• 대한한의학회지
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• 제23권4호
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• pp.73-90
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• 2002

Objectives: This study investigated significant factors that influence functional evaluation of stroke so as to be a fundamental data for estimating prognosis of stroke patients. Methods: 204 patients were studied within 7 days of admission, after the diagnosis of stroke through brain CT scan, brain MRI scan and clinical observations. They were hospitalized in the oriental medical hospital of Dongeui University from February to July in 2001. They were examined at the early stage of onset, after 2 weeks, 4 weeks and 6 weeks, and measured for average mark and the degree of improvement by using the Activity Index. Results: Ischemic stroke, past history of stroke, hypertension, diabetes mellitus, risk factor of obesity, non-professional emergency treatment and hospitalizing time after 1 day from onset, high blood pressure, tachycardia pulse and high blood sugar in abnormal vital sign in acute stage, conscious, cognitive or communication disorder, motor aphasia, dysphagia, constipation for more than 3 days, urinary incontinence, visual field defect, insomnia, and chest discomfort in early stage of onset had a negative influence on functional evaluation. Conclusions: Type of stroke, past history, risk factors, emergency treatment and hospitalizing time after onset, abnormal vital sign and intercurrent symptoms in Acute stage were relevant factors in predicting functional evaluation of stroke.

• Asian Pacific Journal of Cancer Prevention
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• 제16권7호
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• pp.2903-2908
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• 2015

Background: Head and neck cancer (HNC) is the eighth most common cancer as estimated from worldwide data. The incidence of HNC in Peninsular Malaysia was reported as 8.5 per 100,000 population. This study was aimed to determine the treatment outcomes for HNC patients treated in the Oncology Unit of University Malaya Medical Centre (UMMC). Materials and Methods: All newly diagnosed patients with squamous cell carcinoma of head and neck (HNSCC) referred for treatment to the Oncology Unit at UMMC from 2003-2010 were retrospectively analyzed. Treatment outcomes were 5-year overall survival (OS), cause specific survival (CSS), loco-regional control (LRC) and radiotherapy (RT) related side effects. Kaplan-Meier and log rank analyses were used to determine survival outcomes, stratified according to American Joint Committee on Cancer (AJCC) stage. Results: A total of 130 cases were analysed. Most cases (81.5%) were at late stage (AJCC III-IVB) at presentation. The 5-year OS for the whole study population was 34.4% with a median follow up of 24 months. The 5-year OS according to AJCC stage was 100%, 48.2%, 41.4% and 22.0% for stage I, II, III and IVA-B, respectively. The 5-year overall CSS and LCR were 45.4% and 55.4%, respectively. Late effects of RT were documented in 41.4% of patients. The most common late effect was xerostomia. Conclusions: The treatment outcome of HNSCC at our centre is lagging behind those of developed nations. Efforts to increase the number of patients presenting in earlier stages, increase in the use of combined modality treatment, especially concurrent chemoradiotherapy and implementation of intensity modulated radiotherapy, may lead to better outcomes for our HNC patients.

• Journal of Gastric Cancer
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• 제3권1호
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• pp.44-49
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• 2003

Purpose: The aim of this study was to investigate the impact of survivin expression and the decrease or loss of KAI-1 on the clinical stage and the survival rate in gastric adenocarcinomas. Materials and Methods: Expressions of survivin and KAI-1 were immunohistochemically determined in 40 cases of gastric adenocarcinomas. The survivin and KAI-1 expressions were also analyzed by using western blots in 14 cases among them. Results: Resected gastric cancer specimens from 40 patients (intestinal type: 15 cases and diffuse type: 25 cases) were evaluated immunohistochemically. Survivin protein expressions were significantly higher in diffuse types (P=0.03) and in advanced clinical stages (UICC TNM II and III, P=0.02). In contrast, a decrease or loss of KAI-1 expression had no statistically significant correlation with the Lauren classification or the clinical stage. Survivin protein positivity was associated with an unfavorable prognosis. Decrease or loss of KAI-1 was associated with a shorter disease free survivial rate (P < 0.01). The western blot data (n=14) indicated that neither survivin protein over-expression nor KAI-1 down-expression had an significant correlation with the Lauren classification or the clinical stage. Conclusion: In gastric carcinomas, survivin over-expression and decrease or loss of KAI-1 were associated with unfavorable prognosis, being independent prognostic factors along with the clinical stage and the disease free survival rate.

