• Archives of Plastic Surgery
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• v.38 no.3
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• pp.257-262
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• 2011

Purpose: In neurofibromatosis patients, complete surgical excision of the mass is almost impossible and surgical treatment usually consists of multiple serial excisions that only result in a debulking effect. Remnant tumor mass has a gravitational effect on facial soft tissues that leads to sagging of skin and soft tissue, and eventually, facial disfigurement and asymmetry. The purpose of our surgical method is to perform soft tissue lifting with longer lasting effect with less surgical risk of damaging facial nerve and vessels. With external fixation using K-wire or surgical screw, the procedure only called for a short incision length and had additional adhesive properties that enabled anchoring of soft tissue in a lifted position for a longer postoperative period. Methods: A total of 5 neurofibromatosis patients (NF-1) visited our clinic for mass reduction and face lifting. The age of patients ranged from 13 to 42 (mean 28.8 years), and most patients had a long history of multiple excisions in the past. Face lifting was performed in 2 different areas, the periorbital area in 3 patients, and the midface in 2 patients. The materials used in fixation of retaining ligament were K-wire (n=3) and titanium screw (n=2). Results: Follow up period was from 5 month to 3 years and 1 month (mean=2 years and 1 month). All patients conveyed satisfaction with the results and no major complications were reported. The lifting effect lasted for as long as 3 years, and there were no complaints of relapse of soft tissue depression or sagging within the operated area. 1 patient (M/13) needed secondary k-wire insertion and additional mass excision in 1 year and 10 months postoperatively due to tumor growth. In two patients with K-wire fixation, mild dimpling and tenderness were observed in the follow up period, but in about 2 months postoperatively, dimpling was relieved and there was no need for removal of fixating material. Conclusion: Surgical lifting in neurofibromatosis patients can be challenging, for mass excision cannot be done completely and gravitational effect by residual mass can be persistent. External fixation of the retaining ligament in patients with neurofibromatosis can give satisfactory results-for incision length is relatively shorter, and the lifting effect can last longer compared to other various face lifting techniques.

• Journal of Korean Society of Water and Wastewater
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• v.26 no.5
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• pp.669-683
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• 2012

The water supply pipes are buried across wide range of areas, so it is hard to spot them using excavation and takes a large amount of expense. Thus, there is a high risk for direct research and application, accompanying many difficulties in implementation of them. Therefore, it is more economical and convenient to use indirect evaluation variables than direct evaluation of the buried pipes in assessing the degree of pipe deterioration. To assess the degree of pipe deterioration using the indirect evaluation variables, it should be done first to identify how and to what extent they affect the degree of deterioration. This study measured the evaluation variables for pipe deterioration using the pipe endoscope and analyzed the measurement results and the degree of impact on the pipes. In addition, this study attempted to evaluate the adequateness of the pipe deterioration evaluation using the indirect variables based on the analysis results. The evaluation variables measured through the pipe endoscope were the thickness of sediments, size of scale, degree of desquamation and condition of connections. For the indirect evaluation variables, the data such as the property data from GIS pipe network map as well as the material, diameter, age and pipe lining material of the pipe, road type, leakage frequency, average water velocity and water pressure using the leakage repair records was collected. Using the collected data, this study comparatively analyzed the indirect evaluation variables for the degree of pipe deterioration and the results from the pipe endoscope to choose appropriate variables for pipe deterioration evaluation and calculated the weights of the indirect variables on the degree of deterioration. The results showed that the order of the impact of indirect variables on deterioration was pipe age > pipe lining material > road type > leakage frequency > average water velocity with their weights of 0.45, 0.20, 0.15, 0.10, and 0.10, respectively. Conclusively, the results suggest that the measures of sediment thickness, scale size, degree of desquamation and condition of connections are appropriate for the evaluation of pipe deterioration and sufficient for the analysis of the impact of the indirect variables on deterioration.

• The Korean Journal of Food And Nutrition
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• v.27 no.5
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• pp.940-955
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• 2014

