• Title/Summary/Keyword: hazard analysis

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Establishing a Nomogram for Stage IA-IIB Cervical Cancer Patients after Complete Resection

  • Zhou, Hang;Li, Xiong;Zhang, Yuan;Jia, Yao;Hu, Ting;Yang, Ru;Huang, Ke-Cheng;Chen, Zhi-Lan;Wang, Shao-Shuai;Tang, Fang-Xu;Zhou, Jin;Chen, Yi-Le;Wu, Li;Han, Xiao-Bing;Lin, Zhong-Qiu;Lu, Xiao-Mei;Xing, Hui;Qu, Peng-Peng;Cai, Hong-Bing;Song, Xiao-Jie;Tian, Xiao-Yu;Zhang, Qing-Hua;Shen, Jian;Liu, Dan;Wang, Ze-Hua;Xu, Hong-Bing;Wang, Chang-Yu;Xi, Ling;Deng, Dong-Rui;Wang, Hui;Lv, Wei-Guo;Shen, Keng;Wang, Shi-Xuan;Xie, Xing;Cheng, Xiao-Dong;Ma, Ding;Li, Shuang
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3773-3777
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    • 2015
  • Background: This study aimed to establish a nomogram by combining clinicopathologic factors with overall survival of stage IA-IIB cervical cancer patients after complete resection with pelvic lymphadenectomy. Materials and Methods: This nomogram was based on a retrospective study on 1,563 stage IA-IIB cervical cancer patients who underwent complete resection and lymphadenectomy from 2002 to 2008. The nomogram was constructed based on multivariate analysis using Cox proportional hazard regression. The accuracy and discriminative ability of the nomogram were measured by concordance index (C-index) and calibration curve. Results: Multivariate analysis identified lymph node metastasis (LNM), lymph-vascular space invasion (LVSI), stromal invasion, parametrial invasion, tumor diameter and histology as independent prognostic factors associated with cervical cancer survival. These factors were selected for construction of the nomogram. The C-index of the nomogram was 0.71 (95% CI, 0.65 to 0.77), and calibration of the nomogram showed good agreement between the 5-year predicted survival and the actual observation. Conclusions: We developed a nomogram predicting 5-year overall survival of surgically treated stage IA-IIB cervical cancer patients. More comprehensive information that is provided by this nomogram could provide further insight into personalized therapy selection.

A Quality Assurance Study for the Application of Cook/Chill System in School Foodservice Operation (II) - Pork Bulgogi (Broiled Sliced Pork with Sauces) - (학교급식에 Cook/Chill System 적용을 위한 품질보증연구(II) - 돼지불고기 -)

  • Kwak, Tong-Kyung;Moon, Hye-Kyung;Park, Hye-Won;Hong, Wan-Soo;Ryu, Kyung;Chang, Hye-Ja;Kim, Sung-Hee;Choi, Eun-Jung
    • Journal of Food Hygiene and Safety
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    • v.13 no.4
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    • pp.319-331
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    • 1998
  • The purposes of this study were to develop Hazard Analysis Critical Control Point plan applicable to cook/chilled Pork Bulkogi (broiled sliced pork with sauces) in school foodservice operations and to establish reasonable shelf-life limits by assessing food quality during chilled storage period of 5 days. During the product flow, time-temperature profile was recorded and microbiological analyses including mesophilic and psychrotrophic total plate counts, coliform, and fecal coliform and qualitative analyses of Salmonella and Listeria monocytogenes were done. Chemical analyses (pH, acid value, total volatile basic nitrogen), sensory evaluation, and quantitative analysis of thiamin were conducted for 5 days of chilled storage. The number of mesophiles in raw pork ($4.26{\pm}0.11\;Log\;CFU/g$), seasoning mixture ($5.97{\pm}O.04\;Log\;CFU/g$) and marinated pork ($5.56{\pm}0.21\;Log\;CFU/g$) were below the microbial standards for "requires further cooking" food items. Listeria monocytogenes was detected in seasoning mixture. After heating, the number of mesophiles ($5.17{\pm}0.04\;Log\;CFU/g$) were slightly reduced but it did not meet the microbial guidelines of $5\;Log\;CFU/g$ for "ready-to-eat" foods. No other microbes including pathogens were detected. By reheating the menu item after chilled storage, the number of mesophiles were reduced in every phase of 1st day ($4.62{\pm}0.22\;Log\;CFU/g$), 3rd day ($4.55{\pm}0.20\;Log\;CFU/g$) and 5th day ($4.25{\pm}0.16\;Log\;CFU/g$) of chilled storage, and the number of microbes was below the standard limits for "ready-to-eat" foods. At the fifth day of chilled storage, pH (p<0.05), acid value (p<0.01) and TVBN (p<0.05) showed significant increases. Sensory evaluation results did not show any significant change for 5 days of chilled storage. Thiamin content showed a decrease for 5 days of chilled storage. Consequently, the ideal shelflife recommended for Pork Bulkogi was within 3 days of chilled storage. CCPs for Pork Bulkogi were purchasing and receiving of raw meat and some seasoning ingredients, heating, chilling, chilled storage, reheating, and distribution.

