• Asian Pacific Journal of Cancer Prevention
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• v.14 no.6
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• pp.3465-3467
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• 2013

Background: Breast cancer is the most frequent malignant disease amongst young women. If we review local data in Pakistan then breast cancer represents approximately a third of all cancers in females. The age standardized incidence rate (ASR) world per 100,000 is 53.8 and crude incidence rate is 30.9. We have observed during our surgical pathology practice and it is also reported by other Asian studies that breast carcinoma is amongst the leading malignancies in the region and the patients are at least a decade younger than counterparts in developed nations. Age is an important issue in effective screening, diagnosis and management of breast cancer, especially in this geographical region where late presentation and poor prognosis are a hallmark of the disease. Objective: The aim of this study is to determine the frequency of malignant breast lesions in symptomatic young females presenting with breast lumps. Materials and Methods: This is a retrospective study conducted at the Pathology Department, Liaquat National Hospital and Medical College, Karachi. Descriptive and pathology data of malignant breast tumors 1st January 2004 to 31st December 2009 were reviewed, using the departmental archived data. It included both male and female patients up to the age of 25 years. Results: A total of 714 surgical specimens from/of symptomatic breast lesions were received at the pathology department of Liaquat National Medical, in the five years study period, in young females. There were 575 (80%) benign, 119 (16%) inflammatory and 20 (2.8%) malignant lumps. Conclusions: The obtained data for females only up to 25 years of age suggest a massive burden which requires urgent attention. Early assessment of lesions is essential in order to avoid mortality from malignancies.

• Research in Community and Public Health Nursing
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• v.10 no.2
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• pp.467-479
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• 1999

The mortality and morbidity caused by injury and poisoning has been major public health problem in Korea. This study was carried out to get information indispensable in developing prevention srategies peculiar to korean rural area. In this study 1.499 people of 496 households. who are living in five rural villages of Chooncheon City. Kang-Won Province. were interviewed in accordance with structured questionaire in 1996. The results obtained are summarized as follows: 1. The age-standardized annual incidence rates of injury and poisoning per 100 persons surveyed were 4.2 in males and 1.9 in females. The difference between sex was statistically significant. 2. The places where most of injuries and poisonings occurred were road 66.7% among males. road 31.6% among females. 3. The occurrence of the injuries and poisonings were clustered in intensive farming season in both males and females. 4. The laceration and stab wound were the most frequent nature of injuries in males and the fracture was the most frequent nature of injuries in females. The fracture. sprain were more frequent among males but sprain and contusion were more frequent among females. 5. Incidence rates of injuries and poisoning by cause were higher in traffic accidents among males. though falls among females. The cause specific incidence rate by age was high in traffic accident for 30-59 year age group. and for the aged people older than 60 years. 6. In the management pattern, 78.8% of the injuries and poisoning were received medical care in hospitals and clinics, and the duration of the treatment over 4 weeks in 37.0%. The results obtained indicate that organized community effort is urgently required to prevent injuries and poisonings in rural area.

• Clinical and Experimental Pediatrics
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• v.61 no.8
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• pp.239-244
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• 2018

Purpose: Hypothermia at admission is associated with increased mortality and morbidity in preterm infants. We performed a quality improvement (QI) effort to determine the impact of a decrease in admission hypothermia in preterm infants. Methods: The study enrolled very low birth weight (VLBW) infants born at Gangnam Severance Hospital between January 2013 and December 2016. This multidisciplinary QI effort included the use of occlusive wraps, warm blankets, and caps; the delivery room temperature was maintained above $23.0^{\circ}C$, and a check-list was used for feedback. Results: Among 259 preterm infants, the incidence of hypothermia (defined as body temperature <$36.0^{\circ}C$) decreased significantly from 68% to 41%, and the mean body temperature on neonatal intensive care unit admission increased significantly from $35.5^{\circ}C$ to $36.0^{\circ}C$. In subgroup analysis of VLBW infants, admission hypothermia and neonatal outcomes were compared between the pre-QI (n=55) and post-QI groups (n=75). Body temperature on admission increased significantly from $35.4^{\circ}C$ to $35.9^{\circ}C$ and the number of infants with hypothermia decreased significantly from 71% to 45%. There were no cases of neonatal hyperthermia. The incidence of pulmonary hemorrhage was significantly decreased (P=0.017). Interaction analysis showed that birth weight and gestational age were not correlated with hypothermia following implementation of the protocol. Conclusion: Our study demonstrated a significant reduction in admission hypothermia following the introduction of a standardized protocol in our QI effort. This resulted in an effective reduction in the incidence of massive pulmonary hemorrhage.

