• Journal of Nutrition and Health
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• 제39권4호
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• pp.372-380
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• 2006

The purpose of this study was to investigate the association between inflammatory cytokines and chronic disease status in Korean elderly. The subjects were 248 elderly people aged over 65 years recruited from Health Center in Seoul. The subjects were classified into 3 groups based on their disease (diabetes, hypertension, and hyperlipidemia) status: subjects with one diagnosed disease of diabetes, hypertension, and hyperlipidemia fall into singular group (n=89), subjects with more than 2 disease into multiple group (n=39), and those with free of the diseases into normal (n=122). Anthropometric and biochemical characteristics, and dietary intakes were assessed. Dietary intakes were surveyed by 24-recall method. The means of IL-2, IL-6, MCP-1 and C3 were not differ among 3 groups. However, when subjects classified into tertiles of IL-6, MCP-1, TNF-$\alpha$ and C3 and frequencies of each fertile were compared, the multiple group showed significantly lower frequencies in lowest fertile than normal group (p<0.05), suggesting higher tendency of inflammatory responses. For hematological values, blood pressure, triglycerides, fasting blood glucose levels were highest in multiple group (p<0.05) compared to other 2 groups. BMI, body fat(kg), and triceps skinfold thickness were also significantly higher in multiple group than in 2 other groups(p<0.05). Moreover, the concentrations of IL-2, IL-6 and C3 were significantly correlated with hematologic values of fasting blood glucose, total cholesterol, LDL-cholesterol, and triglycerides or obesity factors such as triceps skinfold thickness, BMI, and body fat(%). Among singular and multiple group, the subjects with higher intakes for vitamins A, C, and E showed the higher level of IL-2 and the lower level of MCP-1, and C3. In conclusion, blood concentrations of triglycerides and proinflammatory cytokines, blood pressure, obesity parameters (BMI, body fat, triceps skinfold thickness) were higher in multiple group than in normal, but this result strongly suggest that the increasement of the vitamin A, C, and E intakes would modify the cytokine levels to reduce the inflammatory response in the elderly people with chronic diseases.

• Asian Pacific Journal of Cancer Prevention
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• 제15권5호
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• pp.2057-2060
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• 2014

Purpose: To assess the effect and safety of lobaplatin combinated floxuridine /pirarubicin in transcatheter hepatic arterial chemoembolization(TACE) of unresectable primary liver cancer. Patients and Methods: TACE combined with the chemotherapy regimen was used to treat 34 unresectable primary liver cancer patients. DSA/MRI/CT/blood routine examinations were used to evaluate short term activity and toxicity after 4-5 weeks, the process being repeated if necessary. Results: Among the 34 cases, 1 (2.9%) showed a complete response, 21 (61.7%) a partial response, 8 (23.5%) stable disease, and 4 progressive disease, with a total effective rate of 67.6%. The content of alpha fetoprotein dropped by over 50% in 20 cases (58.8%). The rate of recovery was hepatalgia (88.2%), ascites (47.1%), appetite (55.9%), Performance Status(30.4%). The median follow-up time (MFT) was 281 days (63-558 days), and median progression-free survival was 118.5 days (95%, CI:88.8-148.2days). Adverse reactions (III-IV grade) were not common, with only 4 cases of vomiting and 2 cases of thrombocytopenia (III grade). Conclusions: Lobaplatin-based TACE is an effective and safe treatment for primary liver cancer.

• Journal of Nutrition and Health
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• 제27권10호
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• pp.1048-1057
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• 1994

Nonobese NIDDM patients were studied were studied with respect to changes in visceral protein status, serum glucose and lipids and insulin secretion capacity before and after intake of enteral formula. Patients with renal or hepatic disease, gastrectomy, malabsorption, weight gain over past 6 months and poorly controlled blood glucose level were excluded. Eighteen patients served as case and administered, in addition of their usual diet, 400ml of enteral formula for 8 weeks. Another 18 patients participated in controls and had usual food intake for 8 weeks. In the begining, the levels of fasting and postprandial glucose, glycated hemoglobin, triglyceride, HDL, LDL, total cholesterol, albumin, total protein and transferrin and glucose response area on oral glucose tolerance test were not different between two groups. The response areas of insulin, C-peptide and free fatty acid and serum IGF-1 level were higher in the case than in the control group. Energy intake of patients given enteral formula exceeded their estimated energy requirements(108%) and they consumed a mean of 112g protein per day. Patients given enteral formula showed an increase in body weight(4.4%), serum transferrin(10%), IGF-1(13%) and triglyceride(34%) while controls showed no changes in those parameters at 8 weeks compared to initial values. There were no significant changes after 8 weeks in the levels of glucose, glycated hemoglobin, HDL, LDL, total cholesterol, total protein and albumin and response areas of glucose, insulin, C-peptide and free fatty acid in both groups compared to initial values. This study suggests that nutrition supplement with enteral formula can increase body weight and visceral protein status in nonobese NIDDM patients without changes in blood glucose. However, excessive calorie intake could temporarily increase serum triglyceride. In addition, this study indicates that serum transferrin and IGF-1 are more sensitive indicators to changes of protein intake than serum albumin and total protein.