The purpose of this study was to compare the degree nutrient intake, health status and other characteristics of females aged 65 years and over in a longevity area according to family arrangement. For analysis, 585 female elderly were recruited from the Kugoksoondam area (Kurye, Goksung, Soonchang and Damyang counties), known as the longevity-belt region in Jeonla province, Korea. The subjects were categorized into three groups according to family arrangement (living alone, living with spouse only and living with family). Demographic characteristics were collected, as well as information on physical measurements, blood tests for biochemical indicators, health status and health-related life style, dietary behavior, favorite food groups, consumption frequency of food groups, nutrient intake and mini nutrition assessment. In the group living with their spouse only, the highest education, physical activity, diverse food intake, frequency of eating meats and fish, energy and nutrients intake, and score on the mininutrient status assessment (MNA) were found to be significantly favorable factors. Taken together, these results demonstrated that the group living with their spouse only had relatively superior nutrient intake and the quality of diet. In contrast, the group living alone showed the lowest self-rated economic status, diversity of food intake, and physical activity, with the highest frequency of drinking, smoking and regular exercise for almost everyday compared with the other groups. On the other hand, those living with family demonstrated the lowest intake of supplements or functional foods, and levels of hemoglobin hematocrit MCH, but the highest HBA1c and blood sugar. Therefore, the group living with family was assumed to be at risk of anemia and diabetes. These results could be useful to plan effective strategies to increase the health-life expectancy of Korean elderly people living in rural areas, according to family arrangement.

• Journal of the Korean Home Economics Association
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• v.42 no.8
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• pp.169-185
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• 2004

This study was performed to investigate the characteristics of meal patterns among Koreans of different age groups. The study subjects consisted of preschool children (PC), elementary school children (EC), high school students (HS), college students (CS), and adults over 30 years old living in Seoul and the surrounding areas. A dietary survey was conducted using 24-hour recall method from 1996-1998 and data were collected from 2392 subjects. The subjects over 30 years old were classified as 30∼49 years, 50∼69 years, and over 70 years. EC, HS, and CS groups consumed less than 20％ of their total energy intake from breakfast. PC and EC consumed over 30％ of their energy from snacks. In all age groups, the proportion of subjects who skipped a meal was highest for breakfast and lowest for dinner. Especially, 31.4％ of the CS group skipped breakfast. Breakfast and snacks provided higher quality meals than the others when each meal was assessed by the index of nutritional quality (INQ). Especially, lunch of the HS group, each meal of the EC group and subjects over 70 years of age had a lower diet quality than the others did. The major snack items for PC, EC, HS, and CS groups were milk, ice cream, and snack cakes, but those for subjects over 30 years of age were fruits. The PC group obtained 35.5％ of their energy from snacks, but the proportion of snack energy decreased with increasing age. PC and EC groups obtained a great proportion of calcium, vitamin B2, fat, and cholesterol intake from snacks. Snack foods provided 53.2％, 42.4％, 45.4％, and 24.6％ of those nutrients, respectively, for the PC group and 54.2％, 43.5％, 37.4％, and 26.8％, respectively, for the EC group. These results suggested that each age group had specific meal patterns. Especially, breakfast and snack intake seemed to complement overall diet quality. However, more intervention is needed to improve overall dietary nutrition, e.g., efforts to decrease fat and cholesterol proportion and increase breakfast consumption. These dietary characteristics among different age groups present foundation data for the development of methods to resolve the nutritional problems of each age group.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.13
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• pp.5297-5304
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• 2015

Background: The Pakistan Atomic Energy Commission Cancer Registry (PAECCR) program has made availability of a common cancer incidence database possible in Pakistan. The cancer incidence data from nuclear medicine and oncology institutes were gathered and presented. Materials and Methods: The cancer incidence data for the last 30 years (1984-2014) are included to describe a data set of male and female patients. The data analysis concerning occurrence, trends of common cancers in male and female patients, stage-wise distribution, and mortality/follow-up cases is also incorporated for the last 10 years (2004-2014). Results: The total population of provincial capital Lahore is 9,800,000. The total number of cancer cases was 80,390 (males 32,156, females 48,134). The crude incidence rates in PAECCR areas were 580.8/$10^5$ during 2010 to 885.4/$10^5$ in 2014 (males 354.1/$10^5$, females 530.1/$10^5$). The cancer incidence rates for head and neck (15.70%), brain tumors (10.5%), and non-Hodgkin lymphoma (NHL, 9.53%) were found to be the highest in male patients, whereas breast cancer (46.7%), ovary tumors (6.80%), and cervix (6.31%) cancer incidence rates were observed to be the most common in female patients. The age range distribution of diagnosed and treated patients in conjunction with the percentage contribution of cancer patients from 15 different cities of Punjab province treated at the Institute of Nuclear Medicine and Oncology, Lahore are also included. Leukemia was found to be the most common cancer for the age group of 1-12 years. It has been identified that the maximum number of diagnosed cases were found in the age range of 51-60 years for males and 41-50 years for female cancer patients. Conclusions: Overall cancer incidence of the thirty years demonstrated that head and neck and breast cancers in males and in females respectively are the most common cancers in Punjab province in Pakistan, at rates almost the highest in Asia, requiring especial attention. The incidence of brain, NHL, and prostate cancers among males and ovarian and cervix cancers among females have increased rapidly. These data from a major population of Punjab province should be helpful for implementation of appropriate planning, prevention and cancer control measures and for determination of risk factors within the country.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.5019-5024
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• 2015

