• Tuberculosis and Respiratory Diseases
• /
• v.75 no.2
• /
• pp.52-58
• /
• 2013

Background: More than half of cases for advanced non-small-cell lung cancer (NSCLC) occur in elderly patients with a median age at diagnosis of 70 years. The aim of our study was to examine the clinical features and prognostic factors contributing to mortality in elderly patients with advanced NSCLC. Methods: Following a retrospective review of clinical data, 122 patients aged 70 years and over with a histopathological diagnosis of locally advanced (stage IIIB, n=32) and metastatic (stage IV, n=90) NSCLC between 2005 and 2011 were enrolled. Results: The median age was 76 years (interquartile range, [IQR], 72-80 years), and 85 (70%) patients were male. Fifty-seven (46%) patients had never smoked, and 17 (19%) were in a malnourished state with a body mass index (BMI) of <$18.5kg/m^2$. The initial treatments included chemotherapy (40%) and radiotherapy (7%), but 57% of the patients received supportive care only. The 1-year survival rate was 32%, and the 3-year survival rate was 4%, with a median survival duration of 6.2 months (IQR, 2.5-15.3 months). Male gender (hazard ratio [HR], 2.2; 95% confidence interval [CI], 1.3-3.9; p=0.005), low BMI (HR, 2.3; 95% CI, 1.3-3.9; p=0.004), and supportive care only (HR, 1.9; 95% CI, 1.2-2.9; p=0.007) were independent predictors of shorter survival based on a Cox proportional hazards model. Conclusion: Elderly patients with advanced NSCLC had a poor prognosis, particularly male patients, those with a low BMI, and those who received supportive care only.

• Journal of Gastric Cancer
• /
• v.18 no.2
• /
• pp.142-151
• /
• 2018

Purpose: The modification of the cancer classification system aimed to improve the classical anatomy-based tumor, node, metastasis (TNM) staging by considering tumor biology, which is associated with patient prognosis, because such information provides additional precision and flexibility. Materials and Methods: We previously developed an mRNA expression-based single patient classifier (SPC) algorithm that could predict the prognosis of patients with stage II/III gastric cancer. We also validated its utilization in clinical settings. The prognostic single patient classifier (pSPC) differentiates based on 3 prognostic groups (low-, intermediate-, and high-risk), and these groups were considered as independent prognostic factors along with TNM stages. We evaluated whether the modified TNM staging system based on the pSPC has a better prognostic performance than the TNM 8th edition staging system. The data of 652 patients who underwent gastrectomy with curative intent for gastric cancer between 2000 and 2004 were evaluated. Furthermore, 2 other cohorts (n=307 and 625) from a previous study were assessed. Thus, 1,584 patients were included in the analysis. To modify the TNM staging system, one-grade down-staging was applied to low-risk patients according to the pSPC in the TNM 8th edition staging system; for intermediate- and high-risk groups, the modified TNM and TNM 8th edition staging systems were identical. Results: Among the 1,584 patients, 187 (11.8%), 664 (41.9%), and 733 (46.3%) were classified into the low-, intermediate-, and high-risk groups, respectively, according to the pSPC. pSPC prognoses and survival curves of the overall population were well stratified, and the TNM stage-adjusted hazard ratios of the intermediate- and high-risk groups were 1.96 (95% confidence interval [CI], 1.41-2.72; P<0.001) and 2.54 (95% CI, 1.84-3.50; P<0.001), respectively. Using Harrell's C-index, the prognostic performance of the modified TNM system was evaluated, and the results showed that its prognostic performance was better than that of the TNM 8th edition staging system in terms of overall survival (0.635 vs. 0.620, P<0.001). Conclusions: The pSPC-modified TNM staging is an alternative staging system for stage II/III gastric cancer.

