• Title/Summary/Keyword: high risk population

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Screening of BRCA1/2 Mutations Using Direct Sequencing in Indonesian Familial Breast Cancer Cases

  • Anwar, Sumadi Lukman;Haryono, Samuel J;Aryandono, Teguh;Datasena, I Gusti Bagus
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1987-1991
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    • 2016
  • Breast cancer has emerged as the most prevalent cancer among women worldwide, including in Indonesia. The contribution of genes associated with high-risk breast-ovarian cancers, BRCA1 and BRCA2, in the Indonesian population is relatively unknown. We have characterized family history of patients with moderate- to high-risk of breast cancer predisposition in 26 unrelated cases from Indonesia for BRCA1/2 mutation analyses using direct sequencing. Known deleterious mutations were not found in either BRCA1 or BRCA2 genes. Seven variants in BRCA2 were documented in 10 of 26 patients (38%). All variants were categorized as unclassified (VUSs). Two synonymous variants, c.3623A>G and c.4035T>C, were found in 5 patients. One variant, c4600T>C, was found in a 38 year old woman with a family history of breast cancer. We have found 4 novel variants in BRCA2 gene including c.6718C>G, c.3281A>G, c.10176C>G, and c4490T>C in 4 unrelated patients, all of them having a positive family history of breast cancer. In accordance to other studies in Asian population, our study showed more frequent variants in BRCA2 compared to BRCA1. Further studies involving larger numbers of hereditary breast cancer patients are required to reveal contribution of BRCA1/2 mutations and/or other predisposing genes among familial breast cancer patients in Indonesia.

An Empirical Study on the Location and Management Plan of Public Facilities in the Rural Center Place by Declining Population (인구감소에 따른 농촌지역 거점형 중심지 공공시설 입지 및 운영방안 개선에 관한 실증적 연구)

  • Park, Sung-Jin;Kang, In-Ho
    • Journal of the Korean Institute of Rural Architecture
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    • v.20 no.3
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    • pp.27-35
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    • 2018
  • This study investigated the public use of Myeon Location in Jeollanam - do where the population is at risk of declining. And discussed the rational provision and coordination of public facilities as a guarantee of fundamental rights. As a result of the study, the rational supply and adjustment directions of public facilities are as follows. First, there are problems such as high availability of management, finance, shopping, and health facilities, lack of culture, leisure, community facilities, and weakening of center function. Therefore, in the continuing declining population situation, face management, safety and health facilities should be upgraded to multifunctional facilities, and utilization efficiency and integration should be promoted. In addition, town center rehabilitation should be centered on multifunctional facilities. In addition, elementary schools will have to utilize and preserve them to take advantage of local cultural values as nostalgia storing place that provide incentives for young people and elementary school children in the future. Second, in order to cope with population decline, public facilities need to strengthen public services through complexity and multifunctionality, wide-area operation with neighboring areas, and user-centered operation management.

Type-specific Prevalence of Human Papillomavirus by Cervical Cytology among Women in Brasov, Romania

  • Moga, Marius Alexandru;Irimie, Marius;Oanta, Alexandru;Pascu, Alina;Burtea, Victoria
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6887-6892
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    • 2014
  • The oncogenic role of human papillomavirus (HPV) in triggering cervical cancer, the second most common cancer in women worldwide, is well established. Romania ranks in first place in Europe in terms of the incidence of cervical cancer. Geographical widespread data on HPV type-distribution are essential for estimating the impact of HPV vaccines and cervical cancer screening programmes. In this study we aimed to identify the prevalence of HPV genotypes and to establish correlations with abnormal cervical cytology among the female population of Brasov County, Romania. A total of 1,000 women aged 17.3-57 years, attending routine cervical examination in the Obstetrics and Gynecology Hospital of Brasov, Romania, and undergoing both cytological examination and HPV genotyping were screened. Infection with 35 different HPV genotypes was detected in 39.6% of cytological specimens. Overall HPV infections were highest in young women under 25 years (p<0.0001), in which cervical cytological abnormalities also reached the highest prevalence. Patients infected by HPV-16 or HPV-18 showed the highest prevalence of cervical cytological abnormalities. Some 48.2% of women with abnormal cytology were infected with high-risk HPV types whereas less than 3% of them were infected only with low-risk HPV types. Our study showed that the prevalence of high-risk HPV infection among Romanian women is higher compared to other studies in other geographic areas. Thus, we consider that in areas where there is an increased prevalence of high-risk HPV infections, HPV genotyping should be performed in all women aged between 18 and 45 years, and Pap test should be performed every 6 months in women with high-risk HPV infection, even those with previous normal cervical cytology.

