• Title/Summary/Keyword: outcome factor

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Analysis of Prognostic Factors in Patients with Carcinoma of Uterine Cervix (자궁경부암의 방사선치료시 예후인자의 재분석)

  • Kim Jae Young;Cho Chul Koo;Shim Jae Won;Yoo Seong Yul;Kim Mi Sook;Yun Hyong Geun
    • Radiation Oncology Journal
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    • v.14 no.4
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    • pp.307-315
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    • 1996
  • Purpose : The authors conducted a retrospective analysis of patients with the carcinoma of uterine cervix treated with curative radiation therapy to evaluate the prognostic factors that would affect the results of the therapy and to get the critical ideas in determining more aggressive treatment schedule. Methods and Materials : From January 1987 to December 1988. Four hundreds and sixty patients with uterine cervical carcinomas treated with radiotherapy at KCCH were registered to this retrospective study. One hundred and three patients were treated with external radiation therapy alone, and 357 patients were treated with external radiation followed by low dose rate intracavitary radiation therapy. The follow-up rate was 88% and median follow-up duration was 48 months. Results : The overall 5 year survival rate of the patients was 67.7%, and when classified by FIGO stages, 5 year survival rates were 81.2%, 76.3%, 73.1%, 50%. 52.3%, 11.5% for stages Ib, IIa, IIb, IIIa, IVa respectively. Tumor size(p=0.0002), endocervical growth pattern(p=0.003), lymph node invasion(p=0.0001), mean hemoglobin level(p=0.0001), and pathologic cell type(p=0.0001) were significant prognostic factors and decrease in survival for young age patient group was marginally important (p=0.03). Conclusion : Significant prognostic factors in the radiation therapy of the uterine cervical carcinoma were tumor size, growth pattern of tumor, lymph node invasion, pathologic cell type, hemoglobin level of patients during treatment and lower survival rate in young age group was obvious, too. Patients with large size tumor(${\geq)$4cm), especially combined with endocervical growth patterns or advanced stages(III or more) need more aggressive treatment to improve the outcome of treatment. And positive feature of lymph node invasion affected the result of therapy, so improvement in the diagnostic and therapeutic trial is essential.

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Analysis of the Causes of and Risk Factors for Mortality in the Surgical Repair of Interrupted Aortic Arch (대동맥궁 단절증 수술 사망 원인과 위험인자 분석)

  • Kwak Jae Gun;Ban Ji Eun;Kim Woong-Han;Jin Sung Hoon;Kim Yong Jin;Rho Joon Ryang;Bae Eun Jung;Noh Chung Il;Yun Yong Soo;Lee Jeong Ryul
    • Journal of Chest Surgery
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    • v.39 no.2 s.259
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    • pp.99-105
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    • 2006
  • Background: Interrupted aortic arch is a rare congenital heart anomaly which still shows high surgical mortality. In this study, we investigated the causes of and the risk factors for mortality to improve the surgical outcomes for this difficult disease entity. Material and Method: From 1984 to 2004, 42 patients diagnosed as IAA were reviewed retrospectively. Age, body weight at operation, preoperative diagnosis, preoperative PGE1 requirement, type of interrupted aortic arch, degree of left ventricular outflow stenosis, CPB time, and ACC time were the possible risk factors for mortality. Result: There were .14 hospital deaths. Preoperative use of PGE1, need for circulartory assist and aortic cross clamp time proved to be positive risk factors for mortality on univariate analysis. Preoperative left ventricular outflow stenosis was considered a risk factor for mortality but it did not show statistical significance (p-value=0.61). Causes of death included hypoxia due to pulmonary banding, left ventricular outtract stenosis, infection, mitral valve regurgitation, long cardiopulmonary bypass time and failure of coronary transfer failure in TGA patients. Conclusion: In this study, we demonstrated that surgical mortality is still high due to the risk factors including preoperative status and long operative time. However preoperative subaortic dimension was not related statistically to operative death statistically. Adequate preoperative management and short operation time are mandatory for better survival outcome.

