Background: Lung cancer is a fatal malignancy with high mortality and short survival time. The aim of this study was to estimate survival rates of Iranian patients with lung cancer and its associate predictive factors. Materials and Methods: The study was conducted on 355 patients admitted to hospitals of West Azerbaijan in the year 2007. The patients were followed up by phone calls until the end of June 2014. The survival rate was estimated using the Kaplan-Meier method and log-rank test for comparison. The Cox's proportional hazard model was used to investigate the effect of various variables on patient survival time, including age, sex, Eastern Cooperative Oncology Group (ECOG) performance, smoking status, tumor type, tumor stage, treatment, metastasis, and blood hemoglobin concentration. Results: Of the 355 patients under study, 240 died and 115 were censored. The mean and median survival time of patients was 13 and 4.8 months, respectively. According to the results of Kaplan-Meier method, 1, 2, and 3 years survival rates were 39%, 18%, and 0.07%, respectively. Based on Cox regression analysis, the risk of death was associated with ECOG group V (1.83, 95% CI: 1 Conclusions: The survival time of the patients with lung cancer is very short. While early diagnosis may improve the life expectancy effective treatment is not available.
Objective: The PI3K/PTEN/AKT/mTOR signaling pathway has been implicated in resistance to cisplatin. In the current study, we determined whether common genetic variations in this pathway are associated with platinum-based chemotherapy response and clinical outcome in advanced non-small cell lung cancer (NSCLC) patients. Methods: Seven common single nucleotide polymorphisms (SNPs) in core genes of this pathway were genotyped in 199 patients and analyzed for associations with chemotherapy response, progression-free survival (PFS) and overall survival (OS). Results: Logistic regression analysis revealed an association between AKT1 rs2494752 and response to treatment. Patients carrying heterozygous AG had an increased risk of disease progression after two cycles of platinum-based chemotherapy compared to those with AA genotype (Adjusted odds ratio (OR)=2.18, 95% confidence interval (CI): 1.00-4.77, which remained significant in the stratified analyses). However, log-rank test and cox regression detected no association between these polymorphisms in the PI3K pathway genes and survival in advanced NSCLC patients. Conclusions: Our findings suggest that genetic variants in the PI3K/PTEN/AKT/mTOR pathway may predict platinum-based chemotherapy response in advanced NSCLC patients in a Chinese population.
Park, So Hyun;Lee, Rena;Kim, Kyubo;Ahn, Sohyun;Lim, Sangwook;Cho, Samju
Progress in Medical Physics
/
v.30
no.2
/
pp.59-63
/
2019
Purpose: To manage radiation measurement equipment, a web-based management program has been developed in this study. Materials and Methods: This program is based on a web service and Java Server Pages (JSP) and employs compatibility and accessibility. Results: The first step in the workflow has been designed to create accounts for each user or organization and to log in. The program consists of two parts: fields for listed instruments, and measurement information. The instruments for measuring radiation listed in this program are as follows: ionization chambers, survey meters, thermometers, barometers, electrometers, and phantoms. Instrument properties can be put in the recording fields and browsing for associated instruments can be performed. The main part of the program is the cross-calibration for each ion chamber. For instance, the ionization chamber to be used as a relative dosimeter can be registered by cross-calibration data with a reference chamber calibrated by an accredited laboratory. This program supports methods using the central axis transfer theory for cross-calibration for the ionization chambers. The reference and field ionization chambers were placed in a solid water phantom along the beam central axis at two different depths, and then the positions were switched. Each measured value was used for calculating the cross-calibration factor. Conclusions: Because many instruments are used and managed in radiation oncology departments, systematic, traceable recording is very important. The web-based program developed in this study is expected to be used effectively in the maintenance of radiation measurement instruments.