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The Role of Postoperative External Irradiation for the Incompletely Resected Meningiomas (불완전절제된 수막종에서 수술 후 방사선치료의 역할)

  • Kim Tae-Hyun;Yang Dae-Sik;Kim Chul-Young;Choi Myung-Sun
    • Radiation Oncology Journal
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    • v.18 no.2
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    • pp.85-91
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    • 2000
  • Purpose : The aim of this study is to look for the possible efficacy of postoperative external irradiation for incompletely resected meningiomas. Methods and Materials : From August 198: to January 1997, forty-four patients with intracranial meningioma were treated by postoperative external irradiation. Of the 44 meningiomas, 18 transitional, 13 meningotheliomatous, 6 hemangiopericytic, 4 atypical, 2 fibroblastic and 1 malignant meningioma were identified. We classified all patients into two groups by the histology. The benign group was consisted of the meningotheliomatous, transitional and fibroblastic types. The malignant group was consisted of the atypical, hemangiopericytic and malignat types. In the means of surgery, 37 patients were resected incompletely and 7 patients were managed by biopsy only. After surgery, all patients were received postoperative external irradiation. Radiotherapy was deliverd using Co-60 or 4 MV photon beam to a total dose of 50 to 65 Gy (mean dose 57.4 Gy) with a 1.8 to 2 Gy per fraction. The median follow-up was 48 months (range : 21 $\~$ 101 months). Multivariate analysis of the Influence by age, sex, location, histology and radiation dose on local control has been done using Cox's proportional hazard model. Results : 5-year local control rate was 93.8$\%$ for the benign histology and 51.8$\%$ for the malignant histology (p=0.0110) and overall local control rate at 5 years was 87.4$\%$. The analysis of the prognostic factors, such as age, sex, location, and radiation dose were not significant except for the histology. Conclusion : Adjuvant postoperative external irradiation appears to be significantly improved local control in the patients with incompletely resected meningiomas.

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The Role of External Irradiation for the Locally Advanced Papillary Thyroid Cancers (국소적으로 진행된 갑상선 유두암에서의 방사선치료의 역할)

  • Kim Tae-Hyun;Yang Dae-Sik;Kim Chul-Yong;Choi Myung-Sun
    • Radiation Oncology Journal
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    • v.17 no.3
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    • pp.187-194
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    • 1999
  • Purpose : The aim of this study is to look for the possible efficacy of external irradiation for locally advanced papillary thyroid cancers (stage pT4 or Nl ). Methods and Materials : From August 1981 through September 1997, 91 Patients with locally advanced papillary thyroid cancers (stage pT4 or Nl ) have been treated with external irradiation and followed up at our clinic. All of the patients have been treated with surgical resection. After surgery, 23 patients received postoperative external irradiation with or without ablative radioiodine therapy, whereas the other 68 patients were treated with ablative radioiodine therapy alone. Distributions of sex, age, and stage were comparable in both irradiated and nonirradiated groups. Multivariate analysis of the influence by age, sex, stage, ablative radioiodine therapy and external irradiation on local control were peformed by using Cox's proportional hazard model. Results : Overall survival rates at 7 years were of no significant difference in both groups. There were $98.1\%$ for no RT group and $90\%$ for RT group (p=0.506). 5-year local control rates were significantly different, these were $95.2\%$ for RT group and $67.5\%$ for no RT group (p=0.0408). An analysis of the prognostic factors, age, sex, stage, and RAI were not significant variables, except for the external irradiation. Conclusion : Adjuvant postoperative external irradiation did not affect overall survival, but significantly improved local control in the patients with locally advanced papillary thyroid cancers (stage pT4 or lympy node involvement).

