards in this effort of optimizing of their chances of success in getting into their fellowship program of choice. The thought processes, suggestions and solutions at each phase may be helpful. In conclusion, obtaining a choice fellowship position is as much an art as a science, and maybe some luck. Many factors, some more obvious and objective, some softer and more subtle, can all influence the outcome in one way or another.

• Asian Pacific Journal of Cancer Prevention
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• 제13권9호
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• pp.4623-4626
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• 2012

Background: The risk of treatment-related death (TRD) and febrile neutropaenia (FN) with adjuvant taxane-based chemotherapy for early breast cancer is unknown in Malaysia despite its widespread usage in recent years. This study aims to determine these rates in patients treated in University Malaya Medical Centre (UMMC). Patients and Methods: Patients who were treated with adjuvant taxane-based chemotherapy for early breast cancer stages I, II or III from 2007-2011 in UMMC were identified from our UMMC Breast Cancer Registry. The TRD and FN rates were then determined retrospectively from medical records. TRD was defined as death occurring during or within 30 days of completing chemotherapy as a consequence of the chemotherapy treatment. FN was defined as an oral temperature > $38.5^{\circ}C$ or two consecutive readings of > $38.0^{\circ}C$ for 2 hours and an absolute neutrophil count < $0.5{\times}10^9/L$, or expected to fall below $0.5{\times}10^9/L$. Results: A total of 622 patients received adjuvant chemotherapy during this period. Of these patients 209 (33.6%) received taxane-based chemotherapy. 4 taxane-based regimens were used namely the FEC-D, TC, TAC and AC-PCX regimens. The commonest regimen employed was the FEC-D regimen accounting for 79.9% of the patients. The FN rate was 10% and there was no TRD. Conclusion: Adjuvant taxane-based chemotherapy in UMMC for early breast cancer has a FN rate of 10%. Primary prophylactic G-CSF should be considered for patients with any additional risk factor for FN.

• Structural Engineering and Mechanics
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• 제74권6호
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• pp.789-807
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• 2020

Multiple earthquakes that occur during short seismic intervals affect the inelastic behavior of the structures. Sequential ground motions against the single earthquake event cause the building structure to face loss in stiffness and its strength. Although, numerous research studies had been conducted in this research area but still significant limitations exist such as: 1) use of traditional design procedure which usually considers single seismic excitation; 2) selecting a seismic excitation data based on earthquake events occurred at another place and time. Therefore, it is important to study the effects of successive ground motions on the framed structures. The objective of this study is to overcome the aforementioned limitations through testing a two storey RC building structural model scaled down to 1/10 ratio through a similitude relation. The scaled model is examined using a shaking table. Thereafter, the experimental model results are validated with simulated results using ETABS software. The test framed specimen is subjected to sequential five artificial and four real-time earthquake motions. Dynamic response history analysis has been conducted to investigate the i) observed response and crack pattern; ii) maximum displacement; iii) residual displacement; iv) Interstorey drift ratio and damage limitation. The results of the study conclude that the low-rise building model has ability to resist successive artificial ground motion from its strength. Sequential artificial ground motions cause the framed structure to displace each storey twice in correlation with vary first artificial seismic vibration. The displacement parameters showed that real-time successive ground motions have a limited impact on the low-rise reinforced concrete model. The finding shows that traditional seismic design EC8 requires to reconsider the traditional design procedure.

• 한국균학회지
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• 제33권2호
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• pp.64-68
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• 2005

Streptozotocin으로 당뇨가 유발된 흰쥐에 차가버섯 균사체를 2주간 체중 ka당 200 mg으로 경구투여시킨 후 혈장 glucose, total cholesterol, triglyceride, ALT, 및 AST 활성을 관찰하였고, 차가버섯 균사체의 일반성분을 조사하였다. 그 결과 체증증가는 당뇨 대조군에 비해 약 23.5% 증가하였고, 식이섭취량은 21.0% 낮게 나타났으며, 간장 무게는 18.1% 정도 감소하였다. 혈장 glucose 농도는 차가버섯 균사체 투여군이 당뇨 대조군보다 23.1%가 유의하게 감소하였으며, 혈장 total cholesterol과 triglyceride는 각각 12.6%와 22.6%로 낮게 나타났다. 또한 혈장 ALT와 AST 활성은 당뇨 대조군에 비해 차가버섯 균사체 투여군이 27.6%와 21.9% 낮은 활성을 보였다. 상기와 같은 항당뇨 활성을 가진 차가버섯 균사체의 일반성분을 분석한 결과 조회분 5.55%, 조지방 2.35%, 조단백 28.29%, 탄수화물 9.53% 및 식이섬유 54.28%로 구성되어 있었다.