Ha, Jin-Sil;Jung, Hea-Jung;Byun, Hyae-Jeong;Yoon, Chung-Sik;Kim, Yang-Ho;Oh, In-Bo;Lee, Ji-Ho;Ha, Kwon-Chul
Journal of Environmental Health Sciences
/
v.37
no.6
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pp.406-417
/
2011
Objectives: Exposure to bioaerosols in the indoor environment could be associated with a variety adverse health effects, including allergic disease such atopy. The objectives of this study were to assess children's exposure to bioaerosol in home indoor environments and to evaluate the association between atopy and bioaerosol, environmental, and social factors in Ulsan, Korea. Methods: Samples of viable airborne bacteria and fungi were collected by impaction onto agar plates using a Quick Take TM 30 and were counted as colony forming units per cubic meter of air (CFU/$m^3$). Bioaerosols were identified using standard microbial techniques by differential stains and/or microscopy. The environmental factors and possible causes of atopy based on ISAAC (International Study of Allergy and Asthma in Childhood) were collected by questionnaire. Results: The bioaerosol concentrations in indoor environments showed log-normal distribution (p < 0.01). Geometric mean (GM) and geometric standard deviation (GSD) of airborne bacteria and fungi in homes were 189.0 (2.5), 346.1(2.0) CFU/$m^3$, respectively. Indoor fungal levels were significantly higher than those of bacteria (p < 0.001). The concentration of airborne bacteria exceeded the limit recommended by the Korean Ministry of Environment, 800 CFU/$m^3$, in three out of 92 samples (3.3%) from 52 homes. The means of indoor to outdoor ratio (I/O) for airborne bacteria and fungi were 8.15 and 1.13, respectively. The source of airborne bacteria was not outdoors but indoors. GM of airborne bacteria and fungi were 217.6, 291.8 CFU/$m^3$ in the case's home and 162.0, 415.2 CFU/$m^3$ in the control's home respectively. The difference in fungal distributions between case and control were significant (p = 0.004) and the odds ratio was 0.996 (p = 0.027). Atopy was significantly associated with type of house (odds ratio = 1.723, p = 0.047) and income (odds ratio = 1.891, p = 0.041). Some of the potential allergic fungal genera isolated in homes were Cladosporium spp., Botrytis spp., Aspergillus spp., Penicillium spp., and Alternatia spp. Conclusions: These results suggest that there this should be either 'was little' meaning 'basically no significant association was found' or 'was a small negative' mean that an association was found but it was minor. It's a very improtant distinction. Association between airborne fungal concentrations and atopy and certain socioeconomic factors may affect the prevalence of childhood atopy.
Diabetes mellitus is associated with a variety of adverse health outcomes, including metabolic syndrome and cardiovascular diseases. Recently, diabetes has been receiving increased scientific attention because of the rapid increase in the diabetic population. One of the features of type-2 diabetes mellitus is an elevated glucose level in blood. Fasting glucose level, which is the most basic test, is widely used as a diagnostic indicator of diabetes. Several previous studies reported that TLR4 expression is relatively high in the heart. However, few studies have investigated the association between TLR4 variants and fasting blood glucose to date. Thus, this study tested the association between single nucleotide polymorphisms (SNPs) in the TLR4 gene and fasting glucose in the Korean population. A total of 994 subjects recruited from Seoul were used for the present study. When compared to fasting blood glucose, the TLR4 gene region was shown as a linkage disequilibrium owing to the relatively large gene range. This region also presented as several LD blocks. We found that specific SNPs in the TLR4 gene were associated with the mean fasting glucose (p<0.01). The minor allele frequency of rs1329067 was 16.4%, and individuals with the AA genotype had a higher fasting blood glucose level than those with the GG genotype, suggesting that genetic variants in TLR4 influence glucose levels in Korean adults.