• Journal of Preventive Medicine and Public Health
• /
• v.40 no.1
• /
• pp.23-28
• /
• 2007

Objectives : Chronic infections with hepatitis B or C and alcoholic cirrhosis are three well-known major risk factors for liver cancer. Diabetes has also been suggested as a potential risk factor. However, the findings of previous studies have been controversial in terms of the causal association. Therefore, the aim of this study was to evaluate the association between serum glucose levels and liver cancer development in a Korean cohort. Methods : Thirty-six liver cancer cases were identified in the Korean Multi-Center Cancer Cohort (KMCC). Baseline information on lifestyle characteristics was obtained via questionnaire. Serum glucose levels were measured at the study's enrollment. Relative risks (RRs) were estimated using a Cox proportional hazard regression model. The adjusting variables included age, gender, smoking history, alcohol consumption, body mass index, and hepatitis B surface antigen (HBsAg) seropositivity. Results : The RRs of serum glucose for liver caner were 1.20 (95% CI = 0.48-2.99) for the category of 100 to 125 mg/dL of serum glucose and 2.77 (95% CI = 1.24-6.18) for the >126 mg/dL serum glucose category (both compared to the <100 mg/dL category). In a subgroup analysis, the RR of serum glucose among those who were both HBsAg seronegative and non-drinkers was 4.46 (95% CI = 1.09-18.28) for those with glucose levels >100 mg/dL. Conclusions : The results of this study suggest that a high level of serum glucose can increase liver cancer risk independently of hepatitis infection and drinking history in Koreans. This study implies that glucose intolerance may be an independent risk factor for liver cancer.

• Fire Science and Engineering
• /
• v.15 no.1
• /
• pp.100-107
• /
• 2001

A Interior material, a main cause of fire-growth and generating toxic gas when it burns, should be dealt with great care in life safety design. Nonetheless, it has been used recklessly with undue attention to its contribution to fire in particular in entertainment occupancy and causes many victims in fire. Therefore, this study attempts to examine the current use of interior material in Korea and find out what to be improved and enhanced in terms of related regulations. Based on the comparison and analysis of the Korea regulation with those of advanced nations, suggestions are made for an effective and efficient improvement and complement to the current system. What can be suggested from this study are as follows. The use of interior material should be controlled under the unified regulation of fire-safety codes. Code should be set up so that the current construction enforcement should be applied in retroactive to those entertainment buildings that obtained a license prior to the implementation of the system certifying that the building is fire-resistant and fire-protective. The legislation should be made to control the fire-protection facilities of small-sized, underground entertainments. It should be obliged to present the blueprint displaying the use of interior material at the time of changing occupancy. Or, it should be compelled to report changes that go way without permit to the administrative office. A compulsory provision should be set up to have a fire-resistant performance to movable furniture. The classification index designating the fire hazard of interior material by flame spread rate and smoke toxicity and its test method should be established.

• Journal of radiological science and technology
• /
• v.33 no.3
• /
• pp.185-192
• /
• 2010

Platelets originating from Megakaryocyte are sensitive to radiation along with white blood cells, and thus these platelets are used as an index of radiation hazard as they decrease in advance. Thus, when there is a scarcity of platelets, dot hemorrhage occurs and it leads to decrease of blood corpuscle and a decline in immunity. In particular, when 4~6 Gy whole body irradiation is received, after three weeks, the platelets will decrease to the lowest level, which can be a cause of death by bleeding and anemia. Therefore, this study tried to identify the mechanism of platelet damage and protection effect. The protection substance used in the experiment is Alliin, which is a component of garlic, and it was observed by an Transmission Electron Microscope(TEM) after its injection to the rat's tail vein. In the study, it was found that the cell membrane was severely damaged in a 10-day progressed platelet organ after receiving 5 Gy irradiation. It billowed as balloon-like figure and the glycocalyx became hyperplasia. The minute organ was damaged to the point that it was beyond recognition in a 20-day progressed platelet organ after receiving irradiation, and the cytoplasmic contents were exposed to epilepsy parts and outrageously damaged. Furthermore, the form of granules could also not be observed. A hole was formed in the middle, and the damaged organ was found in a 30-day progressed platelet. However, the form of granules was consistently maintained in the experiment group injecting Alliin, as with the control group, and there was no damage to the cell membrane recognized. Thus, it was possible to verify the effectiveness of radiation protection of the platelet when Alliin was injected to the blood vessel.