Clinical Features and Prognostic Factors in 41 Patients of Primary Nasal/Nasopharyngeal Non-Hodgkin's Lymphoma: Prognostic Significance of Immunophenotype (비/비인강 비호즈킨 림프종의 임상양상과 예후 인자 : 면역 표현형의 임상적 의의)

  • Park Soon-Seo;Park Jong-Beom;Suh Cheol-Won;Park Ji-Woon;Lim Soo-Duk;Huh Joo-Ryung;Nam Soon-Yuhl;Kim Sang-Yoon;Lee Ho-Gyu;Chang Hye-Sook;Kim Tae-Won;Lee Je-Hwan;Kim Sung-Bae
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.2
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    • pp.149-155
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    • 1999
  • Objectives: To study the clinical features of the primary nasal/nasopharyngeal non-Hodgkin's lymphomas and to evaluate the implication of immunophenotyping as a prognostic factor. Patients and Methods: From January 1990 to December 1997,41 patients(median age, 41 years) of primary nasal/nasopharyngeal non-Hodgkin's lymphoma were studied. The clinical records and paraffin-embedded tissue blocks were reviewed retrospectively. The histologic features, immunophenotypic findings(pan-T, pan-B, CD3, CD56) and Epstein-Barr virus in situ hybridizatios were examined. The prognostic factors for clinical outcome were evaluated in these patients. According to Ann-Arbor system, there were 30 patiets(73%) with stage IE, 4(10%) with stage IIE, 3(7%) with stage IIIE, 4(10%) with stage IVE lymphoma. Among the patients with stage IE/IIE, 4 patients received local radiation alone, 4 received chemotherapy alone, 25 received combination chemotherapy and radiotherapy and 1 refused treatment. The patients with stage IIIE/IVE were given combination chemotherapy and radiotherapy. Results: Immunophenotyping were performed in 40 patients and staining results were as follows: 3(7%) patients with B cell, 17(42%) with T cell, 18(44%) with NK/T cell(CD56 positive), and two patients with unclassifiable result. Epstein-Barr(EB) virus in situ hybridization were performed in 28 patients and 23(82%) patients had positive EBV-encoded RNAs(EBERs). 21(55%) patients achieved a complete remission. There was no difference in complete remission between radiation alone and combination therapy. With median follow-up of 30 months, 5-years disease free survival of complete responders was 60% and 5-years overall survival rate was 36%. Multivariate analysis showed that better overall survival was related with absence of B symptoms, ECOG performance${\leq}1$ and non-NK cells. Conclusion: Most of all cases were positive for EBER. Since NK/T phenotype carried the worst prognosis, analysis for CD56 expression should be done. Further prospective studies were warranted to evaluate the role of chemotherapy in stage IE/IIE.

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The Outcome of the 6th ICAO Worldwide Air Transport Conference and Fair Competition Policy in International Air Transport (국제항공운송의 최근 동향과 항공운송의 공정경쟁정책 -ICAO 제6차 세계항공운송회의 결과를 중심으로-)

  • Shin, Dong-Chun
    • The Korean Journal of Air & Space Law and Policy
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    • v.28 no.1
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    • pp.97-114
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    • 2013
  • The 6th Worldwide Air Transport Conference was held in Montreal in March 2013 under the auspices of ICAO. This conference, which has been held every ten years, is dealing with virtually every issue of international air transport, and aiming at updating ICAO policy in order to ensure long-term growth of international civil aviation. Last conference which took place in 2003 focused on the liberalization of air transport, and the 6th conference shifted its focus from whether to push for liberalization, to how to implement it. The main agenda items for the 6th conference was liberalization, safeguards, ownership, fair competition, airports and air navigation facilities, charges, and ICAO policy. The liberalization, and in particular progressive liberalization has been a main theme over the past decades. In the process leading to liberalization, there needs to be the expansion of market access, easing regulation on ownership and control of airlines. Furthermore, the provision of enough infrastructure such as airport and air navigation facilities may be contributing factor to remove impediments to liberalization. However, out of concern as for undermining interests of consumer and the weak, when liberalization is proceeding in a sudden and radical manner, there should be safeguards so as to ensure market participation by developing countries, consumer protection, and economical and transparent decision on taxes and charges. Fair competition which differs from promoting competition in the market, is a policy in order to protect the weak players and consumers from monopoly and oligopoly. The Korean delegation submitted 3 WPs (WP/85, 86 and 87) and 1 IP, and presented WPs, at the conference, which were a lot compared with previous occasions. A paradigm shift was emphasized to expedite the process of liberalization at the 6th conference. The reality is that with many previous recommendations to stress the importance of liberalization, and to urge States to change their attitudes, the pace of the liberalization has been very slow and staggering. The liberalization of air transport will contribute to the growth of air transport and related industry, to create new employment, promoting tourism and regional development, and further to facilitating mutual understanding and exchange, which will also lead to making a barrier-free world. In this context, it is expected that the next conference will also evaluate the on-going process of liberalization.

