Background: Surgical resection of spontaneously ruptured hepatocellular carcinoma (HCC) after successful transarterial embolization (TAE) remains controversial. The aim of this study was to investigate its efficacy in a series of cases. Materials and Methods: We retrospectively examined ruptured HCC cases from Jan 2000 to Dec 2008; all of these 126 cases received TAE as the initial therapy. Subsequently, 74 cases received staged surgical resection, and the remaining 52 cases underwent repeated TACE. The baseline demographic data, tumor characteristics, and long term survival were recorded and compared. Results: The demographic and baseline characteristics were comparable between the hepatic resection and TACE groups; furthermore, no significant difference in the tumor characteristics was detected between the two groups. The differences in in-hospital, 30-day and 90-day mortality between the two groups were not significant (P>0.05). However, the 1-, 3-, and 5-year overall survival rates were 85.1%, 63.5%, and 37.8%, respectively, in the hepatic resection group, which were significantly higher than those in the TACE group (69.2%, 46.2%, and 17.3%, respectively, P=0.004). Univariate and multivariate analyses indicated that these patients benefitted from hepatic resection compared with TACE with respect to long-term outcomes. Conclusions: Staged hepatic resection after TAE is an effective treatment that results in superior long-term survival to repeated TACE.
In a summer study during May to July, involving 12 young Murrah buffalo bulls at forty months of average age, the effects of multiple shower vs single shower body cooling and vitamin A, D and E supplementation on the sexual behaviour, semen quality and freezability were investigated. The animals were divided into two groups (6 animals in each group) and housed in a half-walled shed with proper spacing, the feeding management being identical. The bulls in the control group were given a single shower at 1000 h, whereas the experimental bulls were given four showers at 10,12,14 and 16 h. In addition, the experimental bulls were given vitamin A, D and E injections at fifteen day intervals. The sexual behaviour of bulls was observed in terms of reaction time, sexual aggressiveness and ejaculatory thrust. Semen quality of all the bulls was assessed in terms of volume, mass activity, live-dead sperm and sperm concentration, sperm motility and morphology, and acrosomal abnormality. The sexual behaviour did not vary significantly between the groups, whereas semen quality differed significantly for volume, per cent live sperms, total sperms per ejaculate and total live sperm per ejaculate between groups. It can be concluded that sexual behaviour was not influenced by the thermal comfort treatment coupled with periodic vitamin A, D and E injections. But the treatments improved most of the seminal traits in the experimental group of bulls. However, benefit of treatment was not reflected in the freezability traits of the semen.
Certain indigestible oligosaccharides may benefit gastrointestinal tract via fermentation and proliferation of desirable bacterial species. The purose of this study was to elucidate the effect of selected oligosaccharides, such as fructooligosaccharides(FOS), soybean oliosaccharides(SOE), and highly concentrated branched oligosaccharides(HiBOS), on fecal micorflora proliferation, lipid concentration, lipid peroxide formation and antioxidant enzymes acitivies in plasma and liver of the rats. Thirty two male Sprague-Dawley rats were randomly assigned to one of four treatments ; 1) control diet(AIN-93G diet); 2) control diet +5% FOS ; 3) control diet + 5% SOE ; 4) control diet + 5% HiBOS. The duration of the study was 4 weeks. Fecal bifidobacteria concentration were significantly higher (p<0.05) in the HiBOS group compared with the control after 4 weeks of dietary treatment. FOS and SOE groups also had higher fecal bifidobacteria levels than control, but statistical significance was not found. The concentration of plasma total lipid was decreased by oligosaccharide consumption, especially in HiBOS group(p<0.05). The concentration of plasma total triglyceride was significantly lower in all of the oligosaccharide containing groups compared with the control(p<0.05). The plasma total cholesterol concentration tended to be lower in the oligosaccharide consuming groups than control. The concentrations of hepatic total lipid, triglyceride and total cholesterol were not affected by consumption of oligosaccharides. Thiobarbituric acid reactive substance(TBARS) concentrations and antioxidant enzyme activities in plasma and liver were not affected much by experimental diets. There results suggest that dietary oligosaccharides may be beneficial for increasing intestinal bifidobacteria and lowering plasma lipid levels.
The purposes of this study were to segment the men in twenties and thirties according to clothing benefits sought, and to develop a profile of each segment concerning shopping orientation, self·image, and importance of store attributes. The questionnaire was administered to men in twenties and thirties living in Seoul and data were analyzed by frequency, percentage, factor analysis, cluster analysis, and MANOVA(multivarite analysis of variance). By cluster analysis of clothing benefits sought, three groups were identified and labeled as: (1) the group of focusing the influence of other people and comfort clothing(31.7%): (2) the group of pursuing the fashion trend (48.1%); the group of pursuing the individuality(20.1%). Three groups were then compared through MANOVA on shopping orientation, importance of store attributes, and self-image. Significant differences were found among three groups on three variables. In general, the group of focusing the influence of other people and comfort clothing tended to be ostentatious and tended to wear comfortable clothing. The group of pursuing the fashion trend didn't show specific shopping orientation and just liked to follow the current fashion trend. The group of pursuing the individuality enjoyed the shopping and liked to buy the clothing which enhances the personal character.
