• Title/Summary/Keyword: risk factors

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Analysis of Surgical Results for the Patients with Pulmonary Metastasis from Colorectal Carcinoma (대장암의 전이성 폐암의 수술 결과에 대한 분석)

  • Sim, Hyung-Tae;Kim, Yong-Hee;Shin, Hong-Ju;Chun, Mi-Sun;Bae, Chi-Hoon;Lee, Eung-Sirk;Park, Seung-Il;Kim, Dong-Kwan
    • Journal of Chest Surgery
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    • v.39 no.11 s.268
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    • pp.838-843
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    • 2006
  • Background: The lung is the most common site of metastatic colorectal cancer comprising 10% of all curative resection of colorectal cancer. The reported 5 year survival rate varies among institutions. The purpose of the present study was to present the retrospective analysis of colorectal metastatic lung cancer surgery at our institution. Material and Method: A total of 61 patients undergoing surgery for metastatic colorectal lung cancer between July 1996 and December 2003 were included in the present study. The stage of the primary colorectal cancer, site of pulmonary metastasis, method of lung resection, the number and size of the metastatic nodules, the recurrence rate, and survival were assessed. Result: The 3 and 5 year survival rates were 66% and 41%, respectively. No significant risk factors were identified among the studied variables by either univariate or multivariate analysis. The mean disease free survival rate was 17 months. The most common recurrent site was lung, and among these patients, 3 underwent a second operation and two are still alive. Conclusion: The results of the above data suggest that pulmonary resection of metastatic lung cancer in select patients after curative resection of colon cancer may be a good therapeutic option with the potential for excellent results.

Predictors of Failed Closure of Patent Ductus Arteriosus with the First Course of Indomethacin in Preterm Infants (미숙아 동맥관 개존에서 인도메타신 1차 투여 후 폐쇄 실패의 예측 인자)

  • Lee, Mong-Young;Lim, Dong-Hee;Park, Kyu-Hee;Ha, Gi-Su;Lee, Jang-Hoon;Choi, Byung-Min;Hong, Young-Sook;Yoo, Kee-Hwan;Lee, Joo-Won
    • Neonatal Medicine
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    • v.17 no.1
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    • pp.75-83
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    • 2010
  • Purpose : This study was performed to determine the predictors of failed closure of a patent ductus arteriosus (PDA) following the first course of indomethacin in symptomatic preterm infants. Methods : Forty three of 43 preterm infants, admitted to the neonatal intensive care unit diagnosed with PDA and treated with indomethacin at the Korea University Medical Center between January 1990 and October 2007, ware studied. The perinatal risk factors affecting the failed closure of PDA were retrospectively assessed. Results : The failed PDA closure group included 16 (37%) out of 43 infants three of whom underwent surgery. The closure group included 27 (63%) out of 43 infants. In the failed closure group, the Apgar scores (1 min, 5 min) were significantly higher (P<0.05) and antenatal steroid administration was significantly lower (P<0.05). In addition, dopamine administration was significantly lower (P<0.05) and the mean postnatal age at diagnosis was significantly lower (P<0.05). Multiple logistic regression for the prediction of failed PDA closure found only antenatal steroid administration (OR 0.092, CI 0,010-0.826, P=0.0331) as an associated factor. Conclusion : In patients with antenatal steroid administration the failed PDA closure rate was significantly lower. Therefore, antenatal steroid administration can be considered as an important factor for the closure of PDA in preterm pregnancies.

Clinical Outcome and Long Term Follow-up of Chronic Functional Constipation in Children (소아 만성 기능성 변비의 치료 성적과 장기적 예후)

