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Causes of Sensori-Neural Hearing Impairment in Korean Children (감음신경성난청(感音神經性難聽)의 원인(原因)에 관(關)하여)

  • Rhee, Kyu-Shik;Kim, Young-Soon;Kwon, Do-Ha;Kim, Joo-Ho;Kwon, Yo-Han;Rhee, Tae-Yung;Paik, Choon-Ki;Kim, Doo-Hie
    • Journal of Preventive Medicine and Public Health
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    • v.9 no.1
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    • pp.55-64
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    • 1976
  • This paper presents the results of a survey for the causes of sensori-neural hearing impairment in Korea, The subjects were 1,676 children of total 2,928 enrolled in 16 Deaf Schools; two schools in each area of Seoul, Busan, Kyoungbook, Kyoungnam, Kyounggi and Chunbug, and each one in Chungnam, Chungbug, Chunnam and Jaeju. The data were collected by questionaire with 28 items distributed to their parents. The filling in the check lists were performed by their class teachers, interviewer, for 18 months from September, 1975 to february, 1976. The questionable or missed problems were reaffirmed. The results obtained were as follows. Most of the reasons, 78.5% were acquired characters that could be developed during pregnant period, the time of delivery and the time of after birth. The pure hereditary reasons except the cases complexed with one or two were only 11.3%. Those who could not be defined with any reasons were 10.2%. Among the acquired causes, 5.8% of total subjects were developed for pregnancy: 3.3%, during delivery; and 69.7%, after birth. In the pregnant period, the drug intoxications were 2.4% of total subjects, several diseases such as influenja, bleeding, surgical operation, venereal diseases and rubella etc. were about one percent, and the accompanied with some symptoms of pregnancy intoxication and traumatic events were 2.4%, During time, the cases with delayed rhythmical pain were 16 persons, the immaturities were 11, the asphyxial cases were nine, the errors of forceps delivery were seven, the cases of low body weight inspite of full term were four, the cases with cesarian section were three, the head injuries were two, and the accompanied with three kinds of above reasons were three. During after birth, the cases with acute communicable diseases were 35.4% of total subjects, the fever unknown origin were 16.1%, the chronic otitis media were 3.7%, the meningitis were 3.5%, the gastric and nutritional diseases were 3.5%, the drug intoxications were 4.8%, the blood diseases were 0.3% and the other causes were 2.2%. Here by acute communicable diseases, some importants were measle, 10.1% of total subjects; meningitis, 7.3%; convulsion with some reasons, 4.9%; poliomyelitis. 3.2%; encephalitis, 2.4%; and mumps, rubella, pertusis, scarlet fever, and small pox were somewhat played a role in. Among 59 cases with train diseases, 53 were concussion by the accidents, such as traffic and falling or sliping down etc., the cerebral paralysis and hydrocephalus were two, respectively. And the blood diseases were severe newjaundice in all five cases. If we were summarized with the above mentioned, most of the hearing impairments were introduced by the combined reasons with familial or hereditary factors and the acquired, than by a simple disease. Among the congenital or hereditary hearing impairments classified to now a day, we suppose that the many cases with the acquired causes during pregnancy, delivery and after birth were complexed. Subsequently, the maternal and child health should be more and more developed in our country, also.

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Intracerebral Regional and Vasculature-Specific Distributions of Ischemic Cerebrovascular Diseases: Using MRI and MRA (MRI와 MRA를 이용한 허혈성 뇌혈관 질환의 뇌혈관별 분포에 대한 연구)