• 의학교육논단
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• 제13권2호
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• pp.3-7
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• 2011

The status of medical doctors is relatively high in society. However, in spite of this acknowledged status, physicians are not aware of the extent to which they have the ability to care for patients or how much effort they should make to meet people's expectations. Therefore, we should examine what society asks of doctors and how doctors need to be educated to meet the expectations of society. In this article, the author asserts that physicians need four skills. First, doctors should know how to speak and communicate. In the work of a doctor, language is the most important for tasks such as understanding texts, communication with patients, analyzing data, and starting new projects. Second, doctors should have intuition. In a doctor's medical judgment, intuition is very important and it can initiate from an educated guess. In other words, good intuition can be developed based on a good educated guess, which in turn can derive from one's explored knowledge, communication with one's inner dialogues, and good interpretation skill. Third, doctors should have creativity. Doctors should produce an image about patients from intuition, and those intuitions are based on creativity. Usually, students in medical school have creative ability; therefore, the instructor should facilitate their learning to connect this creativity to free imagination ability and medical skills. Fourth, doctors should be humane. Patients want to communicate with doctors about their disease and further about their lives. The reason why a humane doctor is important is that this humane approach itself could cure patients and reduce their pain. When a doctor's humane attitude is realized in the hospital, the patients and doctors could be pleased sincerely.

• Asian Pacific Journal of Cancer Prevention
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• 제16권4호
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• pp.1545-1551
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• 2015

Purpose: Rectal cancers with high microsatellite-instable have clinical and pathological features that differentiate them from microsatellite-stable or low-frequency carcinomas, which was studied rarely in stage II rectal cancer, promoting the present investigation of the usefulness of microsatellite-instability status as a predictor of the benefit of adjuvant chemotherapy with fluorouracil in stage II rectal cancer. Patients and Methods: Data of 460 patients who underwent primary anterior resection with a double stapling technique for rectal carcinoma at a single institution from 2008 to 2012 were retrospectively collected. All patients experienced a total mesorectal excision (TME) operation. Survival analysis were analyzed using the Cox regression method. Results: Five-year rate of disease-free survival (DFS) was noted in 390 (84.8%) of 460 patients with stage II rectal cancer. Of 460 tissue specimens, 97 (21.1%) exhibited high-frequency microsatellite instability. Median age of the patients was 65 (50-71) and 185 (40.2%) were male. After univariate and multivariate analysis, microsatellite instability (p= 0.001), female sex (p<0.05) and fluorouracil-based adjuvant chemotherapy (p<0.001), the 3 factors were attributed to a favorable survival status independently. Among 201 patients who did not receive adjuvant chemotherapy, those cancers displaying high-frequency microsatellite instability had a better 5-year rate of DFS than tumors exhibiting microsatellite stability or low-frequency instability (HR, 13.61 [95% CI, 1.88 to 99.28]; p= 0.010), while in 259 patients who received adjuvant chemotherapy, there was no DFS difference between the two groups (p= 0.145). Furthermore, patients exhibiting microsatellite stability or low-frequency instability who received adjuvant chemotherapy had a better 5-year rate of DFS than patients did not (HR, 5.16 [95% CI, 2.90 to 9.18]; p<0.001), while patients exhibiting high-frequency microsatellite instability were not connected with increased DFS (p= 0.696). It was implied that female patients had better survival than male. Conclusion: Survival status after anterior resection of rectal carcinoma is related to the microsatellite instability status, adjuvant chemotherapy and gender. Fluorouracil-based adjuvant chemotherapy benefits patients of stage II rectal cancer with microsatellite-stable or low microsatellite-instable, but not those with high microsatellite-instable. Additionally, free of adjuvant chemotherapy, carcinomas with high microsatellite-instable have a better 5-year rate of DFS than those with microsatellite-stable or low microsatellite-instable, and female patients have a better survival as well.

