Journal of the military operations research society of Korea
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v.22
no.2
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pp.126-138
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1996
The statistical control chart has been proven to be the effective tool most widely used in the manufacturing industry for monitoring and controlling the manufacturing processes. However, the Shewhart chart sometimes gives us false information when the distribution of quality characteristics is skewed. Therefore, it cannot serve as the universal quality control chart if there exist odd events in the manufacturing process. The objective of this study is thus to develop the new technique for constructing the limits of quality control chart based on a sample median and range when the distribution of the underlying population is skewed. This new control chart can effectively solve and manage the processes which have the non-normally distributed quality characteristics frequently occurring in the practical situation.
A great variety of penetrating injuries is happening due to the increasing population and violence today. An optimal surgical approach is the key factor for successful repair of a complicated penetrating injury. A 23-year-old woman fell down the stairs from the second floor and received cervico-thoracic penetration injury due to a metalic bar. The metalic bar ruptured the right jugular vein and penetrated the left upper and lower lung. Under cervico-median sternotomy, neck vessels were repaired and the left thorax was successfully entered to repair the damaged lung through the mediastinal pleura. With this approach, the patient's position did not need to be changed during operation, while reduced the operation time compared to the conventional approach (cervical incision and standard thoracotomy).
Aims: To determine the clinical characteristics, pathological features, local and distant failure patterns in patients with carcinoma of major salivary glands treated with surgery and postoperative radiotherapy (PORT). Materials and Methods: We retrospectively reviewed 106 cases of major salivary gland tumor seen at our centre (1998-2008). Sixty five cases of major salivary gland carcinoma were selected for analysis (exclusions: benign, palliative, non-carcinomas). The patient population treated by surgery and PORT was divided into two groups: 1) Patients who underwent surgery and immediate PORT (Primary PORT); 2) Patients with recurrent carcinoma who underwent at least two surgeries and received PORT in the immediate post-operative period of the last performed surgery (Recurrent PORT). Recurrence free survival (RFS) was assessed using the Kaplan-Meier method. Results: Median age was 35 years with a male: female ratio of 1.3:1. The majority of cancers were located in the parotid gland (86.2%) and the most common histology was mucoepidermoid carcinoma (43%). Thirty nine cases (60%) were primary while 26 (40%) were recurrent. Optimal surgery was performed in 59/65 patients (90.8%). 43 patients (66.2%) underwent neck dissection, of which 14 (32.5%) had nodal metastasis. Overall, 61 (93.8%) patients complied with the prescribed radiotherapy. Median dose of PORT was 60 Gy. Median follow-up was 13.1 months (range 2-70). Relapse free survival was 50.4% at 60 months. Some 12 cases (18.5%) recurred with a median time to recurrence of 16.9 months. Conclusions: Surgery and PORT is an effective treatment for major salivary gland carcinoma with over 90% compliance and <20% recurrence. Early treatment with postoperative radiotherapy may increase the survival rate in major salivary gland carcinoma patients.
Kim, Jae Wang;Yun, Byung Min;Shin, Myoung Soo;Kang, Jae Kyoung;Kim, JungJu;Kim, Young Suk
Radiation Oncology Journal
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v.37
no.4
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pp.293-301
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2019
Purpose: External beam radiotherapy (EBRT) is a useful option to treat head and neck skin cancer patients who are not indicated for surgery. In this study, we evaluated the treatment outcomes of EBRT in an Asian population. Materials and Methods: The records from 19 head and neck skin cancer patients (10 with squamous cell carcinoma and 9 with basal cell carcinoma) who were treated with definitive or adjuvant EBRT from 2009 to 2017 were retrospectively reviewed. The radiotherapy doses administered ranged from 50 to 66 Gy (median, 55 Gy) with 2.0-2.75 Gy per daily fraction (median, 2.5 Gy). The T stage at presentation was as follows: Tis (1 patient), T1 (11 patients), T2 (6 patients), and T3 (1 patient). None had regional lymph node disease or distant metastasis at presentation. The local failure-free survival (LFFS) rates, toxicity, and cosmetic results were analyzed. Results: The median age was 75.5 years (range, 52.6 to 92.5 years). The median follow-up duration from the completion of radiotherapy was 44.9 months (range, 5.8 to 82.6 months). One local failure occurred in a patient with a 2.1-cm posterior neck squamous cell carcinoma at 32.5 months after radiotherapy (1/19, 5.3%). The 3-year LFFS rate was 91.7%. No patients died from skin cancer during follow-up, and no grade 3 complications occurred. The cosmetic outcomes were excellent for 16 (84.2%) and good for 3 (15.8%) of the 19 patients. Conclusion: EBRT offers good local control and cosmetic outcomes in patients with head and neck skin cancer, with no grade 3 complications.