The study examined and compared relationships among self-esteem, self-efficacy, and academic achievement of children in poverty and the comparative groups. The subjects of this study were 97 elementary school students who had benefited from the free meal project and 97 students as the comparative group who did not receive the benefit. Descriptive statistics, Cronbach's ${\alpha}$ tests, and multiple regression analysis were employed to analyze the data. The results showed that academic scores of the comparative group were statistically higher than those of children in the poverty group in Korean language, mathematics, science, and sociology. Also, self-esteem of children in the poverty group was lower than that of the comparative group's in terms of leadership and popularity. The poverty group also showed lower self-efficacy in self-regulated efficacy tasks. Finally, multiple regression analysis demonstrated that different sub-factors of self-esteem and self-efficacy predicted the academic achievement of children in poverty group and the comparative groups.
Purpose: Pancreatic carcinoma is one of the most malignant tumors of the alimentary system, with relatively high incidence rates. The purpose of this study was to assess the efficacy and safety of two regimens for advanced pancreatic carcinoma: continuous transarterial infusion versus systemic venous chemotherapy with gemcitabine and 5-fluorouracil. Methods: Of the 48 patients with advanced pancreatic carcinoma receiving chemotherapy with gemcitabine and 5-fluorouracil, 24 received the selective transarterial infusion, and 24 the systemic chemotherapy. For the continuous transarterial infusion group (experimental group), all patients received gemcitabine 1000 mg/$m^2$, given by 30-minute transarterial infusion, on day 1 of a 4-week cycle for 2 cycles, and a dose of 600 mg/$m^2$ 5-fluorouracil was infused on days 1~5 of a 4-week cycle for 2 cycles. For the systemic venous group (control group), gemcitabine and 5-fluorouracil were infused through a peripheral vein, a dose of 1000 mg/$m^2$ gemcitabine being administrated over 30 min on days 1 and 8 of a 4-week cycle for 2 cycles, and a dose of 600 mg/$m^2$ 5-fluorouracil was infused on days 1~5 of a 4-week cycle for 2 cycles. The effectiveness and safety were evaluated after 2 cyclesaccording to WHO criteria. Results:The objective effective rate in transarterial group was 33.3% versus 25% in the systemic group, the difference not being significant (P=0.626). Clinical benefit rates(CBR) in the transarterial and systemic groups were 83.3% and 58.3%, respectively (P=0.014). The means and medians for survival time in transarterial group were higher than those of the systemic group (P < 0.005). at the same time, the adverse effects did not significantly differ between the two groups (P > 0.05). Conclusion: Continuous transarterial infusion chemotherapy with gemcitabine and 5-fluorouracil could improve clinical benefit rate and survival time of patients with advanced pancreatic carcinoma, compared with systemic venous chemotherapy. Since adverse effects were limited in the transarterial group, the regimen of continuous transarterial infusion chemotherapy can be used more extensively in clinical practice. A CT and MRI conventional sequence can be used for efficacy evaluation after chemotherapy in pancreatic carcinoma.
In recent years, national health insurance(NHI) coverage had been expanded gradually for cancer as a severe disease requiring high level of medical expenditure, to reduce patient's financial burden. But, subjective burdens level for out-of-pocket(OOP) money expense are still considerable owing to high medical cost and decent numbers of services not covered by benefit plan. This study aimed to investigate OOP medical expenditures and identify factors influencing subjective financial burden in cancer patients. A 28-items questionnaire for self-reporting by responders was designed to satisfy study goal and finalized following by one pilot study and experts' verification process. Subjects were enrolled during July to October 2010 through regular meetings organized by five patient or patient-advocacy groups had acknowledged the study purpose. Subjects who aged 20 or more, have histories of cancer diagnosis and anticancer drug use, and voluntarily agreed to participate in this study were recruited. Total 107 subjects included in the analysis have cancer lesions in breast, colon, kidney, liver or stomach at the stages from I to IV. Approximately 73% of them has passed less than 5 years since cancer diagnosis. For the OOP medical expenditure regarding cancer, less 6 million won was in 31%, 6-15 million won in 35% and more than 15 million won in 28% of responders, and more than half responders(58%) felt financial burden subjectively. 63% of responders had subscribed commercial insurances, resulting in money receipts of more than 10 million won since cancer diagnoses in 76% of responders. Logistic regression results showed significant differences in subjective OOP financial burden level depending on gender, household income level, benefit type, commercial insurance money receipt degree, year cancer diagnosed, cancer lesion, therapy type, duration of anticancer drug use, drug listing in national formulary, total OOP medical expenditure and total OOP anticancer drug expense. They had mixed feelings both wishes to expand NHI coverage to reduce financial burden(70%) and no willingness to increase premium(59%). This result suggested that NHI might direct future strategies to reduce absolute total OOP medical cost and expand benefit plan coverage in higher burden groups in particular.