  • Ahn, Yoon Jin;Park, Jae Ock
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.2
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    • pp.200-209
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    • 2006
  • Purpose: The purpose of this study was to evaluate the long term outcome and the factors contributing to treatment outcome for chronic functional constipation in children. Methods: Sixty three children were enrolled who had chronic functional constipation and could be followed by telephone contact. They were treated at the Bucheon Soonchunhyang Hospital for more than 1 month and observed from March 2001 to June 2005. We analyzed the clinical features, symptoms and signs, as well as the course and results of treatment. Results: The male to female ratio was 35 (55.6%) : 28 (44.4%). The mean age at the onset of symptoms and diagnosis was $21.1{\pm}23.5$ (1.9~84.0) months and $47.1{\pm}34.2$ (6.9~138.0) months, respectively. The mean defecation frequency before treatment was $3.2{\pm}2.3$ (0.5~10.0) times per week. The symptoms associated with constipation were as follows: soiling 34 (54.0%) which was more common in males than females, large stools in 30 (47.6%), decreased bowel movements less than three times a week in 20 (31.7%), straining during defecation in 19 (30.2%) and retentive posturing 19 (30.2%). The mean duration of follow-up was $34.2{\pm}14.6$ (3.6~60.0) months and 44 (69.8%) patients had their symptoms resolve ("success") and 19 (30.2%) were not resloved ("fail") from the constipation. The time for recovery from soiling, straining during defecation and retentive posturing after treatment was $4.3{\pm}2.4$ (1.0~36.0), $5.0{\pm}1.4$ (0.8~36.0) and $5.0{\pm}3.1$ (1.0~36.0) months, respectively. A relapse of the constipation occurred in 15 (23.8%) patients, 9 (60%) boys and 6 (40%) girls. The time to relapse after cessation of treatment was $2.9{\pm}1.9$ (1.0~6.0) months and the only risk factor associated with relapse was the initial duration of treatment. Conclusion: Most of the patients had resolution of symptoms within five months after treatment; relapse occurred within three months after the interruption of treatment. The duration of treatment was important for recovery and for the prevention of relapse in the constipated children. Thus a long term maintenance of therapy and follow-up is necessary for chronic functional constipation in children.

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The Association between Types of Smoking and Periodontal Disease according to the Survey Year Using the Fourth and Fifth Korea National Health and Nutrition Examination Surveys (조사연도에 따른 흡연 유형과 치주질환의 관련성 분석: 제4기, 제5기 국민건강영양조사를 이용하여)

  • Kim, Myoung-Hee;Yoon, Mi-Sook;Lim, Youn-Hee;Lee, Sae-Rom;Kim, So-Yeon;Park, Seon-Ju;Shin, Sun-Jung
    • Journal of dental hygiene science
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    • v.17 no.6
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    • pp.487-494
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    • 2017
  • There is little evidence on the effects of environmental tobacco smoke (ETS) on prevalence of periodontal disease. The aims of this study were to explore the trends of prevalence of periodontal disease and types of exposure to smoke, including ETS according to the survey year, identify factors affecting periodontal disease, and compare the effect size of periodontal disease between active smokers and secondhand smokers. Data on 11,643 individuals were obtained from the fourth and fifth Korean National Health and Nutritional Examination Surveys. Information on exposure to ETS at home and work was self-reported. Severity of periodontal disease was evaluated using the community periodontal index. A multivariate logistic regression analysis was performed to model periodontal disease using types of smoking and the survey year. Overall, the prevalence of periodontal disease was 26.0% (n=3,029) and about 9% of the study population were secondhand smokers. The prevalence of periodontal disease among smokers was significantly increased according to smoking types by year. Active smokers showed a statistically significant adjusted odds ratio (aOR) for having periodontal disease except in the year 2007, whereas secondhand smokers had significant associations only in 2010 (aOR, 1.68; 95% confidence interval, 1.05 to 2.70) compared to non-smokers. For secondhand smokers, the statistical relationship of predicting periodontal disease was weaker than that of active smokers. However, ETS should separately be considered as an important risk factor for periodontal disease. This study suggested the need for further investigation of the impact of ETS on prevalence of periodontal disease using in-depth research designs and objective measurements for assessing periodontal disease and ETS.