• Journal of Chest Surgery
• /
• v.50 no.2
• /
• pp.86-93
• /
• 2017

Background: The influence of lifestyle diseases on postoperative complications and long-term survival in patients with non-small cell lung cancer (NSCLC) is unclear. The aim of this study was to determine whether lifestyle diseases were significant risk factors of perioperative and long-term surgical outcomes in elderly patients with stage I NSCLC. Methods: Between December 1995 and November 2013, 110 patients aged 65 years or older who underwent surgical resection of stage I NSCLC at Dong-A University Hospital were retrospectively studied. We assessed the presence of the following lifestyle diseases as risk factors for postoperative complications and long-term mortality: diabetes, hypertension, chronic obstructive pulmonary disease, stroke, and ischemic heart disease. Results: The mean age of the patients was 71 years (range, 65 to 82 years). Forty-six patients (41.8%) had hypertension, making it the most common lifestyle disease, followed by diabetes (n=23, 20.9%). The in-hospital mortality rate was 0.9% (n=1). The 3-year and 5-year survival rates were 78% and 64%, respectively. Postoperative complications developed in 32 patients (29.1%), including 7 (6.4%) with prolonged air leakage, 6 (5.5%) with atrial fibrillation, 5 (4.5%) with delirium and atelectasis, and 3 (2.7%) with acute kidney injury and pneumonia. Univariate and multivariate analyses showed that the presence of a lifestyle disease was the only independent risk factor for postoperative complications. In survival analysis, univariate analysis showed that age, smoking, body mass index, extent of resection, and pathologic stage were associated with impaired survival. Multivariate analysis revealed that resection type (hazard ratio [HR], 2.20; 95% confidence interval [CI], 1.08 to 4.49; p=0.030) and pathologic stage (HR, 1.89; 95% CI, 1.02 to 3.49; p=0.043) had independent adverse impacts on survival. Conclusion: This study demonstrated that the presence of a lifestyle disease was a significant prognostic factor for postoperative complications, but not of survival, in elderly patients with stage I NSCLC. Therefore, postoperative complications may be influenced by the presence of a lifestyle disease.

• Journal of Food Hygiene and Safety
• /
• v.20 no.2
• /
• pp.77-82
• /
• 2005

Niacin (vitamin $B_{3}$) is the generic term for nicotinic acid (pyridine 3-carboxylic acid) and nicotinamide (nicotinic acid amide), and coenzyme forms of the vitamin. Large doses of nicotinic acid are associated with a number of adverse effects in human. The effects include flushing, skin itching, nausea, vomiting and gastrointestinal disturbance. This study was conducted to estimate daily intake of niacin by ingestion of food and multivitamin, and to identify risk value related with side effects, which can be caused by large dose intake in population having a typical lifestyle. Induced risk values by comparing only dietary intake level and intake level from both food and multivitamin with upper level as 35 mg/day were 0.53 and $0.81\~6.24$ respectively. Hazard Index over 1 means that occurrence of side effects would be expected in some population. When people intake multivitamin and functional food including niacin, risk value may increase more than risk value identified in this study.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.14
• /
• pp.5721-5727
• /
• 2014