Background: NSCLC is a disease involving uncontrolled cell growth, which could result in metastases into nearby tissues beyond the lungs. Materials and Methods: The aim of the present study was to analyze the influence of epidermal growth factor receptor (EGFR) gene expression on metastasis and survival in NSCLC patients. The present case-control study included 100 cases of NSCLC patients and 100 age and sex matched controls. EGFR gene expression was analyzed by quantitative real time PCR using serum RNA. Association with NSCLC patient survival was analyzed by the Kaplan-Meier method. Results: We analyzed EGFR gene expression and observed mean increased gene expression of 13.5 fold in NSCLC patients. Values reflected overall survival of patients with a median of 15.8 months in the cases of <13 fold increased gene expression vs 6.7 months with >13 fold increased EGFR gene expression (p=0.005). Distant metastatic patients with <13 fold increased EGFR gene expression had 7.9 months of median survival time while>13 fold increased EGFR gene expression had only 5 months of median survival time (p=0.03). Non metastatic patients with <13 fold increased EGFR gene expression had 18 months of median survival time as compared to only 7.1 months with >13 fold increased expression. Conclusions: Higher cell free EGFR mRNA expression may play an important role in causing distant metastases and reducing overall survival of NSCLC patients in the Indian population.
Askari, Faezeh;Parizi, Mehdi Kardoust;Jessri, Mahsa;Rashidkhani, Bahram
Asian Pacific Journal of Cancer Prevention
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v.15
no.5
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pp.2159-2163
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2014
Background: Prostate cancer is the most frequently occurring cancer among males in economically developed countries. Among the several risk factors that have been suggested, only age, ethnicity, diabetes, and family history of prostate cancer are well-established and primary prevention of this disease is limited. Prior studies had shown that dietary intake could be modified to reduce cancer risk. We conducted a hospital-based, casecontrol study to examine the association between dietary patterns and prostate cancer risk in Iran. Materials and Methods: A total of fifty patients with prostate cancer and a hundred controls underwent face-to-face interviews. Factor analysis was used to determine the dietary patterns. Multivariate logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: We defined two major dietary patterns in this population: 'western diet'(high in sweets and desserts, organ meat, snacks, tea and coffee, French fries, salt, carbonated drinks, red or processed meat) and 'healthy diet' (high in legumes, fish, dairy products, fruits and fruit juice, vegetables, boiled potatoes, whole cereal and egg). Both Healthy and western pattern scores were divided into two categories (based on medians). Higher scores on Healthy pattern was marginally significantly related to decreased risk of prostate cancer (above median vs below median, OR =0.4, 95%CI=0.2-1.0). An increased risk of prostate cancer was observed with the higher scores on the Western pattern (above median vs below median, OR=4.0, 95%CI=1.5-11.0). Conclusions: The results of this study suggested that diet might be associated with prostate cancer among Iranian males.
Background: Metastatic renal cell carcinoma (mRCC) status as poor prognosis improved with the introduction of tyrosine-kinase inhibitors, especially sunitinib. There is sparse data reporting from our region on use of sunitinib in metastatic RCC. Thus the present study explores sunitinib usage at our institute. Materials and Methods: An unselected population of patients with metastatic RCC receiving sunitinib was analyzed with respect to patient characteristics, response, toxicity, and outcomes. Results: Fourty-nine patients with a median age of 50.5 years (range 21-71 years) were included. Most were male (61.2%). Twenty‑one (42.9%) had metastatic disease at presentation. Sunitinib was first line therapy in 45. Conventional clear cell carcinoma was the most common pathology present (39 patients; 79.59 %). The most common site of metastasis was the lung (75.5%). Most patients (30) were started at a dose of 50 mg once a day for 4 weeks and then 2 weeks rest. Clinical benefit rate was 73.5% (n= 36), and 22.5% (n= 11) demonstrated progressive disease at first imaging evaluation within the first 3-6 months. The following objective response performed for patients was 48.9% (n=24) and progression at 24.5 % (n=12). The median follow‑up was 16 months (range, 4-34 months), the overall estimated median PFS was 9 months and the estimated median OS was 15 months. Conclusions: This study demonstrated sunitinib is tolerable and effective in advanced/metastatic RCC Egyptian patients and indicates we should further seek second and third lines to increase survival equivalence as reported in the worldwide literature.