Prevalence Rates and Risk Factors of Non-Insulin-Dependent Diabetes Mellitus in Minorities in the United States

  • Sohn, Ae-Ree
    • Korean Journal of Health Education and Promotion
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    • v.2 no.1
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    • pp.97-114
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    • 2000
  • Minority populations in the United States have a higher prevalence of non-insulin-dependent diabetes mellitus (NIDDM) and more persons die of the disease than white persons. This study was to review and compare risk factors and prevalence rates of NIDDM in African Americans, Hispanic s, Korean Americans and Native Americans in the United States. The risk factors of NIDDM, including family history of diabetes, obesity, physical inactivity, diet and age, were reviewed in the minority populations. Risk factors such as obesity, physical inactivity and family history of diabetes occurred to a greater extent in some minority populations than in the white population. Diabetes should be treated as a public health problem for minority populations. Due to the increase of older populations and the increased prevalence of obesity and sedentariness, NIDDM in minorities is nearing epidemic proportions. Good diet and regular exercise can reduce the incidence of NIDDM but an understanding of the cultural aspects of diabetes is imperative in order to provide adequate community health education programs because those programs involve diet and behavior changes, characteristics that are often culturally determined. In summary, it is important to plan a community health education program targeted on NIDDM in a culturally adapted manner that will be received with both comprehension and acceptability. In particular, the program for high-risk populations should be stressed so to prevent diabetes. Preventive approaches to diabetes should be considered because they can be both therapeutic and cost effective.

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Sex-specific differences in the association of a common aldehyde dehydrogenase 2 gene polymorphism and alcohol consumption with stroke risk in a Korean population: a prospective cohort study

  • Shin, Chol;Kwack, KyuBum;Cho, Nam H.;Kim, Seong Hwan;Baik, Inkyung
    • Nutrition Research and Practice
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    • v.9 no.1
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    • pp.79-86
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    • 2015
  • BACKGROUND/OBJECTIVES: It is well-known that alcohol consumption is associated with stroke risk as well as with aldehyde dehydrogenase 2 gene (ALDH2) polymorphisms. However, it is unclear whether ALDH2 polymorphisms are associated with stroke risk independent of alcohol consumption and whether such association is modified by sex. We evaluated sex-specific associations of a common ALDH2 polymorphism and alcohol consumption with stroke risk in a Korean population. SUBJECTS/METHODS: We conducted a prospective cohort study involving 8,465 men and women, aged 40-69 years and free of stroke between June, 2001 and January, 2003, and followed for the development of stroke. We identified new cases of stroke, which were self-reported or ascertained from vital registration data. Based on genome-wide association data, we selected a single-nucleotide polymorphism (rs2074356), which shows high linkage disequilibrium with the functional polymorphism of ALDH2. We conducted Cox proportional hazards regression analysis considering potential risk factors collected from a baseline questionnaire. RESULTS: Over the median follow-up of 8 years, 121 cases of stroke were identified. Carrying the wild-type allele of the ALDH2 polymorphism increased stroke risk among men. The multivariate hazard ratio [95% confidence interval] of stroke was 2.02 [1.03-3.99] for the wild-type allele compared with the mutant alleles, but the association was attenuated after controlling for alcohol consumption. Combinations of the wild-type allele and other risk factors of stroke, such as old age, diabetes mellitus, and habitual snoring, synergistically increased the risk among men. Among women, however, the ALDH2 polymorphism was not associated with stroke risk. CONCLUSIONS: The prospective cohort study showed a significant association between a common ALDH2 polymorphism and stroke risk in Korean men, but not in Korean women, and also demonstrated that men with genetic disadvantages gain more risk when having risk factors of stroke. Thus, these men may need to make more concerted efforts to control modifiable risk factors of stroke.