Eun Kyoung Kim;Ga Yeon Lee;Shin Yi Jang;Sung-A Chang;Sung Mok Kim;Sung-Ji Park;Jin-Oh Choi;Seung Woo Park;Yeon Hyeon Choe;Sang-Chol Lee;Jae K. Oh
Korean Journal of Radiology
/
v.22
no.3
/
pp.324-333
/
2021
Objective: The clinical course of an individual patient with heart failure is unpredictable with left ventricle ejection fraction (LVEF) only. We aimed to evaluate the prognostic value of cardiac magnetic resonance (CMR)-derived myocardial fibrosis extent and to determine the cutoff value for event-free survival in patients with non-ischemic cardiomyopathy (NICM) who had severely reduced LVEF. Materials and Methods: Our prospective cohort study included 78 NICM patients with significantly reduced LV systolic function (LVEF < 35%). CMR images were analyzed for the presence and extent of late gadolinium enhancement (LGE). The primary outcome was major adverse cardiac events (MACEs), defined as a composite of cardiac death, heart transplantation, implantable cardioverter-defibrillator discharge for major arrhythmia, and hospitalization for congestive heart failure within 5 years after enrollment. Results: A total of 80.8% (n = 63) of enrolled patients had LGE, with the median LVEF of 25.4% (19.8-32.4%). The extent of myocardial scarring was significantly higher in patients who experienced MACE than in those without any cardiac events (22.0 [5.5-46.1] %LV vs. 6.7 [0-17.1] %LV, respectively, p = 0.008). During follow-up, 51.4% of patients with LGE ≥ 12.0 %LV experienced MACE, along with 20.9% of those with LGE ≤ 12.0 %LV (log-rank p = 0.001). According to multivariate analysis, LGE extent more than 12.0 %LV was independently associated with MACE (adjusted hazard ratio, 6.71; 95% confidence interval, 2.54-17.74; p < 0.001). Conclusion: In NICM patients with significantly reduced LV systolic function, the extent of LGE is a strong predictor for long-term adverse cardiac outcomes. Event-free survival was well discriminated with an LGE cutoff value of 12.0 %LV in these patients.
Jang, Se Young;Kim, Jihun;Kim, Seonhwa;Lee, Eun Sun;Choi, Eun Jeong
Journal of Korean Academy of Nursing
/
v.54
no.1
/
pp.18-31
/
2024
Purpose: This study aimed to investigate the impact of anthropometric indices of obesity (body mass index [BMI], waist circumference, waist hip ratio, and body fat percentage) on the incidence of hypertension in adults with prehypertension. Methods: A longitudinal study design using secondary data form the Korean Genome and Epidemiology Study was employed. The study included 1,838 adults with prehypertension tracked every two years from 2001 to 2018. Statistical analyses, including frequency assessments, number of cases per 1,000 person-years, log-rank tests, Kaplan-Meier curves, and Cox's proportional hazards regression, were conducted using SPSS version 25. Results: Over the observation period (15,783.6 person-years), 1,136 individuals developed hypertension. The incidence of hypertension was significantly higher in the obesity groups defined by BMI (hazard ratio [HR] = 1.33), waist circumference (HR = 1.34), waist hip ratio (HR = 1.29), and body fat percentage (HR = 1.31) compared to the non-obese group. These findings indicate an increased risk of hypertension associated with obesity as measured by these indices. Conclusion: The study underscores the importance of avoiding obesity to prevent hypertension in individuals with prehypertension. Specifically, BMI, waist circumference, waist hip circumference, and body fat percentage were identified as significant risk factors for hypertension. The results suggest the need for individualized weight control interventions, emphasizing the role of health professionals in addressing the heightened hypertension risk in this population.
Kim, So Yeon;Lee, Ryun Kyung;Kim, Tae hu;Kim, Dong Hoon;Kim, Taeyun;Lee, Soo Hoon;Jeong, Jin Hee;Lee, Sang Bong;Kang, Changwoo
Journal of The Korean Society of Clinical Toxicology
/
v.15
no.1
/
pp.11-16
/
2017
Purpose: The association of hypoalbuminemia with 30-day in-hospital mortality in patients with organophosphate insecticide poisoning (OPI) was studied. Methods: This retrospective cohort study was conducted between January 2006 and November 2013 in the emergency department (ED) after OPI poisoning. A Kaplan-Meier 30-day survival curve and the log-rank test were used to analyze patients stratified according to serum albumin levels on ED admission (hypoalbuminemia or normo-albuminemia). Independent risk factors including hypoalbuminemia for 30-day mortality were determined by multivariate Cox regression analysis. Results: A total of 135 patients were included. Eighty-eight (65%) patients were male and the mean age was $57.3{\pm}17.0$ years. Serum albumin, mean arterial pressure, and Glasgow coma scale score were significantly higher in the survival group than the non-survival group. APACHE II score was significantly lower in the non-survival group than the survival group. The mortality of the hypoalbuminemia group (serum albumin <3.5 g/dl) was 68.8%, while that of the normo-albuminemia group (serum albumin ${\geq}3.5g/dl$) was 15.1%. The area under the ROC curve of the serum albumin level was 0.786 (95% CI, 0.690-0.881) and the APACHE II score was 0.840 (95% CI, 0.770-0.910). Conclusion: Hypoalbuminemia is associated with 30-day mortality in patients with OPI poisoning.