Background: The purpose of this study was to assess the dosimetric and clinical feasibility of volumetric modulated arc based hypofractionated stereotactic radiotherapy (RapidArc) treatment for large acoustic schwannoma (AS >10cc). Materials and Methods: Ten AS patients were immobilized using BrainLab mask. They were subject to multimodality imaging (magnetic resonance and computed tomography) to contour target and organs at risk (brainstem and cochlea). Volumetric modulated arc therapy (VMAT) based stereotactic plans were optimized in Eclipse (V11) treatment planning system (TPS) using progressive resolution optimizer-III and final dose calculations were performed using analytical anisotropic algorithm with 1.5 mm grid resolution. All AS presented in this study were treated with VMAT based HSRT to a total dose of 25Gy in 5 fractions (5fractions/week). VMAT plan contains 2-4 non-coplanar arcs. Treatment planning was performed to achieve at least 99% of PTV volume (D99) receives 100% of prescription dose (25Gy), while dose to OAR's were kept below the tolerance limits. Dose-volume histograms (DVH) were analyzed to assess plan quality. Treatments were delivered using upgraded 6 MV un-flattened photon beam (FFF) from Clinac-iX machine. Extensive pretreatment quality assurance measurements were carried out to report on quality of delivery. Point dosimetry was performed using three different detectors, which includes CC13 ion-chamber, Exradin A14 ion-chamber and Exradin W1 plastic scintillator detector (PSD) which have measuring volume of $0.13cm^3$, $0.009cm^3$ and $0.002cm^3$ respectively. Results: Average PTV volume of AS was 11.3cc (${\pm}4.8$), and located in eloquent areas. VMAT plans provided complete PTV coverage with average conformity index of 1.06 (${\pm}0.05$). OAR's dose were kept below tolerance limit recommend by American Association of Physicist in Medicine task group-101(brainstem $V_{0.5cc}$ < 23Gy, cochlea maximum < 25Gy and Optic pathway <25Gy). PSD resulted in superior dosimetric accuracy compared with other two detectors (p=0.021 for PSD.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.8
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• pp.3721-3729
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• 2014

Background: Cancer is becoming the most important public health burden around the globe. As per the GLOBOCAN 2008 estimates, about 12.7 million cancer cases and 7.6 million cancer deaths were estimated to have occurred in 2008. The burden of cancer cases for India in the year 2020 is calculated to be 1,148,757 (male 534,353; female 614,404) compared to 979,786 in 2010. The pattern of cancer incidence is varying among geographical regions, esophageal cancer for example being high in China, lung cancer in USA, and gallbladder cancer in Chile. The question remains why? Is it due to the diversity in genome pool, food habits, risk factor association and role of genetic susceptibility or some other factors associated with it? In India, the North East (NE)-India region is seeing a marked increase in cancer incidence and deaths, with a very different cancer incidence pattern compared to mainland India. The genome pool of the region is also quite distinct from the rest of India. Northeastern tribes are quite distinct from other groups; they are more closely related to East Asians than to other Indians. In this paper an attempt was made to see whether there is any similarity among the pattern of cancer incidence cases for different sites of NE-India region to South or East-Asia. Materials and Methods: Principal Component Analysis (PCA), Hierarchical Cluster Analysis (HCA), Pearson Correlation coefficient test was assessed to evaluate the linkage of North-East India region to other regions. A p value <0.05 was considered as statistically significant. Results: The results clearly shows that there are similarities in occurrence of cancer incidence patterns for various cancer sites of NE-India with South and East-Asian regions, which may lead to the conclusion that there might be a genetic linkage between these regions.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.sup3
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• pp.113-117
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• 2016