• 한국의사학회지
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• 제22권1호
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• pp.31-45
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• 2009

Eui Bang Shin Gam("醫方新鑑") is a classic on oriental medicines written by Shin Oh (新塢) Han Byung Lyun (韓秉璉) in 1913. It was written under the base of the writer's own experience as well as in the light of 36 other classics on oriental medicines such as Dong Eui Bo Gam ("東醫寶監"), Eui Hak Yip Mun ("醫學入門"), and Kyung Ak Jeon Seo ("景岳全書"). In an attempt to avoid difficult theories and list only the essential informations and formulas for clinical purposes, it attained its own characteristics of not only reorganizing Dong Eui Bo Gam in a pragmatic way but also explaining diseases classified in western medicines in oriental medicines' point of view as well as suggesting medicine formulas regarding such explanations. As a result, it is a complete and efficient medical classic through which one can gain knowledge in both classic oriental medicines and combination of western and oriental medicines. Its special features are making a separate chapter for cholera and Lao Zhai (勞瘵), which is also a contagious disease, and trying in the chapter to explain the diseases in words of oriental medicines; listing details of nine major epidemic and matching them with the diseases known in oriental medicines; and recording a case of enforcing sterilization and preventive injection against contagious diseases. The basic medical theory in Eui Bang Shin Gam are the yin-yang theory, the thesis of fire and water, the thesis of the exterior and the interior, Yun Qi Lun (運氣論), and four institutions of human body. In explaining the basic theories, the writer emphasized strengthening the yang of the body, under the influence of the thoughts of Zhang Ga Bin (張介賓). Since he put the importance of diagnosis first, the first chapter is about diagnosis. There are five different ways of diagnosing a patient mentioned in the book, and acupuncture, pulse, and medicines was considered crucial.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1077-1082
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• 2016

Background: The three standard biomarkers used in breast cancer are the estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2). The Ki-67 index, a proliferative marker, has been shown to be associated with a poorer outcome, and despite absence of standardization of pathological assessment, is widely used for therapy decision making. We aim to study the role of the Ki-67 index in a group of Asian women with breast cancer. Materials and Methods: A total of 450 women newly diagnosed with Stage 1 to 3 invasive breast cancer in a single centre from July 2013 to Dec 2014 were included in this study. Univariable and multivariable logistic regression was used to determine the association between Ki-67 (positive defined as 14% and above) and age, ethnicity, grade, mitotic index, ER, PR, HER2, lymph node status and size. All analyses were performed using SPSS Version 22. Results: In univariable analysis, Ki -67 index was associated with younger age, higher grade, ER and PR negativity, HER2 positivity, high mitotic index and positive lymph nodes. However on multivariable analysis only tumour size, grade, PR and HER2 remained significant. Out of 102 stage 1 patients who had ER positive/PR positive/HER2 negative tumours and non-grade 3, only 5 (4.9%) had a positive Ki-67 index and may have been offered chemotherapy. However, it is interesting to note that none of these patients received chemotherapy. Conclusions: Information on Ki67 would have potentially changed management in an insignificant proportion of patients with stage 1 breast cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제13권4호
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• pp.1111-1113
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• 2012

The ER-/PR+ breast tumor may be the result of a false ER negative result. The aim of this study was to investigate whether there is a difference in patient and tumor characteristics of the ER-/PR+ phenotype in an Asian setting. A total of 2629 breast cancer patients were categorized on the basis of their age, ethnicity, tumor hormonal receptor phenotype, grade and histological type. There were 1230 (46.8%) ER+/PR+, 306 (11.6%) ER+/PR-, 122 (4.6%) ER-/PR+ and 972 (37%) ER-/PR-. ER-/PR+ tumors were 2.5 times more likely to be younger than 50 years at diagnosis (OR: 2.52; 95% CI: 1.72-3.67). Compared to ER+/PR+ tumors, the ER-/PR+ phenotype was twice more likely to be associated with grade 3 tumors (OR:2.02; 95%CI: 1.00-4.10). In contrast, compared to ER-/PR- tumors, the ER-/PR+ phenotype was 90% less likely to be associated with a grade 3 tumor (OR: 0.12; 95%CI:0.05-0.26), and more likely to have invasive lobular than invasive ductal histology (OR: 3.66; 95%CI: 1.47-9.11). These results show that the ER-/PR+ phenotype occurs in a younger age group and is associated with intermediate histopathological characteristics compared to ER+/PR+ and ER-/PR- tumors. This may imply that it is a distinct entity and not a technical artifact.

• Safety and Health at Work
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• 제2권3호
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• pp.273-281
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• 2011

Objectives: Studies examining healthcare workers' exposure to antineoplastic drugs have focused on the drug preparation or drug administration areas. However, such an approach has probably underestimated the overall exposure risk as the drugs need to be delivered to the facility, transported internally and then disposed. The objective of this study is to determine whether drug contamination occurs throughout a facility and, simultaneously, to identify those job categories that are potentially exposed. Methods: This was a multi-site study based in Vancouver, British Columbia. Interviews were conducted to determine the departments where the drugs travel. Subsequent site observations were performed to ascertain those surfaces which frequently came into contact with antineoplastic drugs and to determine the job categories which are likely to contact these surfaces. Wipe samples were collected to quantify surface contamination. Results: Surface contamination was found in all six stages of the hospital medication system. Job categories consistently found to be at risk of exposure were nurses, pharmacists, pharmacy technicians, and pharmacy receivers. Up to 11 job categories per site may be at risk of exposure at some point during the hospital medication system. Conclusion: We found drug contamination on select surfaces at every stage of the medication system, which indicates the existence of an exposure potential throughout the facility. Our results suggest that a broader range of workers are potentially exposed than has been previously examined. These results will allow us to develop a more inclusive exposure assessment encompassing all healthcare workers that are at risk throughout the hospital medication system.