Kim, Myung Soo;Chung, Ho Seok;Hwang, Eu Chang;Jung, Seung Il;Kwon, Dong Deuk;Hwang, Jun Eul;Bae, Woo Kyun;Park, Jae Young;Jeong, Chang Wook;Kwak, Cheol;Song, Cheryn;Seo, Seong Il;Byun, Seok-Soo;Hong, Sung-Hoo;Chung, Jinsoo
Journal of Korean Medical Science
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v.33
no.51
/
pp.325.1-325.10
/
2018
Background: To evaluate survival outcomes and prognostic factors for overall survival (OS) in patients with metastatic renal cell carcinoma (mRCC) who received sunitinib (SU) and pazopanib (PZ) as first-line therapy in real-world Korean clinical practice. Methods: Data of 554 patients with mRCC who received SU or PZ at eight institutions between 2012 and 2016 were retrospectively reviewed. Based on the targeted therapy, the patients were divided into SU (n = 293) or PZ (n = 261) groups, and the clinicopathological variables and survival rates of the two groups were compared. A multivariable Cox proportional hazard model was used to determine the prognostic factors for OS. Results: The median follow-up was 16.4 months (interquartile range, 8.3-31.3). Patients in the PZ group were older, and no significant difference was observed in the performance status (PS) between the two groups. In the SU group, the dose reduction rate was higher and the incidence of grade 3 toxicity was more frequent. The objective response rates were comparable between the two groups (SU, 32.1% vs. PZ, 36.4%). OS did not differ significantly between the two groups (SU, 36.5 months vs. PZ, 40.2 months; log-rank, P = 0.955). Body mass index, Eastern Cooperative Oncology Group PS > 2, synchronous metastasis, poor Heng risk criteria, and liver and bone metastases were associated with a shorter OS. Conclusion: Our real-world data of Korean patients with mRCC suggested that SU and PZ had similar efficacies as first-line therapy for mRCC. However, PZ was better tolerated than SU in Korean patients.
The aim of the present study was to determine whether allogeneic red blood cell transfusions showed a deleterious effect and what might be preoperative risk factors for blood transfusion in patients with TNM stage II colon cancer. Total 470 patients who fulfilled inclusion criteria were selected for a further 10-year follow-up study. We found that there were statistical significance between non-transfused and transfused group in mortality (P=0.018), local recurrence (P=0.000) and distant metastasis (P=0.040). Local recurrence and distant metastasis between 1 to 3 units and more than 3 units group did not show any significant differences. There was no difference in survival rate between non-transfused and 1 to 3 units group (log rank=0.031, P=0.860). The difference between different blood transfusion volume in transfused patients was found (78.77% vs 63.83%, P=0.006). Meanwhile, the significant difference of survival rate was existed between non-transfused group and more than 3 units group (84.83% vs 63.83%, P=0.002 ). Univariate analysis showed the following 3 variables to be associated with an increased risk of allogeneic blood transfusions: preoperative CEA level (P<0.05), location of tumor (P<0.01) and diameter of tumor (P<0.01). Multivariate analysis revealed that location of tumor and diameter of tumor are two independent factors for requirement of perioperative transfusions. Therefore, allogeneic transfusion increase the postoperative tumor mortality, local recurrence and distant metastasis in patients with stage II colon cancer. The postoperative tumor mortality, local recurrence and distant metastasis were not associated with the blood transfusion volume. The blood transfusion volume was associated with the survival rate. Location of tumor and diameter of tumor were the independent preoperative risk factors for blood transfusion.
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