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The Changes of Serum Angiotensin Converting Enzyme Activity in Lung Cancer Patients (폐암 환자의 혈청 Angiotensin Converting Enzyme 활성도의 변화)

  • Jeong, Ki-Ho;Choi, Hyung-Seok;Yoo, Chul-Gyu;Lee, Kye-Young;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.4
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    • pp.310-317
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    • 1992
  • Background: Angiotensin converting enzyme is a glycoprotein peptidyldipeptide hydrolase which cleaves the c-terminal dipeptides of several oligopeptides. It is a menbrane-bound protein mainly synthesized by the endothelial cells. Since the lung has the largest capillary bed of any organ in the body, it is here that ACE acts on circulating substrates like angiotensin I and bradykinin. It is well known that ACE correlates with disease activity in sarcoidosis and also there are reports that changes in serum ACE activity are found in many acute and chronic lung diseases. So we planned this study to see if serum ACE activity can act as a prognostic factor in lung cancer. Methods: Forty-one newly diagnosed lung cancer patients were included in the study group. There were 19 patients with squamous cell lung cancer, 13 with adenocarcinoma, and 9 with small cell carcinoma. Patients were excluded from the study if they had high blood pressure, heart disease, liver disease, renal disease, or other lung disease. Serum ACE activity was analyzed according to cell type, staging, mode of treatment, and clinical response to treatment. Results: 1) There was no difference in serum ACE activity between lung cancer patients and the control group. Also no difference in serum ACE activity was found according to cancer cell type or staging. 2) In patients who underwent curative resection of lung cancer, serum ACE activity was decreased significantly after the operation. 3) In patients who were diagnosed as non-small cell lung cancer and were treated with 4 cycles of anti-cancer chemotherapy without clinical improvement, changes in serum ACE activity were not seen after the treatment. 4) In patients diagnosed as small cell lung cancer treated with 4 cycles of anti-cancer chemotherapy with clinical improvement, changes in serum ACE activity were also not observed. Conclusion: Serum ACE activity was decreased after lung resection but had no relation to cell type, staging, or clinical response to treatment in lung cancer patients. Therefore, serum ACE activity is not suitable in predicting clinical outcome of lung cancer patients.

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Postoperative Adjuvant Chemoradiotherapy in Rectal Cancer (직장암의 근치적 수술 후 보조 화학방사선요법)

  • Chang, Sei-Kyung;Kim, Jong-Woo;Oh, Do-Yeun;Chong, So-Young;Shin, Hyun-Soo
    • Radiation Oncology Journal
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    • v.24 no.3
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    • pp.157-163
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    • 2006
  • [ $\underline{Purpose}$ ]: To evaluate the role of postoperative adjuvant chemoradiotherapy in rectal cancer, we retrospectively analyzed the treatment outcome of patients with rectal cancer taken curative surgical resection and postoperative adjuvant chemoradiotherapy. $\underline{Materials\;and\;Methods}$: A total 46 patients with AJCC stage II and III carcinoma of rectum were treated with curative surgical resection and postoperative adjuvant chemoradiotherapy. T3 and T4 stage were 38 and 8 patients, respectively. N0, N1, and N2 stage were 12, 16, 18 patients, respectively. Forty patients received bolus infusions of 5-fluorouracil ($500\;mg/m^2/day$) with leucovorin ($20\;mg/m^2/day$), every 4 weeks interval for 6 cycles. Oral Uracil/Tegafur on a daily basis for $6{\sim}12$ months was given in 6 patients. Radiotherapy with 45 Gy was delivered to the surgical bed and regional pelvic lymph node area, followed by $5.4{\sim}9\;Gy$ boost to the surgical bed. The follow up period ranged from 8 to 75 months with a median 35 months. $\underline{Results}$: Treatment failure occurred in 17 patients (37%). Locoregional failure occurred in 4 patients (8.7%) and distant failure in 16 patients (34.8%). There was no local failure only. Five year actuarial overall survival (OS) was 51.5% and relapse free survival (RFS) was 58.7%. The OS and RFS were 100%, 100% in stage N0 patients, 53.7%, 47.6% in N1 patients, and 0%, 41.2% in N2 patients (p=0.012, p=0.009). The RFS was 55%, 78.5%, and 31.2% in upper, middle, and lower rectal cancer patients, respectively (p=0.006). Multivariate analysis showed that N stage (p=0.012) was significant prognostic factor for OS and that N stage (p=0.001) and location of tumor (p=0.006) were for RFS. Bowel complications requiring surgery occurred in 3 patients. $\underline{Conclusion}$: Postoperative adjuvant chemoradiotherapy was an effective modality for locoregional control of rectal cancer. But further investigations for reducing the distant failure rate are necessary because distant failure rate is still high.