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Initial results from spatially averaged coherency, frequency-wavenumber, and horizontal to vertical spectrum ratio microtremor survey methods for site hazard study at Launceston, Tasmania (Tasmania 의 Launceston 시의 위험 지역 분석을 위한 공간적 평균 일관성, 주파수-파수, 수평과 수직 스펙트럼의 비율을 이용한 상신 진동 탐사법의 일차적 결과)

  • Claprood, Maxime;Asten, Michael W.
    • Geophysics and Geophysical Exploration
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    • v.12 no.1
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    • pp.132-142
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    • 2009
  • The Tamar rift valley runs through the City of Launceston, Tasmania. Damage has occurred to city buildings due to earthquake activity in Bass Strait. The presence of the ancient valley, the Tamar valley, in-filled with soft sediments that vary rapidly in thickness from 0 to 250mover a few hundreds metres, is thought to induce a 2D resonance pattern, amplifying the surface motions over the valley and in Launceston. Spatially averaged coherency (SPAC), frequency-wavenumber (FK) and horizontal to vertical spectrum ratio (HVSR) microtremor survey methods are combined to identify and characterise site effects over the Tamar valley. Passive seismic array measurements acquired at seven selected sites were analysed with SPAC to estimate shear wave velocity (slowness) depth profiles. SPAC was then combined with HVSR to improve the resolution of these profiles in the sediments to an approximate depth of 125 m. Results show that sediments thicknesses vary significantly throughout Launceston. The top layer is composed of as much as 20m of very soft Quaternary alluvial sediments with a velocity from 50 m/s to 125 m/s. Shear-wave velocities in the deeper Tertiary sediment fill of the Tamar valley, with thicknesses from 0 to 250m vary from 400 m/s to 750 m/s. Results obtained using SPAC are presented at two selected sites (GUN and KPK) that agree well with dispersion curves interpreted with FK analysis. FK interpretation is, however, limited to a narrower range of frequencies than SPAC and seems to overestimate the shear wave velocity at lower frequencies. Observed HVSR are also compared with the results obtained by SPAC, assuming a layered earth model, and provide additional constraints on the shear wave slowness profiles at these sites. The combined SPAC and HVSR analysis confirms the hypothesis of a layered geology at the GUN site and indicates the presence of a 2D resonance pattern across the Tamar valley at the KPK site.

Postoperative Radiotherapy in Malignant Tumors of the Parotid Gland (이하선 악성종양의 수술 후 방사선 치료)

  • Chung Woong-Ki;Ahn Sung Ja;Nam Taek Ken;Chung Kyung-Ae;Nah Byung Sik
    • Radiation Oncology Journal
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    • v.16 no.3
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    • pp.251-258
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    • 1998
  • Purpose : This study was performed to analyze the factors affecting local control in malignant tumors of the parotid gland treated with surgery and postoperative radiation. Materials and methods : Twenty-six patients were treated for malignant tumors of the parotid gland from 1986 to 1995 at Department of Therapeutic Radiology, Chonnam University Hospital. Age of the patients ranged from 14 to 72 years (median : 55 years). Histologically 10 patients of mucoepidermoid carcinoma, 7 of squamous cell carcinoma, 4 of acinic cell carcinoma, 4 of adenoid cystic carcinoma and 1 of adenocarcinoma were treated. Total parotidectomy was performd in 15 of 26 patients, superficial in 7, subtotal in 4. Facial nerve was sacrificed in 5 patients. Postoperatively 4 patients had residual disease, 4 had positive resection margin. Radiation was delivered through an ipsilateral wedged pair of photon in 11 patients. High energy electron beam was mixed with photon in 15 patients. Electron beam dose ranged from 900 cGy to 3800 cGy (median 1700 cGy). Total radiation dose ranged from 5000 cGy to 7560 cGy (median : 6020 cGy). Minimum follow-up period was 2 years. Local control and survival rate were calculated using Kaplan-Meier method. Generalized Wilcoxon test and Cox proportional hazard model were used to test factors affecting local control. Results : Five (19$\%$) of 26 patients had local recurrence. Five year local control rate was 77$\%$. Overall five year survival rate was 70$\%$. Sex, age, tumor size, surgical involvement of cervical lymph node, involvement of resection margin, surgical invasion of nerve, and total dose were analyzed as suggested factors affecting local control rate. Among them patients with tumor size less than 4 cm (p=0.002) and negative resection margin (p=0.011) were associated with better local control rates in univariate analysis. Multivariate analysis showed only tumor size factor is associated with local control rate (p=0.022). Conclusion : This study suggested that tumor size is important in local control of malignant tumors of parotid gland.