Quantile regression is an efficient method for predicting and estimating the relationship between explanatory variables and percentile points of the response distribution, particularly for extreme percentiles of the distribution. To study the relationship between urbanization and cancer morbidity, we here applied quantile regression. This cross-sectional study was conducted for 9 cancers in 345 cities in 2007 in Iran. Data were obtained from the Ministry of Health and Medical Education and the relationship between urbanization and cancer morbidity was investigated using quantile regression and least square regression. Fitting models were compared using AIC criteria. R (3.0.1) software and the Quantreg package were used for statistical analysis. With the quantile regression model all percentiles for breast, colorectal, prostate, lung and pancreas cancers demonstrated increasing incidence rate with urbanization. The maximum increase for breast cancer was in the 90th percentile (${\beta}$=0.13, p-value<0.001), for colorectal cancer was in the 75th percentile (${\beta}$=0.048, p-value<0.001), for prostate cancer the 95th percentile (${\beta}$=0.55, p-value<0.001), for lung cancer was in 95th percentile (${\beta}$=0.52, p-value=0.006), for pancreas cancer was in 10th percentile (${\beta}$=0.011, p-value<0.001). For gastric, esophageal and skin cancers, with increasing urbanization, the incidence rate was decreased. The maximum decrease for gastric cancer was in the 90th percentile(${\beta}$=0.003, p-value<0.001), for esophageal cancer the 95th (${\beta}$=0.04, p-value=0.4) and for skin cancer also the 95th (${\beta}$=0.145, p-value=0.071). The AIC showed that for upper percentiles, the fitting of quantile regression was better than least square regression. According to the results of this study, the significant impact of urbanization on cancer morbidity requirs more effort and planning by policymakers and administrators in order to reduce risk factors such as pollution in urban areas and ensure proper nutrition recommendations are made.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.2889-2894
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• 2016

This study aimed to modify behavior regarding liver fluke and cholangiocarcinoma prevention in Chumphuang district, Nakhon Ratchasima province, Thailand through integrated learning. A total of 180 participants were included through purposive selection of high-risk scores on verbal screening. Participants attended the health education program which applied the health belief model included family based, knowledge station based, academic merit based and community based learning. Data were collected using a questionnaire composed of 4 parts: 1) personal information, 2) knowledge, 3) perceived susceptibility, severity, benefits, and barriers, 4) practice regarding liver fluke and cholangiocarcinoma prevention. The result revealed that the majority were female (79.9%), age ${\geq}60$ years old (33.2%), primary school educational level (76.1%), and agricultural occupation (70.1%). The mean scores of knowledge, perception, and practice to liver fluke and cholangiocarcinoma prevention, before participated the integrative learning were low, moderate, and low, respectively. Meanwhile, the mean score of knowledge, perceived susceptibility, severity, benefits, and barriers, and practice regarding liver fluke and cholangiocarcinoma prevention, were higher with statistical significance after participation in the integrated learning. This finding indicates that health education programs may successfully modify health behavior in the rural communities. Therefore they may useful for further work behavior modification in other epidemic areas.

• Asian-Australasian Journal of Animal Sciences
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• v.28 no.6
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• pp.903-910
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• 2015

To maintain a predominantly pasture-based system, the large herd milked by automatic milking rotary would be required to walk significant distances. Walking distances of greater than 1-km are associated with an increased incidence of undesirably long milking intervals and reduced milk yield. Complementary forages can be incorporated into pasture-based systems to lift total home grown feed in a given area, thus potentially 'concentrating' feed closer to the dairy. The aim of this modelling study was to investigate the total land area required and associated walking distance for large automatic milking system (AMS) herds when incorporating complementary forage rotations (CFR) into the system. Thirty-six scenarios consisting of 3 AMS herds (400, 600, 800 cows), 2 levels of pasture utilisation (current AMS utilisation of 15.0 t dry matter [DM]/ha, termed as moderate; optimum pasture utilisation of 19.7 t DM/ha, termed as high) and 6 rates of replacement of each of these pastures by grazeable CFR (0%, 10%, 20%, 30%, 40%, 50%) were investigated. Results showed that AMS cows were required to walk greater than 1-km when the farm area was greater than 86 ha. Insufficient pasture could be produced within a 1 km distance (i.e. 86 ha land) with home-grown feed (HGF) providing 43%, 29%, and 22% of the metabolisable energy (ME) required by 400, 600, and 800 cows, respectively from pastures. Introduction of pasture (moderate): CFR in AMS at a ratio of 80:20 can feed a 400 cow AMS herd, and can supply 42% and 31% of the ME requirements for 600 and 800 cows, respectively with pasture (moderate): CFR at 50:50 levels. In contrast to moderate pasture, 400 cows can be managed on high pasture utilisation (provided 57% of the total ME requirements). However, similar to the scenarios conducted with moderate pasture, there was insufficient feed produced within 1-km distance of the dairy for 600 or 800 cows. An 800 cow herd required 140 and 130 ha on moderate and high pasture-based AMS system, respectively with the introduction of pasture: CFR at a ratio of 50:50. Given the impact of increasing land area past 86 ha on walking distance, cow numbers could be increased by purchasing feed from off the milking platform and/or using the land outside 1-km distance for conserved feed. However, this warrants further investigations into risk analyses of different management options including development of an innovative system to manage large herds in an AMS farming system.