  • Kim, Ham-Gyum
    • Journal of radiological science and technology
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    • v.33 no.3
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    • pp.223-230
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    • 2010
  • The purpose of this study was to utilize Magnetic Resonance Imaging (MRI) and Magnetic Resonance Angiography (MRA) to analyze intracerebral regional distributions (hot spot) of ischemic cerebrovascular diseases which were characterized by stenosis and occlusion cerebral vasculature, except for cerebrovascular diseases induced by rupture of cerebral vasculature in terms of Korean people's cerebrovascular diseases, so that it could apply the findings of analysis to clinical practices. This study focused only on analyzing intracerebral regional distributions of ischemic cerebrovascular diseases that are characterized by stenosis and occlusion cerebral vasculature, because there are different etiologic mechanisms of ischemic cerebrovascular diseases like hemorrhagic cerebrovascular diseases (caused by rupture of cerebral vasculature) and cerebral infarction (induced by atheromatous arteriosclerosis). As a result, this study could come to the following findings of analysis: 1. According to sex ratio analysis, it was found that male group comprised larger portion of total 626 subjects in this study than female one (55.0% > 45.0%). 2. According to analysis on actual intracerebral regional distributions of ischemic cerebrovascular diseases, it was found that most subjects (37.5 %) were attacked by such diseases on the right side of cerebral vasculature, which was followed by left side of cerebral vasculature (35.1%) and bilateral cerebral vasculature (27.3%) respectively. 3. According to analysis on actual intracerebral regional distributions of ischemic cerebrovascular diseases, it was found that internal carotid artery (ICA) comprised the largest portion (38.9%) of those distributions, which was followed by middle cerebral artery (MCA, 35.7%), posterior cerebral artery (PCA, 13.4%), anterior cerebral artery (ACA, 6.0%) and vertebral artery (VA, 3.3%) respectively. 4. It was found that there was no subject attacked by any disease on A-com region, and there was only one male subject attacked by cerebrovascular diseases on P-com region. 5. It was found that female group was more susceptible to the attack of cerebrovascular diseases on MCA region than male one (54.6% > 42.2%), which means significant differences depending upon sex on statistical basis ($x^2$ = 9.64, p < .01). 6. It was found that male group was more susceptible to the attack of cerebrovascular diseases on ICA region (56.4% > 46.8%), which means significant differences depending upon sex on statistical basis ($x^2$ = 5.71, p < .05). 7. Moreover, it was also found that male group was more susceptible to the attack of cerebrovascular diseases on BA region (2.3% > 0.4%), which means significant differences depending upon sex on statistical basis ($x^2$ = 4.25, p < .05). 8. However, it was found that there was not any significant difference in intracerebral vasculature-specific distributions of cerebrovascular diseases depending on age of subjects, and stenosis comprised larger portion of cerebrovascular diseases than occlusion.

Trial for Drug Susceptibility Testing of Mycobacterium tuberculosis with Live and Dead Cell Differentiation (세포 염색 방법을 이용한 결핵균 감수성 검사법)

  • Ryu, Sung-Weon;Kim, Hyun-Ho;Bang, Mun-Nam;Park, Young-Kil;Park, Sue-Nie;Shim, Young-Soo;Kang, Seongman;Bai, Gill-Han
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.3
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    • pp.261-268
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    • 2004
  • Background : The resurgence of tuberculosis and outbreaks of multidrug resistant (MDR) tuberculosis have increased the emphasis for the development of new susceptibility testing of the Mycobacterium tuberculosis for the effective treatment and control of the disease. Conventional drug susceptibility testings, such as those using egg-based or agar-based media have some limits, such as the time required and difficulties in determining critical inhibitory concentrations, but these are still being used in many diagnostic laboratories because of no better lternatives, considering cost and accuracy. To overcome these limits, a rapid and simple method for new susceptibility testing, using live and dead assays, was applied for a bacterial cell viability assay to distinguish dead from live bacterial cells based on two-color fluorescence. Materials and Methods Strains : Forty strains were used in this study, 20 susceptible to all antituberculosis drugs and the other 20 resistant to the four first line antituberculosis drugs isoniazid, rifampicin, streptomycin and ethambutol. Antibiotics : The four antibiotics were dissolved in 7H9 broth to make the following solutions: $0.1{\mu}g\;isoniazid(INH)/m{\ell}$, $0.4{\mu}g\;rifampicin(RMP)/m{\ell}$, $4.0{\mu}g\;streptomycin(SM)/m{\ell}$ and $4.0{\mu}g\;ethambutol(EMB)/m{\ell}$. Results : Live and dead Mycobacterium tuberculosis cells fluoresced green and red with the acridin (Syto 9) and propidium treatments, respectively. These results are very well accorded with conventional drug susceptibility testing by proportional method on Lowensen-Jensen media (L-J) containing 4 drugs (INH, RMP, EMB and SM), showing a 93.7 % accordance rate in susceptible strains and 95% in resistant strains. Conclusion : The results of the drug susceptibility testing using the live and dead bacterial cell assay showed high accordance rates compared with the conventional proportion method on L-J. This finding suggests that the live and dead bacterial cell assay can be used as an alternative to conventional drug susceptibility testing for M. tuberculosis strains.