Objectives: This study was conducted to measure the decline in the health-related quality of life (HRQoL) associated with some diseases in South Korean adults. Methods: The EQ-5D health states in the 2005 National Health and Nutrition Examination Survey (NHNES) and the Korean EQ-5D valuation set were used to obtain the EQ-5D indexes of the study subjects. Each disease group was defined when the subjects reported to the NHNES that they were diagnosed with the corresponding disease during the previous 1 year by physicians. Since the distributions of the EQ-5D indexes in each subgroup were negatively skewed, median regression analysis was used to estimate the effects of specific diseases on the HRQoL. Median regression analysis produced estimates that approximated the median of the EQ-5D indexes and there are more robust for analyzing data with many outliers. Results: A total of 16,692 subjects (6,667 patients and 10,025 people without any disease) were included in the analysis. As a result of the median regression analysis, stroke had the strongest impact on the HRQoL for both males and females, followed by osteoporosis, osteoarthritis, rheumatic arthritis, and herniation of an intervertebral disc. While asthma had a significant impact on the HRQoL only in men, cataract, temporo-mandibular dysfunction, and peptic ulcer significantly affected the HRQoL only in women. Conclusions: Stroke and musculoskeletal diseases were associated with the largest losses of the HRQoL in Korean adults.
Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy in clinical practice, with a 0.1% life time risk in the general population. Conventional neurophysiological studies have been useful in the diagnosis of this condition, as have a number of more specialized procedures. Therefore, we evaluated the diagnostic sensitivities of several parameters in nerve conduction technique for CTS patients. We analyzed 100 patients (159 hands) who were diagnosed with CTS clinically and electrophysiolosically. Median motor and sensory nerve conduction velocities (MCV and SCV) with wrist, palm, and finger stimulation were performed in traditional methods. Sensitivities of each test were calculated and compared to normal control data. The sensitivities of existing nerve conduction method were noted in terminal latency on median nerve, 2nd finger-wrist segment, 3rd finger-wrist segment, palm-wrist segment and distoproximal ratio, as 72.96%, 92.45%, 94.34%, 94.97%, and 97.48%, respectively. In the early course of CTS, sensory nerve conductions in the median nerve are more valuable than motor nerve conduction. Sensory nerve conductions are usually affected before motor nerve conductions in CTS. In this study, we detected that slowing of median SCV was the most frequent in the distoproximal ratio.
Purpose: Chest injuries in multiple trauma patients are major predisposing factor for increased length of stay in intensive care unit, prolonged mechanical ventilator, and respiratory complications such as pneumonia. The aim of this study is the evaluation of lung injury score as a risk factor for prolonged management in intensive care unit (ICU). Methods: Between June to August in 2011, 46 patients admitted to shock and trauma center in our hospital and 24 patients had associated chest damage without traumatic brain injury. Retrospectively, we calculated injury severity score (ISS), lung injury score, and the number of fractured ribs and performed nonparametric correlation analysis with length of stay in ICU and mechanical ventilator support. Results: Calculated lung injury score(<48 hours) was median 1(0-3) and ISS was median 30(8-38) in study population. They had median 2(0-14) fractured ribs. There were 2 bilateral fractures and 2 flail chest. Ventilator support was needed in 11(45.8%) of them for median 39 hours(6-166). The ISS of ventilator support group was median 34(24-34) and lung injury score was median 1.7(1.3-2.5). Tracheostomy was performed in one patient and it was only complicated case and ICU stay days was median 9(4-16). In correlation analysis, Lung injury score and ISS were significant with the length of stay in ICU but the number of fractured ribs and lung injury score were predicting factors for prolonged mechanical ventilator support. Conclusion: Lung injury score could be a possible prognostic factor for the prediction of increased length of stay in ICU and need for mechanical ventilator support.
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