Clinico-Hematological Profile and Risk Stratification in Patients with Essential Thrombocythemia: Experience from Pakistan

  • Sultan, Sadia;Irfan, Syed Mohammed;Tanveer, Quratulain;Ali, Navaira
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7659-7661
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    • 2015
  • Background: Essential thrombocythemia (ET) is a Philadelphia chromosome-negative myeloproliferative neoplasm characterized by sustained thrombocytosis and megakaryocytic hyperplasia. It is an uncommon hematological malignancy which primarily affects elderly individuals. The rational of this study was to determine its clinico-hematological profile along with risk stratification in Pakistan patients. Materials and Methods: In this retrospective cross sectional study, 21 patients with ET were enrolled from January 2011 to December 2014. Data was analyzed with SPSS version 21. Results: The mean age was $56.7{\pm}19.0years$ (range 18-87) and the male to female ratio was 1:1.1. Of the total, 62% of patients were above 50 years of age. Overall 61.9% were diagnosed incidentally and were asymptomatic. In symptomatic patients, major complaints were weakness (19%); erythromelalgia (14.2%), transit ischemic attack (9.5%) and gastrointestinal bleed (4.7%). The mean hemoglobin count was $11.7{\pm}2.4g/dl$ with a total leukocyte count of $13.3{\pm}8.1{\times}10^9/l$ and platelets count of $1188.8{\pm}522.2{\times}10^9/l$. Serum lactate dehydrogenase, serum creatinine and uric acid were $454.3{\pm}127.8$, $1.2{\pm}0.5$ and $7.4{\pm}3.4$ respectively. According to risk stratification, 57.1% were in high risk; 23.8% in intermediate risk while 19.1% in low risk group. Conclusions: ET in our patients in Pakistan, unlike in the West, is seen in a relatively young population. Primarily patients were asymptomatic and risk stratification revealed predominance of high risk disease in our setting.

Endoscopic Findings in a Mass Screening Program for Gastric Cancer in a High Risk Region - Guilan Province of Iran

  • Mansour-Ghanaei, Fariborz;Sokhanvar, Homayoon;Joukar, Farahnaz;Shafaghi, Afshin;Yousefi-Mashhour, Mahmud;Valeshabad, Ali Kord;Fakhrieh, Saba;Aminian, Keyvan;Ghorbani, Kambiz;Taherzadeh, Zahra;Sheykhian, Mohammad Reza;Rajpout, Yaghoub;Mehrvarz, Alireza
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1407-1412
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    • 2012
  • Background & Objectives: Gastric cancer is a leading cause of cancer-related deaths in both sexes in Iran. This study was designed to assess upper GI endoscopic findings among people > 50 years targeted in a mass screening program in a hot-point region. Methods: Based on the pilot results in Guilan Cancer Registry study (GCRS), one of the high point regions for GC-Lashtenesha- was selected. The target population was called mainly using two methods: in rural regions, by house-house direct referral and in urban areas using public media. Upper GI endoscopy was performed by trained endoscopists. All participants underwent biopsies for rapid urea test (RUT) from the antrum and also further biopsies from five defined points of stomach for detection of precancerous lesions. In cases of visible gross lesions, more diagnostic biopsies were taken and submitted for histopathologic evaluation. Results: Of 1,394 initial participants, finally 1,382 persons (702 women, 680 men) with a mean age of $61.7{\pm}9.0$ years (range: 50-87 years) underwent upper GI endoscopy. H. pylori infection based on the RUT was positive in 66.6%. Gastric adenocarcinoma and squamous cell carcinoma of esophagus were detected in seven (0.5%) and one (0.07%) persons, respectively. A remarkable proportion of studied participants were found to have esophageal hiatal hernia (38.4%). Asymptomatic gastric masses found in 1.1% (15) of cases which were mostly located in antrum (33.3%), cardia (20.0%) and prepyloric area (20.0%). Gastric and duodenal ulcers were found in 5.9% (82) and 6.9% (96) of the screened population. Conclusion: Upper endoscopy screening is an effective technique for early detection of GC especially in high risk populations. Further studies are required to evaluate cost effectiveness, cost benefit and mortality and morbidity of this method among high and moderate risk population before recommending this method for the GC surveillance program at the national level.