The Utility of Measurement of Plasma N-terminal Pro-brain Natriuretic Peptide in Diagnosis of Pulmonary Hypertension (폐동맥고혈압 진단에 있어 N-terminal Pro-brain Natriuretic Peptide 측정의 유용성)

  • Hahn, Chang Hoon;Kang, Seok Min;Moon, Jin Wook;Cho, Jae Hee;Hwang, Sang Yon;Lee, Jung Min;Park, Moo Suk;Chung, Jae Ho;Kim, Young Sam;Kim, Se Kyu;Chang, Joon;Shim, Won Heum;Kim, Sung Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.1
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    • pp.67-76
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    • 2004
  • Background : Pulmonary hypertension is a poor prognostic factor in patients with chronic respiratory disease. However, diagnosing pulmonary hypertension is a difficult procedure which often requires an invasive test. Thus new alternative biochemical markers would be useful in clinical field and are in search. We sought to assess the role of plasma N-terminal pro-brain natriuretic peptide(NT-proBNP) in patients with pulmonary hypertension. Method : We measured plasma NT-proBNP level in twenty nine patients suspected for pulmonary hypertension. Pulmonary hypertension was defined as being right ventricular systolic pressure more than 35 mm Hg estimated by Doppler echocardiography. Plasma NT-proBNP level was measured by electrochemiluminescence sandwich immunoassay. Results : The log-transformed values for plasma NT-proBNP levels showed a linear correlation (correlation coefficiency: 0.783, p-value <0.001) with right ventricular systolic pressure. Plasma NT-proBNP levels closely correlated with right ventricular systolic pressure, right ventricular hypertrophy, interventricular septal flattening and right ventricular dilatation. Conclusion : Our results suggest that the measurement of plasma NT-proBNP level is an useful marker of the presence of pulmonary hypertension.

Prognostication by Cluster Analysis of COX-2, MMP-9 and P53 Expression and by Clinico-pathologic Correlation Analysis in Non-small Cell Lung Cancer (비소세포폐암에서 COX-2,MMP-9와 돌연변이형 p53 의 발현이 생존에 대한 예후 분석)

  • Shin, Jong Wook;Choi, Jae Ho;Park, In Won;Yoo, Jae Hyung
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.1
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    • pp.31-41
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    • 2007
  • Background: In pathogenesis and prognosis of lung cancer, significance of enormous types of genetic expression were very compounding and undetermined. We performed this study to search association between clinical characteristics and expression of COX-2, MMP-9 and p53 in non-small cell lung cancer. Methods: Ninety-one patients with adenocarcinoma or squamous cell carcinoma were enrolled. We had searched clinical data retrospectively and performed immunohistochemical staining for COX-2, MMP-9 and p53. We had analyzed significance of these three genes in clinical features and prognosis for survival. Results: 1) In squamous cell carcinoma, male was predominant and was significantly correlated with smoking. 2) Major prognostic determinants for overall survival were curative resection. 3) Expression of COX-2 was more frequent in adenocarcinoma than in squamous cell carcinoma. 4) Negative staining of COX-2, MMP-9 and p53 was more frequent in squamous cell carcinoma than adenocarcinoma. 5) Survival duration was longer in the group with positive expression of p53 and negative for COX-2 and MMP-9 (median duration of survival = 165.6 weeks) than groups with the other expressional patterns. 6) Significant correlation was found between expression of MMP-9 and COX-2. In squamous cell carcinoma, expression of MMP-9, COX-2 and mutant p53 were mutually correlated. 7) COX-2 expression was significant prognostic factor for survival in resected cancer group. In unresected inoperable non-small cell lung cancer group, MMP-9 was statistically significant prognostic factor for overall survival. Conclusion: COX-2 and MMP-9 might have some roles for progression or prognosis in some selected patients with non-small cell lung cancer. COX-2 and MMP-9 may have some roles for disease progression or prognosis in selected patients with NSCLC.