Concentration Levels and Distribution Characteristics of Polycyclic Aromatic Hydrocarbons (PAHs) at Ambient Air in Industrial Complex Area (공단지역 대기 중 다환방향족탄화수소화합물(PAHs)의 농도수준 및 분포특성)

  • Jung, Jong-Hyeon;Phee, Young-Gyu;Cho, Sang-Won;Ok, Gon;Shon, Byung-Hyun;Lee, Kwan;Lim, Hyun-Sul
    • Clean Technology
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    • v.17 no.4
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    • pp.379-388
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    • 2011
  • The purpose of this study was to investigate the concentration levels, distribution characteristics and blood concentration of Polycyclic Aromatic Hydrocarbons (PAHs) at ambient air in Industrial Complex Area. The samples were collected at 4 sites in Industrial Complex Area and its vicinities. The result indicated that there was the difference of PAHs concentration as followed local characteristics. The level of average concentration of PAHs in the air in Industrial Complex Area was $14.52{\sim}193.48ng/m^3$. The level of average concentration of six materials with possibility of cancer creation was $1.65{\sim}13.44ng/m^3$. The concentrations of PAHs were generally low, but Jechul-dong is considered an area where consistent monitoring of PAHs is required. In addition, benzo(a)pyrene was detected in every atmospheric sample, however the concentration was not high. The level of concentration of benzo(a)pyrene in the air in the Jechul-dong was $2.89ng/m^3$. But, the concentration of the PAHs in Jechul-dong showed that the Benzo(a)pyrene concentration is above $1ng/m^3$ of air quality standard(EU). The results of the concentration level of PAHs in the blood from 240 persons who were exposed directly were surveyed, it was $1.12{\sim}11.45ng/m^3$ for man and $1.20{\sim}26.89ng/m^3$ for woman. It was indicated that the difference between the genders was very little. The accumulation inside human was anticipated as the PAHs concentration in the blood for the aged was very high. Industrial Complex Area and its vicinities are an area which has been greatly influenced by PAHs and environmental contaminants. It is necessary to control the emission sources of PAHs and to construct an observation system at Industrial Complex Area from now on. It is time to reduce the risk factors for health and environmental disease to protect the health of resident in Industrial Complex Area and its vicinities.

Clinical Significance of Lymph Node Micrometastasis in Patients with Stage 1 Non-Small Cell Lung Cancer (제1기 비소세포폐암 환자에서 임파절 미세전이와 예후와의 상관관계)

  • 최필조;노미숙;이재익
    • Journal of Chest Surgery
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    • v.36 no.5
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    • pp.348-355
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    • 2003
  • Background: The prognostic significance of lymph node micrometastasis in non-small cell lung cancer remains controversial. We therefore investigated the clinicopathologic factors related to lymph node micrometastsis and evaluated the clinical relevance of micrometastasis with regard to recurrence. Material and Method: Five hundred six lymph nodes were obtained from 41 patients with stage 1 non-small ceil lung cancer who underwent curative resection between 1994 and 1998. Immunohistochemical staining using anti-cytokeratin Ab was used to detect micrometastasis in these lymph nodes. Result: Micrometastatic tumor cells were identified in pN0 lymph nodes in 14 (34.1%) of 41 patients. The presence of lymph node micrometastasis was not related to any clinicopathoiogic factor (p) 0.05). The recurrence rate was higher in patients with micrometastasis (57.1%) than in those without (37.0%), but the difference was not significant (p=0.22). Patients with micrometastasis had a lower 5-year recurrence-free survival rate (48.2%) than those without micrometastasis (64.1%), with a borderline significance (p=0.11), The S-year recurrence-free survival rate (25.0%) in the patients with 2 or more micrometastatic lymph nodes was significantly lower than that in the patients with no or single micrometastasis (p=0.02). In multivariate analysis, multiple lymph node micromestasis us was a significant independent predictor of recurrence (p=0.028, Risk ratio=3.568). Conclusion: Immunehistochemical anti-cytokeratin staining was a rapid, sensitive, and easy way of detecting lymph node micrometastasis. The presence of lymph node micrometastasis was not significantly associated with the recurrence, but had a tendency toward a poor prognosis in stage 1 non-small cell lung cancer. Especially, the presence of multiple micrometastatic lymph nodes was a significant and independent predictor of recurrence.