• Journal of Preventive Medicine and Public Health
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• v.39 no.3
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• pp.255-262
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• 2006

Objectives: This study is conducted to identify the cancer incidence in Gwangju during the 5-year period from 1998 to 2002 and to assess the completeness and validity of the cancer registry data during this time period. Methods: All cases that had a diagnosis of invasive cancer (ICD-10 sites C00-C97) during the study period were retrieved from the records of the Gwangju Cancer Registry (GCR), which theoretically includes all the cancer cases in Gwangju. All the cases during the study period were analyzed by gender, age group and cancer sites. The completeness (mortality/incidence ratio and age-specific incidence curve) and validity (histologic verification, primary site unknown, age unknown and death certificate only) of the cancer registry in Gwangju were analyzed by gender, age group and cancer sites for the 5-year period. Results: The overall cancer incidence was higher in the males than in the females (age-standardized incidence rates (ASR) 299.8 and 172.4 per 100,000, respectively). In males, the most common cancer was stomach (ASR: 65.8), followed by liver (ASR: 50.5), bronchus and lung (ASR: 50.5), colo-rectum (ASR: 26.7), oesophagus (ASR: 10.6), and bladder (ASR: 10.3) in descending order. In females, the most common cancer was stomach (ASR: 26.8), followed by thyroid (ASR: 20.7), breast (ASR: 20.4), cervix uteri (ASR: 14.3), bronchus and lung (ASR: 13.0), liver (ASR: 10.7) and colo-rectum (ASR: 17.2) in descending order. The overall quality (completeness and validity) of the cancer registry was at the in 'good' level. Conclusions: These results will be useful in the overall context of planning and evaluating of cancer control activities in Gwangju.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7587-7593
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• 2013

Background: Cancers of gastric and esophagus are the most frequent gastrointestinal (GI) tract cancers in Iran. This study aimed to analyze time trends of GI tract cancers in Guilan province by gender and age to provide solid scientific evidence for cancer prevention and control. Materials and Methods: The data were obtained from the Guilan Cancer Registry System and Guilan Provincial Health Center, over the 15 year period between 1997 and 2011. Crude incidence and age standardized (AS)incidence rates were calculated and annual percent change was estimated by Joinpoint software for long term trend analysis. Results: During the study period, 8,332 cases of GI malignances with a male to female ratio of 1:1.73 were registered in Guilan province. The AS rates for esophageal, gastric, colon and rectal cancers were 5.97, 14.5, 7.59 and 3.58 per 105 respectively. While the trend was declining and relatively constant for esophageal and gastric cancer, respectively, the incidence trend for colon and rectal cancers was of increase over the period of the study. Conclusions: The results indicated that the incidence of GI cancers was relatively low in Guilan province compared to neighboring provinces. An effective cancer control program including prevention measures, early detection and effective treatment needs to be implemented to reduce cancer morbidity and mortality.

• Journal of Environmental Health Sciences
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• v.43 no.3
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• pp.240-246
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• 2017

Objectives: This study was conducted to evaluate the vulnerability of the human health sector to $PM_{10}$ due to climate change in Incheon over the period of 2005-2014. Methods: Vulnerability to $PM_{10}$ consists of the three categories of climate exposure, sensitivity, and adaptive capacity. The indexes for climate exposure and sensitivity indicate positive effects, while adaptive capacity shows a negative effect on vulnerability to $PM_{10}$. The variables in each category were standardized by the rescaling method, and respective relative regional vulnerability was analyzed through the vulnerability index calculation formula of the Intergovernmental Panel on Climate Change. Results: Regions with a high exposure index were the western and northern urban areas with industrial complexes adjacent to a highway, including Bupyong-gu and Seo-gu. Major factors determining the climate exposure index were the $PM_{10}$ concentration, days of $PM_{10}$ >= $100{\mu}g/m^3$, and $PM_{10}$ emissions. The regions showing a high sensitivity index were urban regions with high populations; these commonly had a high mortality rate for related diseases and vulnerable populations. Conclusions: This study is able to support regionally adjusted adaptation policies and the quantitative background of policy priority since it provides information on the regional health vulnerability to $PM_{10}$ due to climate change in Incheon.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.5063-5067
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• 2015

Background: Colorectal cancer (CRC) is the most common gastrointestinal malignancy and is a significant cause of mortality. Its incidence is generally increasing in Asia. Reports from the West have indicated that the incidence of rectal cancer is increasing in the younger population. This study assessed the time trend of CRC in Brunei Darussalam specifically assessing the different age groups at which the incidences start to increase. Materials and Methods: The National Cancer registry was reviewed (1991 to 2014). The age standardized rate (ASR) and the age specific incidence rates (ASIRs) for three time periods (1991-1998), (1999-2006) and (2007-2014) were calculated. Results: The mean age of diagnosis was $59.3{\pm}14.6$ years old, incidences being slightly higher amongst men (57.6%) and Malays (67.1%). The most common tumor type was adenocarcinoma (96.4%). Rectal cancers accounted for 35.2% (n=372/1,056) of all cancers of the large bowel; more men were affected than women. The proportion of rectal cancer was also high among the indigenous group. In the three time periods, the ASR for CRC increased from 16 per 100,000 (1991-1998) to 19.6 per 100,000 (1999-2006) and 24.3 per 100,000 (2007-2014). The ASIRs for CRC increased markedly between the time periods 1998-2006 and 2007-2014, beginning in the 40-44 years age group. For rectal cancers, the ASIRs started to increase in the 25-29 age group onward whereas for colon cancers, the increase was observed at a later age, starting from the 45-49 age group. Conclusions: Our study showed an increase in the incidence of CRC including in the younger age groups. The increase was seen earlier in rectal cancer compared to colon cancer. These data mirror the trends reported from the West.