A Study about the Factors Affecting Hearing loss in Adolescent's use of Personal Cassette Players(PCPs) (휴대용 카세트 사용 청소년의 청력관련 요인)

  • Lim, Kyung-Hee;Park, Kyung-Min;Park, Myung-Hwa
    • Research in Community and Public Health Nursing
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    • v.12 no.1
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    • pp.125-141
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    • 2001
  • The purpose of this study was to investigate the factors affecting hearing loss in adolescent's use of PCPs, and to give the basic data for adolescent's hearing conservation program development and prevention education against their hearing loss. This study was a descriptive research about three factors affecting hearing loss; the knowledge and attitude about noise, the perception of hearing loss and the hearing threshold. The subjects of this study were 383 students in two general high schools and two vocational high schools in Teagu. They have been using PCPs but with no current or past ear disease. This study was carried out from Sep. 1. 2000 to Oct. 24, 2000. The instrument used for the knowledge and attitude about noise was a questionnaire developed by Rhee. Kyung Yong and Yi. Kwan Hyung(1996). The instrument used for the perception of hearing loss was a Smith Hearing Screening Questionnaire. A Belton Model 112 Audiometer. air-conduction hearing test instrument. was used for the hearing threshold. Data was analysed by a SPSS/Win 10.0 program with frequency. percentage, t-test. ANOVA and pearson correlation. The results of this study were as follows; 1. The average of concern about hearing scored the highest $3.66{\pm}0.70$. The average of perceived susceptibility scored $2.64{\pm}0.85$ and the average of knowledge about noise scored $2.13{\pm}0.56$. The average of total knowledge and attitude about noise scored $2.82{\pm}0.46$. The average of discomfort of hearing loss($2.51{\pm}0.81$) scored higher than that fear of hearing loss($1.35{\pm}0.53$). The average of total perception of hearing loss scored $1.93{\pm}0.59$. The hearing threshold of the subjects scored the highest at 500Hz(Lt. $23.21{\pm}6.62$, Rt. $23.39{\pm}7.02$) and scored higher in order of 1000Hz, 2000Hz, 4000Hz and 8000Hz. 2. The knowledge and attitude about noise and the perception of hearing loss were both affected only by one important characteristic, which was general and vocational high schools. The knowledge and attitude about noise raked (t=5.258, p=0.000), and perception of hearing loss raked(t=2.241. p=0.026). However. several other important characteristics also impacted significantly on the knowledge and attitudes about noise. They included grade (t = 1. 987. p=0.048), father's education(F=2.745. p=0.043), marks(F=3.157, p=0.044), drinking(t=2.307, p=0.022) and smoking(t=2.587, p=0.010). The left hearing threshold differed significantly by sex at 1000Hz(t=5.175, p<0.001) and 8000Hz (t=3.334, p<0.01). According to general and vocational high schools (p<0.001), at 500Hz (t=-5.056), 1000Hz (t=-5.253), 2000Hz (t=-4.905), 4000Hz (t=-4.704) and 8000Hz (t=-5.204) significant differences were also shown. Marks were significant at 1000Hz (F=3.824, p<0.05) and drinking was found to be significant at 500Hz(t=2.203, p<0.05). The right hearing threshold differed significantly by sex at l000Hz(t=5.557. p<0.001). 4000Hz(t=2.234. p<0.05) and 8000Hz (t=2.730. p<0.01). According to general and vocational high schools(p<0.001) at 500Hz (t=-4.730), 1000Hz(t=-6.271). 2000Hz (t=-4.573). 4000Hz(t=-3.554) and 8000Hz (t=-3.405) significant differences were also shown. Grades impacted at 500Hz(t=2.201. p<0.05) and 4000Hz(t=2.511. p<0.05), while marks were significant at l000Hz(F=4.1l5. p<0.05) and drinking was significant at 500Hz(t=2.333. p<0.05). 3. The left hearing threshold in accordance with use of PCPs differed significantly at 2000Hz(F=2.996. p=0.03l) according to volume level and at 8000Hz(F=2.197. p=0.022) according to duration${\times}$hours per day. The right hearing threshold differed significantly at l000Hz(F=3.075. p=0.028) according to volume level and at 8000Hz(F=2.925. p=0.034) according to duration. 4. The knowledge and attitudes about noise showed a light positive correlation with the perception of hearing loss. A positive correlation was shown. as stated previously in all Hz, between the left hearing threshold and the right hearing threshold, especially the highest correlation at 2000Hz(r=0.761. p=0.000). This study has shown that the factors related to adolescent's use of PCPs are important as they impact significantly an adolescent's hearing. These results then indicate that in future, when designing a hearing conservation program and prevention education this data should be considered.