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Smoking Status and Serum NSE Level, as Prognostic Factors in Adenocarcinoma of Lung (원발성 폐선암 환자에서 예후인자로 흡연 및 NSE 수치의 의의)

  • Kim, Hee Kyoo;Ok, Chul Ho;Jung, Mann Hong;Jang, Tae Won
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.6
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    • pp.582-589
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    • 2005
  • Background : The incidence of lung adenocarcinoma, which is more prevalent in women and nonsmokers, is increasing. The aim of this study was to determine the prognostic factors of an adenocarcinoma of the lung. Material and method : The clinical information of patients diagnosed with an adenocarcinoma of the lung at the Kosin University Gospel Hospital from January 1994 to July 2004 was reviewed retrospectively. The survival time of these patients was analyzed by the patient's age, gender, performance status, weight loss, smoking history, location of the primary tumor, clinical stage, serologic tumor markers, and treatment modality. Results : For all 422 patients with an adenocarcinoma of the lung, 247 (58.5%) were male, and their mean age was 59.8 years the. The majority of patients were smokers (58.3%), and the tumors were located in the periphery (59.7%). In the smokers, the tumor was located more in the central airway compared to the non-smokers (42.8% vs. 31.9%, p=0.12). The overall median survival time was 390 days (95% CI;304-436 days). Univariate survival analysis revealed that an older age (${\geq}65$ years old), male, weight loss, smoker, central type, advanced clinical stage, elevated serum carcinoembryonic antigen (CEA, >5 ng/ml) and neuron specific enolase (NSE, >15 ng/ml), and the supportive care only were significantly poor prognostic factors. The median survival time was shorter in the smokers than nonsmokers (289 days vs. 533 days, p<0.001). In addition, it was also shorter in the elevated NSE group than in the normal range group (207 days vs. 469 days, p<0.001). Multivariate analysis showed that age, clinical stage, serum NSE, smoking status, and treatment modality were independent predictors of survival (hazard ratios: 1.68, 1.94, 1.92, 2.39 and 1.57, respectively). Conclusions : Smoking is an important prognostic factor in an adenocarcinoma of the lung, but not gender. This suggests that the better prognosis of women is more related with the lower rate of smoking. In addition, the elevated serum NSE is also an important prognostic in an adenocarcinoma of the lung.

Evaluation of hazardous factors for the application of HACCP on production and transportation flow in home-delivered meals for the elderly (노인을 위한 가정배달급식의 생산 및 배송단계에 HACCP 적용을 위한 위해요인 분석 1)

  • 김혜영;류시현
    • Korean journal of food and cookery science
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    • v.19 no.2
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    • pp.195-209
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    • 2003
  • The purpose of this study was to identify the hazard analysis critical control point on food production and transportation flow, applied to home-delivered meals for the elderly. To carry out this study, 1) pan-fried oak mushroom and meat, soy sauce glazed hair tail, and roasted dodok were selected as high nutrient and preferred foods for the elderly and 2) time, temperature, and microbiological quality(standard plate count, coliform, Salmonella spp, Vibrio parahaemolyticus, Staphylococcus spp., Escherichia coli O157:H7, and Listeria monocytogenes) were measured at various phases of the home-delivered meal production and its transportation flows. The results of this experiments are as follows: The temperature measured at cooling phases during the home-delivered meal production flows was 19.2 ∼ 20.0$^{\circ}C$ for the pan- fried oak mushroom and meat and the roasted dodok and was 24.0 ∼ 25.2$^{\circ}C$ for the soy sauce glazed hair tail. These temperature were in the potentially dangerous zone. Microbiological analysis showed that S. spp. was higher in the raw ingredients, including oak mushroom, hair tail, radish, and dodok, than the standard limit. SPC was lower than the standard limit from cooking to transportation phase, but SPC increased significantly during the cooling and packaging phase. The level of coliform detected was far lower than the standard limit and was not detected at all during the transportation phase. Few S. spp. was detected in the pan-fried oak mushroom and meat, but was found in above standards limit during the wrap packaging phase in the soy sauce glazed hair tail and roasted dodok. The level decreased rapidly during the holding and transportation phase. Sal. spp., V. parahaemolyticus, S. spp., E. coli O157:H7, and L. monocytogenes were not detected. For the pan-fried oak mushroom and meat, the critical control points were during the purchasing and receiving of raw ingredients, cooling, and packaging phases. For the soy sauce glazed hair tail and roasted dodok, the critical control points were during the purchasing and receiving of raw ingredients, preparation, cooling, and packaging phases.