Folate intake, Methylenetetrahydrofolate Reductase Polymorphisms in Association with the Prognosis of Esophageal Squamous Cell Carcinoma

  • Jing, Chen;Huang, Zhijie;Duan, Yuqin;Xiao, Xinrong;Zhang, Ru;Jiang, Jianqing
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.2
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    • pp.647-651
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    • 2012
  • Aim: An epidemiological study was conducted based on an esophageal cancer patient's cohort to investigate the association of folate intake and MTHFR C677T polymorphism with the prognosis of esophageal cancer in a Chinese population. Methods: 167 patients aged 37-75 years who had histological confirmed diagnosis of esophageal squamous cell cancer were collected from Jan. 2006 to Jan. 2008. MTHFR genotypes at the C677T site were analyzed by PCR-based RFLP methods, and the folate intake was computed by multiplying the food intake (in grams) and the folate content (per gram) of food in our questionnaire. Results: We found associations between the prognosis of esophageal cancer and smoking status, T and N stages. Individuals carrying the MTHFR 677CT and TT genotypes showed a shorter survival time than with the CC genotype, with adjusted HRs (95% CI) of 1.20 (0.56-2.15) and 2.29 (1.30-4.28), respectively. Similarly, those carrying MTHFR 677T allele had a 1.86-fold risk of death. A higher folate concentration showed a significant decreased risk of death, with an HR (95% CI) of 0.45 (0.18-0.87). Individuals with high folate intake and the MTHFR 677CC genotype showed a significant decreased risk of esophageal cancer (0.43, 0.25-0.89).Conclusion: Our findings supports the hypothesis that high folate intake and active MTHFR C677T polymorphism may exert protective roles in the prognosis of esophageal cancer in the Chinese population.

High-Sensitivity C-Reactive Protein and Risks of All-Cause and Cause-Specific Mortality in a Japanese Population

  • Nisa, Hoirun;Hirata, Akie;Kohno, Michiko;Kiyohara, Chikako;Ohnaka, Keizo
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.5
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    • pp.2643-2648
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    • 2016
  • Background: High-sensitivity C-reactive protein (hsCRP) levels are lower in Japanese compared with Western subjects. Since it is uncertain whether hsCRP is a potent predictor of mortality at low CRP concentrations, the present study examined associations with all-cause and cause-specific mortality in a large population of Japanese. Materials and Methods: Subjects were 4,737 men and 6,343 women aged 49-76 years participating in the baseline survey of an ongoing cohort study of lifestyle-related diseases between February 2004 and July 2006. Hazard ratios for all-cause and cause-specific mortality associated with hsCRP levels were estimated using Cox proportional hazards regression. Results: A total of 436 all-cause deaths occurred during a median follow-up of 8 years. The main cause of death was cancer. In men, hsCRP levels were positively associated with the risk of all-cause mortality as well as deaths from cancer and cardiovascular disease (CVD). All-cause mortality hazards for the 2nd (0.34-0.84 mg/L) and the 3rd (${\geq}0.85mg/L$) tertiles of hsCRP were 1.27 (95% confidence interval [CI], 0.93-1.73) and 1.75 (1.30-2.37), respectively (p for trend=0.001). In women, increased risk of all-cause and cause-specific mortality associated with elevated hsCRP levels was observed, but the associations were not statistically significant. Conclusions: HsCRP may be an independent predictor of all-cause, cancer and CVD mortality in apparently healthy Japanese men, but not women. The differential effect of hsCRP in predicting mortality risk by sex warrants further investigation.

The Risk Analysis for the Rail Transport of Explosives (폭약류의 철도수송에 따른 리스크 평가)

  • Lee, Jae-Hean;Song, Dong-Woo;Lee, Su-Kyung
    • Journal of the Korean Institute of Gas
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    • v.15 no.2
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    • pp.33-39
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    • 2011
  • This study presented quantitative risk analysis in case of transporting explosive materials by railway. Accident types were classified into accidents of in station and in transit. And the study presented an initial value of accident frequency through derailment accident and crushing one according to each type, and drew the results of accident frequency through event tree analysis. Damage impact evaluation used TNT equivalent method and probit analysis method. As the result of risk evaluation, railway transportation of explosive materials passing through areas which are high in population density is appeared to be able to cause a large number of personnel injury when occurring accidents. Specially, the accident of explosive transportation combined with petroleum was forecasted as easily resulting in large explosive accident. Consequently, there is a necessity to reduce consequences by decreasing passage through areas where are high in population density, and take measures for lessening the risks in case of transporting dangerous explosive materials.