To clarify whether gastric cancer patients can benefit from laparoscopy-assisted surgery completed by junior surgeons under supervision of expert surgeons, data of 232 patients with gastric cancer underwent operation performed by inexperienced junior surgeons were reviewed. Of the 232 patients, 137 underwent laparoscopy-assisted resection and in 118 cases this approach was successful. All of these 118 patients were assigned to laparoscopic group in this study, 19 patients who were switched to open resection were excluded. All laparoscopic operations were performed under the supervision of expert laparoscopic surgeons. Some 95 patients receiving open resection were assigned to the open group. All open operations were completed independently by the same surgeons. Short-term outcomes including oncologic outcomes, operative time intra-operative blood loss, time to first flatus, time to first defecation, postoperative hospital stay and perioperative complication were compared between the two groups. The numbers of lymph nodes harvested in the laparoscopic and open groups were $21.1{\pm}9.6$ and $18.2{\pm}9.7$ (p=0.029). There was no significant difference in the length of margins. The mean operative time was $215.9{\pm}32.2$ min in laparoscopic group and $220.1{\pm}34.6min$ in the open group (p=0.866), and the mean blood loss in laparoscopic group was obviously less than that in open group ($200.9{\pm}197.0ml$ vs $291.1{\pm}191.4ml$; p=0.001). Time to first flatus in laparoscopic and open groups was $4.0{\pm}1.0$ days and $4.3{\pm}1.2$ days respectively and the difference was not significant (p=0.135). Similarly no statically significant difference was noted for time to first defecation ($4.7{\pm}1.6$ vs $4.8{\pm}1.6$, p=0.586). Eleven patients in the laparoscopic group and 19 in the open group suffered from peri-operative complications and the difference between the two groups was significant (9.3% vs 20.0%, p=0.026). The conversion rate for laparoscopic surgery was 13.9%. Patients with gastric cancer can benefit from laparoscopy-assisted operations completed by inexperienced junior surgeons under supervision of expert laparoscopic surgeons.
Lately, as the problem of the aged poverty becomes a big social issue, this paper studies the problem of financial stability with respect to the income and consumption of before-and-after retirement generations. After dividing the data in Korean Longitudinal Study of Ageing(KLoSA) into retired and non-retired groups, this study compares the difference among ageing groups by cross analysis and t-test. First, the result tells that the total personal income of retired group is lower than the one of non-retired group. Second, the public pension income benefit ratio of retired group is only 30% of it's total income, and the amount of public pension appears to be 40% of the total pension income. The benefit ratio of the personal pension income is low as about 1% in both groups, The private transfer income of the retired group takes relatively large portion in its total personal income. Third, as people gets older, financial stability gets worse because consumption does not decrease as much as the income decreases. Fourth, it is turned out that the expectation of old life supporting from nation is low in both groups. Fifth, the factors that affects the income of the public pension in the retired group are gender, age, education, and health status, when compared with the factors to the personal total income of the non-retired group. In terms of policy, this paper emphasizes the needs of the intensification of the public pension and the support for the revitalization of the personal pension.
Chon, Song Bin;Jung, Sung Koo;Kwak, Young Ho;Suh, Gil Joon;You, Eun Young;Shin, Sang Do
Tuberculosis and Respiratory Diseases
/
v.57
no.2
/
pp.148-159
/
2004
Background : This study was conducted to evaluate the survival benefit of the bronchial arterial embolization (BAE) for patients presenting with non-traumatic hemoptysis. Methods : The clinical data were retrospectively collected from the medical records and the Order Communicating Systems (OCS). The information dealing with death was collected from national death certificates. After enrolled patients were divided with two group such as BAE group (patients who were managed with BAE) and non-BAE group (patients who were managed with conservative modality), the survival benefit of BAE was estimated during the observational period of 24 months through using the Kaplan-Meier survival graph and the Cox-proportional hazard regression analysis. Results : The number of total cases was 272. Of these, BAE group involved 63 and non-BAE group involved 209. 69 cases had the malignant pulmonary lesions, 149 cases had non-malignant chronic lung lesion such as the mycobacteria infection, fungus ball, or bronchiectasis (BE), and 54 cases had the other pathologic conditions. For each sub-groups such as 'malignant lung lesion' group, 'non-malignant chronic lung lesion' group as well as about all cases, the adjusted hazard ratios (HRs) of BAE for death was not significantly different compared to the conservative management. But the adjusted HRs as to underlying causes such as 'malignant lung lesion' group and 'the other conditions' group increased significantly compared to 'non-malignant chronic lung lesion' group. Conclusion : There was no significant survival benefit by BAE procedure on survival in patients presenting with non-traumatic hemoptysis.
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