• 대한두경부종양학회지
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• 제21권1호
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• pp.26-31
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• 2005

Backgrounds and Objectives: Squamous cell carcinomas of the oral cavity(SCOC) in TNM stage I & II have relatively high chance to be cured compared to those in the advanced stage, but sometimes result in the treatment failure with poor prognosis. There have been few reports on the patterns of failure and the clinical courses for SCOC in stage I & II after the failure of initial treatment. This study is directed at identifying the clinical outcomes of stage I & II SCOC and the salvage rate after initial treatment and suggesting an optimal level of treatment by analyzing the patterns of failure. Material and Methods: The medical records of 36 patients with SCOC, initially diagnosed between 1995 and 2001 as TNM stage I & II were reviewed retrospectively. The patterns of failure, salvage treatment, clinical courses, and the survival of these subjects were analyzed. The minimum follow-up period of no-evidence of disease(NED) was 12 months with an average of 32.2 months. Results: Overall rate of the treatment failure in SCOC of stage I & II was 41. 7%(15/36 cases). Most of the treatment failure in the subjects with stage I tumors occurred in regional lymph node. Local failure was the most frequent form of failure in the subjects with stage II tumors after wide excision of primary tumor with elective neck dissection and/or radiation therapy. No significant correlation was noted between the safety margin and the local failure. Elective neck dissections in stage I & II SCOC had a tendency to reduce regional failure (p=0.055). The salvage rates at 24 months were 85.7% in stage I, and 37.5% in stage II. The 3-year survival rate after the failure of initial treatment was 55.0%. Conclusion: SCOC of stage I & II after the failure of initial treatment showed poor prognosis despite of the salvage treatments. This study implies that the elective neck dissections for regional lymph node should be required for SCOC of stage I & II to reduce the treatment failure.

• 대한치과의사협회지
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• 제49권3호
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• pp.136-145
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• 2011

Oral cavity cancer accounts for approximately 3-4% of all malignancies and is a significant worldwide health problem. The Korea Central Cancer Registry estimates that there will be approximately 1500 new cases of oral cancer in Korea. Oral cancer occurs most commonly in middle-aged and elderly individuals. The majority of oral malignancies occur as squamous cell carcinomas and despite remarkable advances in treatment modalities, the 5-year survival rate has not significantly improved over the past several decades, hovering at about 50% to 60%. The unfavorable 5-year survival rate may be attributable to several factors. First, oral cancer is often diagnosed at a late stage, with late stage 5-year survival rates as low as 22%. Additionally, the development of secondary primary tumors in patients with early stage disease has a major impact on survival. The early detection of oral cancer and premalignant lesions offers the promise to cure chance of oral cancer. The major diagnostics moddalities for oral cancer include oral cavity examination, supravital staining, oral cytology, and optical detection systems. But the clinical finding of oral mucosa is the most important key to confirm the oral cancer until now. The traditional clinical examination of oral cavity can be performed quickly, is without additional diagnostic expense to patients, and may be performed by health care professionals. Therefore, clinicians must be well-acquainted with clinical characteristics of oral cancer and practice routine screening for oral cancer in dental clinic to decrease the morbidity and mortality of disease.

• Communications for Statistical Applications and Methods
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• 제15권5호
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• pp.727-735
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• 2008

Consider a clinical trial in which the main end-point is survival. Suppose after the start of the study an intermediate event occurs which may be influenced by a covariate(or treatment). In many clinical studies the occurrence of an intermediate event may change the survival distribution. This investigation develops two-stage model which, in the first stage, models the effect of covariate on the intermediate event and models the relationship between survival time and covariate as well as the intermediate event. In this paper, the two-stage model is presented in order to model intermediate event and a test based on this model is also provided. A numerical simulations are carried out to evaluate its overall significance level.

• Asian Pacific Journal of Cancer Prevention
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• 제14권8호
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• pp.4567-4570
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• 2013

Background: Nasopharyngeal carcinoma (NPC) is the commonest radiocurable cancer in Malaysia. This study aimed to determine the treatment outcomes and late effects of radiotherapy for NPC patients treated in University Malaya Medical Centre (UMMC). Materials and Methods: All newly diagnosed patients with NPC referred for treatment to the Oncology unit at UMMC from 2004-2008 were retrospectively analyzed. Treatment outcomes were 5 years overall survival (OS), disease free survival (DFS), cause-specific survival (CSS), locoregional control (LRC) and radiotherapy-related late effects. The Kaplan-Meier method was used for survival analysis and differences in survival according to AJCC stage was compared using the log-rank test. Results: A total of 176 patients with newly diagnosed NPC were treated in UMMC during this period. Late presentation was common, with 33.5% presenting with T3-4 disease, 84.7% with N1-3 disease and 75.6% with AJCC stage 3-4 disease. Radical RT was given to 162 patients with 22.7% having RT alone and 69.3% having CCRT. The stipulated OTT was 7 weeks and 72.2% managed to complete their RT within this time period. Neoadjuvant chemotherapy was given to 14.8% while adjuvant chemotherapy was administered to 16.5%. The 5 years OS was 51.6% with a median follow up of 58 months. The 5 years OS according to stage were 81.8% for stage I, 77.9% for stage II, 47.4% for stage III and 25.9% for stage IV. The 5 years overall CSS, DFS and LRC were 54.4%, 48.4% and 70.6%, respectively. RT related late effects were documented in 80.2%. The commonest was xerostomia (66.7%). Other documented late effects were hearing deficit (17.3%), visual deficit (3.1%), neck stiffness (3.1%), dysphagia (3.4%), cranial nerve palsy (2.5%), pneumonitis (0.6%) and hypothyroidism (1.2%). Conclusions: The 5 years OS and LRC in this study are low compared to the latest studies especially those utilizing IMRT. Implementation of IMRT for NPC treatment should be strongly encouraged.