Molecular Genetic Analysis of Behcet's Disease in Korean (한국인 베체트 환자의 분자유전학적 연구)

  • Park, Sang-Bum;Nam, Youn-Hyoung;Park, Su-Min;Lee, Sang-Hyun;Ahn, Young-Chang;Cho, Min-Ho;Kim, Jong-Gyu;Choi, Jae-Gu;Kim, Seong-Kyu;Jang, Won-Cheoul
    • Journal of the Korean Chemical Society
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    • v.51 no.6
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    • pp.536-542
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    • 2007
  • Behcet's disease (BD) is a chronic inflammatory disorder, involving several organs. Inflammation in the disease is thought to be mediated by cytokines derived from T-helper type 1 (Th1) lymphocytes. Although the exact pathogenesis for BD is not completely understood, it has been suggested that the disease is triggered in genetically susceptible individuals by environmental factors, such as microbial agents. It is noted that multiple genes, including MHC (major histocompatibility complex) and non-MHC genes, are implicated in the pathogenesis of BD. This study tries to determine whether HLA-B51, IL-18, SLC11A1 and TNF-α polymorphisms are associated with susceptibility to Behcet's disease in Koreans. As a results, HLA-B51 was a genetic factor with the strongest association with BD. But it is still uncertain whether this HLA molecule is directly involved in the pathogenesis of BD. Although the IL-18 gene polymorphisms were not associated with a susceptibility to BD in the Korean population, the patients carrying the GG genotype at position 137 had a higher risk of developing the ocular lesions. This study suggests that the allele 3 and the genotype allele 3 / allele 3 of 5'-promoter (GT)n polymorphism in the SLC11A1 gene may have a protective effect for the development of BD in the Korean population. There were no evidences for genetic association conferred by the TNF-α gene with respect to susceptibility to BD.

Endocrine dysfunction after bone marrow transplantation during childhood and adolescence (소아 및 청소년기에서 골수이식 후에 발생할 수 있는 내분비 기능 부전)

  • Jin, Hye Young;Choi, Jin-Ho;Im, Ho-Joon;Seo, Jong-Jin;Moon, Hyung-Nam;Yoo, Han-Wook
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.420-427
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    • 2010
  • Purpose : Several complications can occur in patients who received bone marrow transplantation (BMT) during childhood and adolescence. This study aims to investigate endocrine dysfunctions after BMT so that better care can be provided to care for long-term survivors of BMT. Methods : One hundred patients (61 males, 39 females) were included in this study. Clinical parameters such as initial diagnosis, age at BMT, conditioning regimen, presence of graft-versus-host disease (GVHD), growth pattern, thyroid function, and pubertal status were retrospectively reviewed to evaluate risk factors associated with endocrine dysfunction. Results : Height standard deviation score (SDS) at BMT, after 1 year of BMT, and at the last visit were $0.08{\pm}1.04$, $-0.09{\pm}1.02$, and $-0.27{\pm}1.18$, respectively (P =0.001). Height SDS significantly decreased in patients who received total body irradiation (TBI) (P =0.017). One of the patients who received TBI demonstrated growth hormone deficiency. Thirty (31.9%) of 94 patients had compensated hypothyroidism. Incidence of compensated hypothyroidism was higher among those who had GVHD (odds ratio 2.82, P =0.025). Of the 32 patients (17 males, 15 females) who were over 14 years in male and 13 years in female at the last visit, 16 (3 males, 13 females) had increased luteinizing hormone (LH) or follicle-stimulating hormone (FSH). Abnormal elevation of LH or FSH was more common in females (odds ratio 30.3, P =0.001). Conclusion : The most common endocrine dysfunction was ovarian insufficiency. Regular check-up for endocrine function needs to be required due to high incidence of endocrine dysfunction in patients with BMT.

A study on the Logical Reclassification of Parcel Service Tariffs (택배요금기준의 합리적 재설정에 관한 연구)