• 대한지역사회영양학회지
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• 제13권2호
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• pp.276-287
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• 2008

Diabetic mellitus in an older population is associated with increased basal oxidative stress and free radical accentuated by hyperglycemic challenge. Enhanced free radical in diabetic elderly can cause the oxidative damage and such damage can be protected by antioxidant defense system. It is believed that vitamin C, A and E are the most abundant and effective antioxidants in human plasma. The purpose of this study was to determine the antioxidant status in Korean diabetic elderly using the case-control study. The antioxidant status was examined by determining plasma levels of antioxidant vitamins (vitamin C, A, E, ${\beta}$-carotene), total antioxidant status (TAS) and thiobarbituric acid reactive substance (TBARS) and intakes of vitamin C, A, ${\beta}$-carotene and retiol. Fasting glucose and HbA1c levels and serum lipid profiles (triglyceride (TG), total cholesterol, HDL-cholesterol and LDL-cholesterol) were also determined. Diabetic subjects were 122 elderly persons over 60 years old, visiting public health center, and control subjects were 96 healthy elderly persons living in Ulsan, Korea and they were matched by age, gender, smoking and drinking status. The diabetic and control subjects were divided into sub-groups according to the status of using diet therapy and vitamin supplement. The subjects were interviewed to collect data on their general characteristics, disease history, vitamin supplement, diet therapy and health-related habits by questionnaires. Their dietary intakes were obtained by means of semi-quantitative food frequency questionnaires (SQFFQ). Fasting plasma glucose and HbA1c levels were significantly higher in diabetes than in control subjects, and plasma total cholesterol level of diabetes was not significantly different from that of control subjects. However serum HDL cholesterol level of diabetes was significantly lower and serum TG level of diabetes was significantly higher than those of control group. The average vitamin A and ${\beta}$-carotene intakes of diabetes were significantly higher than those of control subjects. There was no significant difference in plasma vitamin C, ${\beta}$-carotene, and TBARS levels between two groups, but plasma vitamin A, E and TAS levels were significantly higher in diabetes than those in control group. Plasma vitamin A and TAS levels of diabetic subjects using diet therapy were higher than those of control using diet therapy, and plasma vitamin E, ${\beta}$-carotene and TAS levels of diabetic subjects using vitamin supplements were significantly higher than those of controls using vitamin supplements. These results suggested that diabetic mellitus could enhance antioxidant defences against reactive oxygen species and interest in healthy eating such as consumption of more antioxidant nutrients.

• Asian Pacific Journal of Cancer Prevention
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• 제14권5호
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• pp.2851-2857
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• 2013

Objective: REPS2 plays important roles in inhibiting cell proliferation, migration and in inducing apoptosis of cancer cells, now being identified as a useful biomarker for favorable prognosis in prostate and breast cancers. The purpose of this study was to assess REPS2 expression and to explore its role in esophageal squamous cell carcinoma (ESCC). Methods: Protein expression of REPS2 in ESCCs and adjacent non-cancerous tissues from 120 patients was analyzed by immunohistochemistry and correlated with clinicopathological parameters and patient outcome. Additionally, thirty paired ESCC tissues and four ESCC cell lines and one normal human esophageal epithelial cell line were evaluated for REPS2 mRNA and protein expression levels by quantitative RT-PCR and Western blotting. Results: REPS2 mRNA and protein expression levels were down-regulated in ESCC tissues and cell lines. Low protein levels were significantly associated with primary tumour, TNM stage, lymph node metastasis and recurrence (all, P < 0.05). Survival analysis demonstrated that decreased REPS2 expression was significantly associated with shorter overall survival and disease-free survival (both, P < 0.001), especially in early stage ESCC patients. When REPS2 expression and lymph node metastasis status were combined, patients with low REPS2 expression/lymph node (+) had both poorer overall and disease-free survival than others (both, P < 0.001). Cox multivariate regression analysis further revealed REPS2 to be an independent prognostic factor for ESCC patients. Conclusions: Our findings demonstrate that downregulation of REPS2 may contribute to malignant progression of ESCC and represent a novel prognostic marker and a potential therapeutic target for ESCC patients.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.743-746
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• 2013