• 대한한방부인과학회지
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• 제21권4호
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• pp.228-236
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• 2008

Purpose: The purposes of this study is to provide basic informations on oriental medical research and treatment through analysis of breast cancer patients, who visited M $\mu$ integrative cancer center, O O university East-West neo medical center. Methods: Electronic medical records of 106 breast cancer patients who visited oriental medical center from June 2, 2006 to February 28, 2008 were selected to collect clinical data of those patients. Clinical data were analyzed for types of clinical characteristics, and received therapies. For analysis of survival and recurrence, Kaplan-Meier method was used. All the data were processed and analyzed using SPSS version 13.0. Results: Average age of breast cancer patients, who visited oriental medical center was 48.72 ($\pm$10.13). The stage distribution record indicated stage I (5.8%), stage II (7.0%), stage III (5.8%), and stage IV (81.4%). Original purposes of patients were analyzed to be supplementary treatment for western therapy (68.9%), treatment for recurrence prevention (18.9%), and oriental medical treatment (12.2%) in order. While receiving oriental medical treatment, 60.4% of patients received conventional medical treatment simultaneously. Conclusion: Majority of patients who visited oriental medical hospital were stage IV at terminal stage and mainly visited for the purpose of supportive care. Further clinical study of breast cancer patients is needed to validate the effectiveness of oriental medical treatment based on this study.

• Asian Pacific Journal of Cancer Prevention
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• 제14권7호
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• pp.4215-4221
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• 2013

Purposes: Lung cancer is prevalent worldwide and improvements in timely and effective diagnosis are need. Pentraxin-3 as a novel serum marker for lung cancer (LC) has not been validated in large cohort studies. The aim of the study was to assess its clinical value in diagnosis and prognosis. Methods: We analyzed serum PTX-3 levels in a total of 1,605 patients with LC, benign lung diseases and healthy controls, as well as 493 non-lung cancer patients including 12 different types of cancers. Preoperative and postoperative data were further assessed in patients undergoing LC resection. The diagnostic performance of PTX-3 for LC and early-stage LC was assessed using receiver operating characteristics (ROC) by comparing with serum carcinoembryonic antigen (CEA), cytokeratin 19 fragments (CYFRA 21-1). Results: Levels of PTX-3 in serum were significantly higher in patients with LC than all controls. ROC curves showed the optimum diagnostic cutoff was 8.03ng/mL (AUC 0.823, [95%CI 0.789-0.856], sensitivity 72.8%, and specificity 77.3% in the test cohort; 0.802, [95%CI 0.762-0.843], sensitivity 69.7%, and specificity 76.4% in the validate cohort). Similar diagnostic performance of PTX-3 was observed for early-stage LC. PTX-3 decreased following surgical resection of LC and increased with tumor recurrence. Significantly elevated PTX-3 levels were also seen in patients with non-lung cancers. Conclusions: The present data revealed that PTX-3 was significantly increased in both tissue and serum samples in LC patients. PTX-3 is a valuable biomarker for LC and improved identification of patients with LC and early-stage LC from those with non-malignant lung diseases.

• 생물정신의학
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• 제20권4호
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• pp.119-128
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• 2013

Objectives Memory impairment is a very important mental health issue for elderly and adults. Mild cognitive impairment (MCI) is a prodromal stage of Alzheimer's disease (AD). Early detection of the prodromal stage of patients with AD is an important topic of interest for both mental health clinicians and policy makers. Methods Electroencephalograpgy (EEG) has been used as a possible biological marker for patients with MCI, and AD. In this review, we will summarize the clinical implications of EEG and ERP as a biological marker for AD and MCI. Results EEG power density, functional coupling, spectral coherence, synchronization, and connectivity were analyzed and proved their clinical efficacy in patients with the prodromal stage of AD. Serial studies on late event-related potentials (ERPs) were also conducted in MCI patients as well as healthy elders. Even though these EEG and ERP studies have some limitations for their design and method, their clinical implications are increasing rapidly. Conclusion EEG and ERP can be used as biological markers of AD and MCI. Also they can be used as useful tools for early detection of AD and MCI patients. They are useful and sensitive research tools for AD and MCI patients. However, some problems remain to be solved until they can be practical measures in clinical setting.