The Results of Primary Radiotherapy following Breast-Conserving Surgery for Early Breast Cancer (조기 유방암에서 보존적 수술후 방사선치료성적)

  • Koh Kyoung Hwan;Kim Mi Sook;Yoo Seong Yul;Cho Chul Koo;Kim Jae Young;Kim Yong Kyu;Moon Nan Mo;Paik Nam Sun;Lee Jong Inn;Choi Dong Wook
    • Radiation Oncology Journal
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    • v.13 no.2
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    • pp.163-171
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    • 1995
  • Purpose: Primary radiation therapy following breast-conserving surgery has been an accepted alternative to mastectomy during the past 2 decades. In this country, however, the practice of conservative therapy for early invasive breast cancer has not been generalized yet. The purpose of this report was to evaluate the results and complications of breast conservation therapy in Korean Cancer Center Hospital(KCCH). Materials and Methods: From January 1987 to December 1989. 45 Patients with early breast cancer treated with conservative treatment in KCCH were studied retrospectively Median follow up was 54 months(range, 4 to 82 months) . All patients received partial mastectomy (biopsy, tumorectomy. or quadrantectomy) and radiation therapy. Twenty eight patients received axillary dissection The breast was treated with two opposing tangential fields (total 50 Gy or 50.4 Gy in 5 weeks with daily target dose of 2 Gy or 1.8 Gy) Thirty patients received chemotherapy before and after radio-therapy Eleven patients received hormonal therapy. Results: Five-year survival rate, 5-rear disease free survival rate and 5-year local control rate were 87.2%, 86.5% and 97.6%,$ respectively. Administration of systemic Therapy (chemotherapy or hormonal therapy) correlated with good prognosis but statistically not significant (0.05 < p < 0.1). The severe late complication rate was 8.9% Conclusion: Primary radiation therapy following breast-conserving surgery for early breast cancer is an alternative treatment comparing to radical treatment. Long term follow-up and more patients collection is needed to evaluate the Prognostic factor and cosmetic outcome.

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Analysis of Prognostic Factors in Glioblastoma Multiforme (다형성 교모세포증 환자의 예후인자 분석)

  • Chang Sei Kyung;Suh Chang Ok;Lee Sang Wook;Keum Ki Chang;Kim Gwi Eon;Kim Woo Cheol
    • Radiation Oncology Journal
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    • v.14 no.3
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    • pp.181-189
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    • 1996
  • Purpose : To find the more effective treatment methods that improving the survival of patients with glioblastoma multiforme(GBM), we analyze the prognostic factors and the outcome of therapy in patients with GBM. Materials and Methods : One hundred twently-one patients with a diagnosis of GBM treated at Severance Hospital between 1973 and 1993 were analyzed for survival with respect to patients characteristics, that is, duration of symptom, age, and Karnofsky performance status, as well as treatment related variables such as extent of surgery and radiotherapy. Results : The median survival time(MST) and 2-year overall survival rate (OSR) of the patients with GBM were 13 months and $20.8\%$, respectively. Duration of symptom, age, Karnofsky performance status(KPS), radiotherapy, and extent of surgical resection were associated with improved survial in a univariate analysis. Patients whose duration of symptom was longer than 3 months, had the 2-year OSR of $47.2\%$(p=0.0082), who were younger than age 50, $32.9\%$(p=0.0003) In patients with a KPS of 80 or higher, the 2-rear OSR was $36.9\%$(p=0.0422). Patients undergoing radiotherapy had the 2-year OSR of $22.9\%$(p=0.0030), and surgical resection of $23.3\%$ (p<0.000). A Cox regression model confirmed a significant correlation of duration of symptom, age, radiotherapy, and extent of surgical resection with survival, excluding KPS(P=0.8823). The 2-year OSR were $22.3\%$ and $19.4\%$, combined with chemotherapy or without, respectively(p=0.6028). The duration of symptom of 3 months or shorter, 50 years of age or older, and undergoing stereotactic biopsy only were considered as risk factors, then patients without any risk factors had the MST of 29 months and 2-year OSR of $53.9\%$ compared to 4 months and $0\%$ for Patients who had all 3 risk factors. Most of all treatment failures occurred in the primary tumor site($80.4\%$). Conclusion : The duration of symptom, age, radiotherapy, and extent of surgical resection were a prognostically significant indeuendent variables. To get a better survival, it seems to be reasonable that the study design which improves the local control rates is warranted.