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The Study on the Family Functionality and Spousal Relationship of Middle-aged Women to Develop Health Promoting Program (중년여성의 건강증진 프로그램 개발을 위한 기초연구 -가족기능과 부부관계를 중심으로-)

  • Yang, Kyung-Hee;Kim, Young-Hee
    • Research in Community and Public Health Nursing
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    • v.12 no.3
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    • pp.680-695
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    • 2001
  • The purpose of this study was to provide basic data for developing nursing intervention for middle-aged women. This study identified health status, family functionality and spousal relationship and analyzed relationship between individual characteristics and family functionality/ spousal relationship. The subjects, of this study were 1.723 women from 45 to 55 years of age, who lived in J city. Data were analyzed using percentages, means, t-tests, ANOVA and Pearson's correlation coefficients with the SPSS statistical program. The results of the study were as follow: 1. The rate of women who perceived themselves to be healthy was 36.6%, those who did not was 30.8%. The most frequent health problem was a disease of the skeletal system (13.2%). 2. The mean score of family functionality was $3.25{\pm}.60$, with cohesion score of $3.58{\pm}.66$ and adaptability score of $2.99{\pm}.63$. 3. The mean score of total spousal relationship was $3.22{\pm}.42$; the relationship with in-laws was 3.78; sexual relationship, 3.74; life style, 3.44; and recreational activity. 3.39. 4. The women who experienced menopause perceived themselves to be unhealthier than those who did not. 5. Healthy women had a high score at total spousal relationship. personality of spouse. life style, recreational activity, and children's influence. 6. The women from 40 to 50 years of age. and women who graduated from middle or high school and had medium economic status showed a high score in family functionality. There was no correlation between family functionality and experience of the menopause. 7. Lower aged women were not good in personality of spouse (p<.05), sexual relationship (p<.05), and relationship with relatives (p<.05), Inexperienced women's menopause was influenced by their children (p<.05), Women who graduated from middle or high school (p<.001) and had medium economic status (p<.05) showed a high score in spousal relationship. 8. The higher the family functionality score. the higher spousal relationship. score (p<.001): love and communication (p<.001), personality of husband (p<.05), and religion (p<.001). relationship with relatives (p<.05), but the lower the score of recreational activity (p<.05), and share of role (p<.001) in the spousal relationship. 9. In the family functionality, the higher the cohesion score. the higher was the adaptability score (p<.001). l) The higher the cohesion score, the higher were love and communication, personality of husband. life style. sexual relationship. and children's influence, but the lower were share of role in spousal relationship(p<.001). 2) The higher the adaptability score, the higher were love and communication, religion, but the lower were the personality of husband, life style. sexual relationship, recreational activity, relationship with relatives, share of role(p<.001), and children's influence in spousal relationship (p<.05). 10. Variables within the spousal relationship have relationships with other variables. 1) The higher the love and communication score. the higher personality of husband religion, life style, communication. relationship with relatives, and children s influence (p<.001). 2) The higher personality of husband life style sexual relationship. recreational activity, relationship with relatives, share of role, and children's influence (p<.001). 3) The higher the religion score, the lower the recreational activity score (p<.05). 4) The higher the life style, the higher were the sexual relationship, recreational activity. relationship with relatives. share of role, and children's influence (p<.001). 5) The higher the sexual relationship score. the higher were recreational activity. relationship with relatives, share of role. and children's influence (p<.001). 6) The higher the recreational activity, the relationship with relatives, share of role. and children's influence (p<.001). 7) The higher the relationship with relatives, the higher were the share of role. the higher children's influence (p<.001). In conclusion. the spousal relationship was not good in unhealthy women, and the family functionality was related with the age of women and educational level. Also the spousal relationship was related with the age of women, personality of husband, sexual relationship. relationship with relatives by marriage and influence of sons and daughters. Menopause was related with spousal relationship, not related with family functionality. And the family functionality not related with perceived health status. but was correlated with spousal relationship. Therefore, the health management program for middle-aged woman should take place before menopause and must be based on promoting the family functionality and spousal relationship as well as physical health.