• Journal of Chest Surgery
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• v.45 no.2
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• pp.95-100
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• 2012

Background: The purpose of this report is to describe the perioperative outcomes of standard carotid endarterectomy (CEA) with general anesthesia, routine shunting, and tissue patching in symptomatic carotid stenoses. Materials and Methods: Between October 2007 and July 2011, 22 patients with symptomatic carotid stenosis (male/female, 19/3; mean age, $67.2{\pm}9.4$ years) underwent a combined total of 23 CEAs using a standardized technique. The strict surgical protocol included general anesthesia and standard carotid bifurcation endarterectomy with routine shunting. The 8-French Pruitt-Inahara shunt was used in all the patients. Results: During the ischemic time, the shunts were inserted within 2.5 minutes, and 5 patients (22.7%) revealed ischemic cerebral signals (flat wave) in electroencephalographic monitoring but recovered soon after insertion of the shunt. The mean shunting time for CEA was $59.1{\pm}10.3$ minutes. There was no perioperative mortality or even minor stroke. All patients woke up in the operating room or the operative care room before being moved to the ward. One patient had difficulty swallowing due to hypoglossal nerve palsy, but had completely recovered by 1 month postsurgery. Conclusion: Routine shunting is suggested to be a safe and reliable method of brain perfusion and protection during CEA in symptomatic carotid stenoses.

• Journal of Chest Surgery
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• v.45 no.2
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• pp.91-94
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• 2012

Background: Despite improved managements for acute respiratory distress syndrome (ARDS), its mortality remains high. Extracorporeal membrane oxygenation (ECMO) has emerged as the final option for the treatment of ARDS unresponsive to conventional measures. This study describes our experiences of venovenous ECMO support for the treatment of ARDS. Materials and Methods: Between 2007 and 2010, 56 patients (aged $56.6{\pm}13.4$ years, 43 males) received venovenous ECMO for the treatment of ARDS. The detailed clinical records were retrospectively reviewed. Results: Before the institution of ECMO support, 35 patients (55.4%) required nitric oxide inhalation, 35 patients (55.4%) received continuous renal replacement therapy, and 20 patients (35.7%) were in shock status. The median duration of ECMO support was 164 hours (range, 5 to 1,413 hours). 27 (48%) patients could be successfully weaned from ECMO. Of them, 7 (13%) survived to discharge. On logistic regression analysis, a requirement for higher inspiratory pressure before ECMO support was the only significant factor that could predict ECMO weaning failure. Conclusion: The outcome of venovenous ECMO support for the treatment of ARDS was suboptimal. Further improvements in outcomes should be made through the accumulation of experience and establishment of a standardized protocol for the management of ECMO.

• Journal of Korean Medical Science
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• v.33 no.48
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• pp.309.1-309.13
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• 2018

Background: The aim of this study was to observe long-term outcomes of very low birth weight infants (VLBWIs) born between 2013 and 2014 in Korea, especially focusing on neurodevelopmental outcomes. Methods: The data were collected from Korean Neonatal Network (KNN) registry from 43 and 54 participating units in 2013 and 2014, respectively. A standardized electronic case report form containing 30 items related to long-term follow up was used after data validation. Results: Of 2,660 VLBWI, the mean gestational age and birth weight were $29^{1/7}{\pm}2^{6/7}$ weeks and $1,093{\pm}268g$ in 2013 and $29^{2/7}{\pm}2^{6/7}$ weeks and $1,125{\pm}261g$ in 2014, respectively. The post-discharge mortality rate was 1.2%-1.5%. Weight < 50th percentile was 46.5% in 2013 and 66.1% in 2014. The overall prevalence of cerebral palsy among the follow up infants was 6.2% in 2013 and 6.6% in 2014. The Bayley Scales of Infant Developmental Outcomes version II showed 14%-25% of infants had developmental delay and 3%-8% of infants in Bayley version III. For the Korean developmental screening test for infants and children, the area "Further evaluation needed" was 5%-12%. Blindness in both eyes was reported to be 0.2%-0.3%. For hearing impairment, 0.8%-1.9% showed bilateral hearing loss. Almost 50% were readmitted to hospital with respiratory illness as a leading cause. Conclusion: The overall prevalence of long-term outcomes was not largely different among the VLBWI born between 2013 and 2014. This study is the first large national data study of long-term outcomes.