Objectives: To evaluate the performance of clustering methods used in the prognostic assessment of categorical clinical data for hepatocellular carcinoma (HCC) patients in China, and establish a predictable prognostic nomogram for clinical decisions. Materials and Methods: A total of 332 newly diagnosed HCC patients treated with hepatic resection during 2006-2009 were enrolled. Patients were regularly followed up at outpatient clinics. Clustering methods including the Average linkage, k-modes, fuzzy k-modes, PAM, CLARA, protocluster, and ROCK were compared by Monte Carlo simulation, and the optimal method was applied to investigate the clustering pattern of the indices including platelet count, platelet/lymphocyte ratio (PLR) and serum aspartate aminotransferase activity/platelet count ratio index (APRI). Then the clustering variable, age group, tumor size, number of tumor and vascular invasion were studied in a multivariable Cox regression model. A prognostic nomogram was constructed for clinical decisions. Results: The ROCK was best in both the overlapping and non-overlapping cases performed to assess the prognostic value of platelet-based indices. Patients with categorical platelet-based indices significantly split across two clusters, and those with high values, had a high risk of HCC recurrence (hazard ratio [HR] 1.42, 95% CI 1.09-1.86; p<0.01). Tumor size, number of tumor and blood vessel invasion were also associated with high risk of HCC recurrence (all p< 0.01). The nomogram well predicted HCC patient survival at 3 and 5 years. Conclusions: A cluster of platelet-based indices combined with other clinical covariates could be used for prognosis evaluation in HCC.

• The Journal of Engineering Geology
• /
• v.17 no.3
• /
• pp.393-404
• /
• 2007

The purpose of this study is to capture the essentials in survey and evaluation scheme which are able to assess the hazard of a rock slope systematically. Statistical analysis are performed on slope instability parameters related to failure of the rock slope. As the slope instability parameters, twelve survey items are considered such as tension crack, surface deformation, deformation of retaining structures, volume of existing failures, angles between strike of discontinuity and strike of cut slope face, angles between dip of discontinuity and dip of cut slope face, discontinuity condition, cut slope angle, rainfall or ground water level, excavation condition, drainage condition, reinforcement. A total of 233 road cut slopes located in Gyeongnam were considered. The stability of the road cut slopes were evaluated by estimating the slope instability index(SII) and corresponding stability rank. 126 rock slopes were selected to analyze statistical relation between SII and slope instability parameters. The multiple regression analysis was applied to derive statistical models which are able to predict the SII and corresponding slope stability rank. Also, its applicability was explored to predict the slope failures using the variables of slope instability parameters. The results obtained in this study clearly show that the methodology given in this paper have strong capabilities to evaluate the failures of the road cut slope effectively.

• Journal of Environmental Impact Assessment
• /
• v.20 no.4
• /
• pp.497-507
• /
• 2011

This research studied human health risk assessment of benzene from industrial complexes of Chungcheong Province (Seosan industrial complex) and Jeonla Province (Iksan industrial complex and Yeosoo industrial complex). The residents near the industrial complexes areas can be often exposed to volatile organic compounds (e.g., benzene, toluene, xylenes) through a number of exposure pathways, including inhalation of the organic pollutant via various environmental matrices (air, water and soil), contaminated water, and soil intake. Benzene is well known to be a common carcinogenic and toxic compound that is produced from industrial and oil refinery complexes. In this study, a number of samples from water, air, and soil were taken from the residential settings and public school zones located near the industrial complex sites. Based on the carcinogenic risk assessment, the risk estimates were slightly above $10{\times}10^{-6}$ at all three industrial sites. According to deterministic risk assessment, inhalation was the most important route. The distribution of benzene in the environment would be dependent on vapor pressure, and the physical property influencing the extent of the potential risks. Non-carcinogenic risk assessment of benzene shows that the values of Hazard Index(HI) were much lower than 1.0 at all industrial complexes. Therefore, benzene was not a cause of concern in terms of non-carcinogenic risk posed to the residents near the sites. When compared to probabilistic risk assessment, the CTE(central tendency exposure) cancer risk values of deterministic risk assessment were close to the mean values predicted by the probabilistic risk assessment. The RME(reasonable maximum exposure) values fell within the range of 95% to 99.9% estimated by the probabilistic risk assessment. Since the values of carcinogenic risk assessment were higher than $10{\times}10^{-6}$, further detailed monitoring and refined risk assessment for benzene may be warranted to estimate more reliable and potential inhalation risks to receptors near the industrial complexes.