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Blood Pressure Cuff Bladders Tailored For Koreans (한국인 맞춤형 혈압계 커프 블래더)

  • Hwang, Lark Hoon;Park, Woo Sung;Na, Seung Kwon
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.38C no.9
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    • pp.822-829
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    • 2013
  • Hypertension is one of the most common clinical diseases, with an increasing prevalence globally. Hypertension triggers various harmful consequences and affects multiple organs. Life-long care may be required in some cases. According to the Korea Center for Disease Control and Prevention, the prevalence of hypertension is gradually increasing. A 2011 survey revealed that 28.9% of Korean adults had hypertension. The prevalence rates were slightly higher among men than women. Accurate measurement of blood pressure(BP) is crucial to classify patients, to identify BP-related risks, and to inform correct treatment. For accurate blood pressure measurement, the use of a cuff bladder size appropriate for the mid-upper arm circumference(MUAC) is essential. Incorrect sized cuff bladder is one of the main causes of equipment error affecting sphygmomanometer accuracy. When commercial sphygmomanometers were examined, the cuff bladders differed from the dimensions specified in the ISO 81060-1:2007 standards. Undercuffing is responsible for a spurious overestimation of BP in patients with large arms leading to overdiagnosis of hypertension, whereas overcuffing (that is, use of relatively large cuffs with small arms), may be responsible for an opposite problem, leading to erroneous underestimation of BP levels. The cuff bladder sizes recommended by the American Heart Association(AHA) are an arm circumference(AC) of 17-25 cm for small-sized adults, AC of 24-32 cm for adults, AC of 32-42 cm for normal-sized adults, and AC of 42-50 cm for obese adults. In contrast, the AC of Korean adults ranges from 23-31 cm, belonging to a single type of adult bladder. Three types of bladders are necessary for Korean adults with an AC of 23-31cm. Hospitals often use one or two differently-sized Western cuffs for adult patients, which can yield inaccurate BP determinations. Cuff bladders with dimensions based on anthropometric reference data obtained from Koreans will aid hospitals to measure BP more accurately.