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Gastrointestinal Stromal Tumor (GIST) of the Stomach: Clinicopathologic Analysis and Outcome (위에 발생한 위장관 간질성 종양의 임상병리학적 특성과 치료성적)

  • Ryu Je-Seock;Lee Sung-Ryul;Choi Sae-Byeol;Park Sung-Soo;Lee Ju-Han;Kim Seung-Joo;Kim Chong-Suk;Chae Yang-Seok;Mok Young-Jae
    • Journal of Gastric Cancer
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    • v.5 no.1
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    • pp.40-46
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    • 2005
  • Purpose: Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms of the gastrointestinal tract. GISTs are positive for the expression of c-Kit protein at immunohistochemistry, and their clinical presentations vary. This retrospective study was performed to evaluate the clincopathologic characteristics of GISTs and to define the prognostic factors. Materials and Methods: 40 patients who underwent a complete resection of a GIST during the period $1996\~2003$ at the Department of Surgery, Korea University College of Medicine, were studied. We divided them into low- and high-risk. groups by using tumor size and mitotic count: 23 cases were low risk, and 17 were high risk. Clinicopathologic features, immunohistochemical findings, and prognoses were compared between the low- and the high-risk groups. Results: The mean age of the 40 patients was $61.3\pm11.1$years, and the male-to-female ratio was 1:1.1. There was no significant difference in age and sex between the groups. A comparative analysis revealed tumor size, mitotic count, clinical symptoms, preoperative pathologic diagnosis, ulceration, and necrosis to be variables that had statistically significant differences between the high- and the low-risk groups. In the univariate analysis, tumor size, mitotic count, ulceration, necrosis, and abnormal endoscopic ultrasound findings were associated with disease-free survival, but in the multivariate analysis, mitotic activity was the only independent factor associated with disease-free survival. 8 patients had recurrences during the follow-up period, and four of them were treated with STI-571 (imatinib mesylate, $Gleevec^{(R)}$). The treated patients have survived until now; however, two of non-treated patients died from disease progression. Conclusion: Based on this study, tumor size, ulceration, and necrosis are significant factors affecting survival, and mitotic activity may be a useful prognostic marker. STI-571 may be used in an adjuvant setting because the drug has shown anticancer activity in patients with recurrence or metastasis.

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A Study on the Lifestyle and Coffee Consumption Motivation (라이프스타일과 커피소비동기에 관한 연구)

  • Jung, Ja Young;Kim, Kwang Jin
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.8 no.3
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    • pp.53-65
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    • 2013
  • In Korea recently the consumption of coffee has been drastically increased and majority of people who are more than $20^{th}$ are drinking more than a cup of coffee every day. Nowadays coffee a kind of essential items in modern urban society. As the popularity of the coffee is increasing, As the coffee consumption is growing, the studies on coffee also have been increased. Many of the studies on coffee were focused on the consumer attitudes, coffee shops and franchise coffee shops, and coffee components or ingredients. As the products of the coffee are becoming diverse, the consumers of coffee also becoming diverse. There was a study showing that coffee has variety of types, and that motivations and attitudes for coffee consumption are different depend on demographic statistics such as age and life styles. On this study main focus was life style and consumer's motivation on coffee consumption. For this study the survey was conducted on the people living in Seoul City and Kyengkido from March 1, 2013 to March 31, 2013. 600 questionnaires were distributed and 480 were collected and 470 were used for analysis of this study. The statistics program used in this study was SPSS. The method used in the analysis wee factors analysis test, reliability test, validity test, t-testy, One-Way ANOVA, and regression analysis. In this study according to the factor analysis, the life styles were classified the following six categories ; wellbeing pursuit, taste pursuit, atmosphere pursuit, dine-out pursuit, instant pursuit, and economic value pursuit. The factors of coffee consumption motivation were 6; wellbeing consumption motivation, changing mood consumption motivation, social consumption motivation, habitual consumption motivation, and emotional consumption motivation. The demographic factors used in this study were age, marital status, occupation, educational background, residence, income, and eating-out expenses. The hypothesis used in this study were two. The first hypo-thesis was whether the coffee consumption was affected by the life styles. The second hypo-thesis was whether there was any statistical differences on the motivation of coffee consumption according to the characteristics of life style. The outcome of this study demonstrated that life styles had partial impact on coffee consumption motivations. According to the characteristics of the life style, except for the habitual consumption motivation, all the other factors showed statistical differences on coffee consumption motivations according the characteristics of life styles.

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