Analysis of the Operation Status and Function based on the Overseas Accident Investigation Agency (국외 재난원인조사기구의 운영 현황 및 기능분석)

  • Lee, Kyung-Su;Yang, Seung-Ho;Kim, Yeon-Ju;Park, Jihye;Kim, Tai-Hoon;Kim, Hyunju
    • Journal of the Society of Disaster Information
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    • v.17 no.3
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    • pp.442-453
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    • 2021
  • Purpose: The objective of this study is to suggest desirable direction of Korean accident investigation organization by analyzing the operation status and way of overseas developed countries' investigation agency. Method: To accomplish the objective of this study, we were examined four main characteristics of accident investigation agencies of the U.S., Japan, and Sweden, focusing on (1); the background of the establishment, (2);organizational structure, (3);major tasks and functions, (4); accident investigation procedures. Result: First, the purpose of its establishment and task is to prevent recurrence of disasters and accidents, at the same time, administrating and researching duties such as legal system, policy, recommending improvement and conducting scientific disaster-cause analysis to contribute safety for the government. Second, it is operated as an independent organization under the president, not belonging to the ministry, in order to enable fair investigation in an impartial position. Third, it has the authority to be recognized for its expertise in the results of investigation. In other words, it is operated as a permanent organization with professional personnel, and secures authority through the accident research with indepth investigation and high-quality recommendations. Conclusion: The overseas investigation agencies rapidly manage and coordinate their operational practices in order to resolve national requirements and social conflicts with fairness, accuracy and expertise in accident investigations. In order to prevent the recurrence of similar events, Korea needs to efficiently reconstruct its investigative functions distributed by each government department. In addition, institutional improvement is needed to make general adjustments at the national level, organize and operate control tower for when the accident has happened.

Microbial Qualities of Parasites and Foodborne Pathogens in Ready to Eat (RTE) Fresh-cut Produces at the On/Offline Markets (즉석섭취 신선편의 절단 과일 및 채소의 원충류 및 병원성 식중독균의 미생물학적 품질 실태 연구)

  • Jeon, Ji Hye;Roh, Jun Hye;Lee, Chae Lim;Kim, Geun Hyang;Lee, Jeong Yeon;Yoon, Ki Sun
    • Journal of Food Hygiene and Safety
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    • v.37 no.2
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    • pp.87-96
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    • 2022
  • Recently, the purchase of fresh-cut produce and meal kits has increased. Ready-to-eat (RTE) fresh-cut products have potentially hazard of cross-contamination of various microorganisms in the processes of peeling, slicing, dicing, and shredding. There are frequent cases of protozoa food poisoning, such as Cyclospora and Cryptosporidium, caused by fresh-cut products. The objective of the study is to investigate the microbiological qualities of various types of RTE fresh-cut products in the domestic on/offline markets. RTE fresh-cut fruits cup (n=100), fresh-cut vegetables (n=50), and vegetables in meal kits (Vietnamese spring rolls and white radish rolls kits, n=50) were seasonally analyzed. The contamination levels of hygienic indicator organisms, yeast and mold (YM), and foodborne pathogens (Bacillus cereus, Staphylococcus aureus, Listeria monocytogenes, Salmonella spp., and Escherichia coli O157:H7) were monitored. Overall, the lowest microbiological qualities of meal kits vegetables were observed, followed by RTE fresh-cut fruits cup and fresh-cut vegetables. Contamination levels of total aerobic bacteria, coliforms, and YM in meal kits vegetables were 5.91, 3.90, and 4.71 logs CFU/g, respectively. From the qualitative analysis, 6 out of 200 RTE fresh-cut products (3%) returned positive result for S. aureus. From the quantitative analysis, the contamination levels of S. aureus in purple cabbage from a meal-kit and fresh-cut pineapple were below the acceptable limit (100 CFU/g). Staphylococcus enterotoxin seg and sei genes were detected in RTE fresh-cut celery and red cabbage from meal-kits, respectively. S. aureus contamination must be carefully controlled during the manufacturing processes of RTE fresh-cut products. Neither Cyclospora cayetanensis nor Cryptosporidium parvum was detected in the samples of RTE fresh-cut products and vegetables from meal-kits from the Korean retail markets.