Anti-atopic Effects of Castanea crenata Inner Shell Extracts Fermented by Lactobacillus bifermentans (Lactobacillus bifermentans로 발효한 율피의 항아토피 효과)

  • Kim, Bae Jin;Son, Woo Rim;Choi, Mi Ok;Jo, Seung Kyeung;Jung, Hee Kyoung;Lee, Jin Tae;Kim, Hak Yoon;Kwoen, Dae Jun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.9
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    • pp.1378-1386
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    • 2013
  • Atopic dermatitis (AD) is a common skin disease characterized by chronic and relapsing inflammatory dermatitis with immunological disturbances. In spite of the continuous increase in the incidence of AD, it is regrettable that till date there is no effective treatment to treat the same. Therefore, the present study was designed to examine the possible anti-atopic effects of Castanea crenata inner shell extracts fermented by Lactobacillus bifermentans (FCS) in 2,4-dinitrochlorobenzene (DNCB) induced AD in NC/Nga mice. Based on the results of HPLC analysis, we found that FCS contains anti-inflammatory factors such as gallic acid (10.18 mg/g) and ellagic acid (2.14 mg/g). The groups that we have used in this study included 0.1%, 1%, 5% fermented Castanea crenata inner shell extracts (FCS 0.1, FCS 1, FCS 5), 1,3-butylene glycol treated control (AD), and normal mice. After topical FCS treatment, we observed that the clinical severity score for AD was lower in both the FCS 1 and FCS 5 groups than the AD group. We also proved beyond doubt that there was improvement of melanin, erythema and skin moisture indices in the FCS 5 group. Spleen index and gene expression levels of pro-inflammatory cytokines such as IL-$1{\beta}$ and TNF-${\alpha}$ were significantly decreased in the FCS 5 group compared to the AD group (P<0.05). Further, we also found that the level of serum immunoglobulin E (IgE) in the FCS-treated group was decreased in a concentration-dependent manner. The results of our study suggest that FCS can be effectively used as a cosmeceutical ingredient for both the prevention and improvement of AD.

Prognosis and Treatment Outcomes of Gastric Cancer Patients with Hepatic Metastasis (간전이 위암환자의 치료 결과 및 예후)

  • Kim, Eun-Mi;Kim, Se-Won;Kim, Sang-Woon;Lee, Kyung-Hee;Hyun, Myung-Soo;Park, Won-Kyu;Chang, Jae-Chun;Song, Sun-Kyo
    • Journal of Gastric Cancer
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    • v.6 no.4
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    • pp.237-243
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    • 2006
  • Purpose: This study was conducted to evaluate the treatment outcomes and the prognosis for gastric cancer patients with hepatic metastasis. Materials and Methods: This retrospective study was based on the medical records of 85 gastric cancer patients with hepatic metastasis (62 synchronous and, 23 metachronous) who received chemotherapy with or without resectional therapy from March 1990 to March 2006. The survival rate was analyzed according to clinicopathologic factors and therapeutic factors, such as whether or not a gastrectomy, a hepatic resection, and/or chemotherapy had been performed. Results: The median survival of gastric cancer patients with hepatic metastasis was 11 months (synchronous: 11 months and metachronous: 17 months). The rates of gastrectomies and hepatic resections in the synchronous group were 24.1% and 16.1%, respectively A 23.5% prevalence of extra-hepatic metastasis was observed. The median survivals of patients who underwent a gastrectomy with a hepatic resection, a gastrectomy alone, and non-surgical treatment were 60, 18, and 9 months, respectively (P<0.05). The disease-free median survival of the metachronous group was 8 ($3{\sim}39$) months. There was no difference in initial pathologic stage and frequency of hepatic metastasis after the gastrectomy in the metachronous group. In the synchronous group, extra-hepatic metastasis, a gastrectomy as the operative procedure, a hepatic resection as the operative procedure and the response to chemotherapy were statistically significant in the univariate analysis, and a hepatic resection as the operative procedure, the response to chemotherapy, and extra-hepatic metastasis were independant prognostic factors identified by the multivariate analysis. In the metachronous group, extra-hepatic metastasis, the response to chemotherapy and differentiation were statistically significant in the univariate analysis, and extra-hepatic metastasis was an independent prognostic factor identified by the multivariate analysis. Conclusion: An aggressive surgical therapy and effective chemotherapy are necessary in the treatment of gastric cancer patients with hepatic metastasis. (J Korean Gastric Cancer Assoc 2006;6:237-243)

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