Background: Some studies have indicated an inverse relationship between cancer risk and sunlight exposure. Others have reported that the prognosis of some cancers such as prostate, colon, ovarian and non melanoma skin cancer, were affected by the season in which the cancer was diagnosed. In our study, we evaluated whether season is prognostic in Turkish patients with breast cancer. Materials and Methods: A total of 517 patients from Kayseri Training and Research Hospital were analysed retrospectively. Patients were divided into 4 groups according to season of cancer diagnosis: winter, spring, summer and autumn. The prognostic factors for disease free survival and overall survival were investigated. Results: No significant differences were found among groups regarding prognostic factors overall. Only estrogen receptor status and lymphovascular invasion were independent prognostic factors (p=0.001 and p=0.001 respectively). We found significantly differences for mean disease free survival among groups (p=0.019). Winter group had better mean DFS while summer group had worse DFS. Mean overall survival was similar in the four groups (p=0.637). Conclusions: The season is not an independent predictive factor. However, due to interaction with other factors, we think that the season of cancer diagnosis is important for cancer prognosis.

• Radiation Oncology Journal
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• 제32권3호
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• pp.132-137
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• 2014

Purpose: To evaluate non-sentinel lymph node (LN) status after sentinel lymph node biopsy (SNB) in patients with breast cancer and to identify the predictive factors for disease failure. Materials and Methods: From January 2006 to December 2007, axillary lymph node (ALN) dissection after SNB was performed for patients with primary invasive breast cancer who had no clinical evidence of LN metastasis. A total of 320 patients were treated with breast-conserving surgery and radiotherapy. Results: The median age of patients was 48 years, and the median follow-up time was 72.8 months. Close resection margin (RM) was observed in 13 patients. The median number of dissected SNB was two, and that of total retrieved ALNs was 11. Sentinel node accuracy was 94.7%, and the overall false negative rate (FNR) was 5.3%. Eleven patients experienced treatment failure. Local recurrence, regional LN recurrence, and distant metastasis were identified in 0.9%, 1.9%, and 2.8% of these patients, respectively. Sentinel LN status were not associated with locoregional recurrence (p > 0.05). Close RM was the only significant factor for disease-free survival (DFS) in univariate and multivariate analysis. The 5-year overall survival, DFS, and locoregional DFS were 100%, 96.8%, and 98.1%, respectively. Conclusion: In this study, SNB was performed with high accuracy and low FNR and high locoregional control was achieved.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.6001-6006
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• 2015

Background: Pancreatic cancer is the fourth leading cause of cancer related death with median survival ranging from 3 to 6 months for metastatic disease. Palliative chemotherapy has been the backbone of treatment in advanced stage and has evolved over time. Data pertaining to the disease are scarce from our part of the world where treatment poses a significant challenge due to lack of resources. Materials and Methods: A retrospective chart review was performed for all patients presenting with stage IV pancreatic carcinoma at a tertiary care hospital in Karachi, Pakistan between January 2008 and December 2012. Data were collected using a pre-designed, coded questionnaire looking at patient characteristics, treatment given and outcome. Results: 101 patients were found to be eligible. Mean age was $56.7{\pm}12.8years$, the male to female ratio was 2:1 and most patients had a good performance status. More than half of the tumors were located in the head (57%, n=58) and almost all were adenocarcinomas (95%, n=96). Some 58% (n=59) received first line chemotherapy of which 49% (n=29) received gemcitabine-based regimens and 39% (n=23) received FOLFIRINOX. The median progression free survival for gemcitabine based treatment was 2.9 months (IQR=1.6-5.6) as opposed to 7.3 months (IQR=4.5-9.2) for FOLFIRINOX (P=0.02). Median overall survival was 4.9 months (IQR=2.3-9.5) for first line gemcitabine based treatment and 10.5 months (IQR=7.0-13.2) for first line FOLFIRINOX therapy (P=0.002). Patients on FOLFIRINOX had better survival across all subgroups. Inpatient admissions and dose reductions were more frequent with FOLFIRINOX but the difference between the two regimens was not statistically significant. FOLFIRINOX could be successfully administered as outpatient therapy to a number of patients. Conclusions: FOLFIRINOX remains a suitable first line option in patients with metastatic pancreatic cancer with good performance status even in a resource-poor country where diagnostic and supportive care facilities may be less than optimal and cost is a limitation.