  • Cho, Yoon-Sung;Lee, Tae-Hwee
    • Journal of Distribution Science
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    • v.10 no.5
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    • pp.45-55
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    • 2012
  • In Korea, the parcel delivery service was launched officially in 1992, and the market has grown to 13.2 billion units, or 3.5 trillion won, as of 2011. The service companies accept small packages under 30 kg and deliver them on the next day in most domestic areas. This service plays an important role in business and personal activities. The parcel service companies have themselves designed the tariff for the delivery service based on two criteria: weight and the sum of three side lengths. Further, the tariff is graded in steps of three or four rate structures based on size (small, medium, large, and extra-small). However, the basic freight rate is generally decided according to the cargo's weight or measurement size, and an extra rate is added according to some factors (handling, stowability, liability, and so on). The parcel service tariff adopted by the companies is illogically designed, and this study was carried out to assess the need for redesigning the tariff structure. The cargo volume cannot be logically reflected by three side lengths. For example, two parcels measuring 160 cm based on three side lengths may have different volumes, one measuring 0.152 cbm (53.33 cm × 53.33 cm × 53.34 cm) and the other 0.05 cbm (100 cm × 50 cm × 10 cm). A small package of less than120 cm (sum of three side lengths) may have a volume of as much as 0.064 cbm (40 cm × 40 cm × 40 cm). Sample comparison showed that 17% of medium-size parcels (based on the sum of three side lengths) are small-volume packages, 24% of large-size parcels are small- or medium-volume packages, and 40% of extra-big-size parcels are big- or under-size packages. Therefore, if parcel service companies rate their services for volume cargo based on the three side lengths standard, users may have to pay higher than normal rates, particularly because a large percentage of parcels are volume cargo. According to this study, the average weight per 1 cbm is less than 300 kg. Therefore, users face an increasing risk of paying higher than logical freight charges. Generally, transportation companies are called "public interest enterprises," and parcel service companies operate as postal services. Public interest enterprises must provide the delivery service to all customers without discrimination at a reasonable service level and logical service charges. Therefore, parcels service tariffs must be designed and adopted logically. In this study, freight theories and prior research findings were used to consider the importance of freight rates, and distortion of parcel service rates based on the three side lengths system was verified through regression analysis of a parcel sample and sample comparison. In conclusion, volume sizes based on three side lengths have a higher correlation to the rate level than does the sum of three side lengths. Further, compared to the sum of three side lengths, volume size has a higher correlation to cargo weight, which is the most basic factor determining transportation cost. Therefore, the existing parcel service tariff should be changed to weight- and volume-based rates, and the tariff must be graded in steps of 8 to 10 higher rate structures for a logical freight schedule based on service cost.

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The Study of the Diet Style and Relationships among Vitamin and Nutrient Supplement Intakes, Serum Lipid Levels, Blood Sugar and Blood Pressure of Adult Female (채식 성인여성의 식사형태 및 비타민, 영양제 복용과 혈중 지질, 혈당, 혈압과의 관련성에 관한 비교연구)

  • 차복경;최원경
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.31 no.2
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    • pp.306-314
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    • 2002
  • The purpose of this study is to examine the relation between vegetarian diet and the risk factors of cardiovascular disease. The subjects of the study were 127 Buddhist nuns (age: 23 ~79 yr) for vegetarians and 235 healthy female adults (age: 23 ~79 yr) for non-vegetarians. This study covers food consumption survey, anthropometric measurement, amount of energy expenditure, physical activity and clinical examination. Average body mass index (BMI) of vegetarians and non-vegetarians were 22.47 and 21.08, waist/hip ratio (WHR) was 0.85 and 0.84, percentage of body fat (%BF) was 28.79 and 26.55, respectively. Average duration of vegetarian diet of the vegetarians was 13.16 years. The triglyceride levee of the vegetarians was significantly lower for those who take nutrient tablet compared to those who either take vitamins or who do not take any nutrient supplement. Taking vitamins or nutrient tablet did not give any significant difference in total-cholesterol and LDL-cholesterol for vegetarians, while significantly high triglyceride was observed for the non-vegetarians taking nutrient tablet than the ether non-vegetarians. Taking vitamins or nutrient tablet did not affect the lever of HDL-cholesterol for either vegetarians or non-vegetarians. Athrogenic index (AI) was lower for the vegetarian group tailing nutrient tablet and for the non-vegetarian group not taking vitamins and nutrient tablet, than the other respective groups. Blood sugar of the vegetarians who take nutrient tablet was significantly lower than those tailing vitamins, while blood sugar of the non-vegetarians not taking any nutrient supplement was significantly lower than those taking nutrient tablet.