• Title/Summary/Keyword: survival outcome

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Human Life in Saemangeum after Reclamation (새만금 간척사업 후 주민의 삶)

  • Hahm, Han-Hee
    • Journal of the Korean Society for Marine Environment & Energy
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    • v.13 no.4
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    • pp.313-326
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    • 2010
  • This paper explores the changing aspects of the fishing village and fishermen since the beginning of the Saemangeum Reclamation Development Project in 1991. The Saemangeum Project was neither appropriate nor effective because it adopted an outdated development policy. It should have been obvious that as a result of the Project, tideland where various kinds of clams, crabs, oyster, and many other marine resources live would be lost. The fishermen in the affected area have suffered various hardships. The most acute problem at present is the disappearance of their subsistence activity that threatens their families' survival. Facing the crisis, they view fishing as their most valuable resource. Overlooking the Saemangeum Lake which is newly formed, they view the sea and tideland as their treasure boxes or bank deposits. From the beginning until now, the government did not pay attention to the concerns of the fishermen and their communities. It was an outcome of the typical top-down bureaucratic decision making. Until recently the government has persisted in its position that the primary goal of the reclamation project was to increase agricultural land. In July 23, 2009, the government suddenly announced the new Saemangeum development plan. The new plan focusing on the industrial city complex was quite different from the old plan. Regardless of the revised plan the lives of the villagers in the coastal areas have already been significantly altered. Most villagers no longer depend on fishery. Many have already left their homestead and moved away in order to search new jobs or find another coastal area where they can continue their fishing.

The Study on the Patterns and Formation Factors of the International Conflicting Area (국제분쟁지역의 유형 및 형성요인에 관한 연구)

  • Lee, Han-Bang
    • Journal of the Korean association of regional geographers
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    • v.8 no.2
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    • pp.199-215
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    • 2002
  • The socio-economic and environmental systems of world are in turmoil. International conflicts are placed in their geographical context through the integration of maps. Changes in the world political map have often been the outcome of wars and conflicts associated with major geopolitical transitions. We identify five basic types--proto-nationalism, unification nationalism, separation nationalism, liberation nationalism and renewal nationalism. Political leaders in a wide range of contexts have been able to appeal to the nationalist doctrine to justify their actions. In recent years indigenous peoples have found a new voice in their struggle for survival. Although colonial empire's ending followed long and bloody struggles in some places. We really cannot understand the modem world as a whole if we do not understand the dynamic of that part of it which has endured and struggled against colonialism. The patterns of the international conflicting area are divided internal conflict type, mixed conflict type, international conflict type. The formation factors of the international conflicting area are divided ethnic group, religion, colonialism, resource, territory. There has recently been a resurgence of Islam's importance in world affairs. The oil crises of the 1970s gave new international leverage to several Muslim states.

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Hormone Receptor, HER2/NEU and EGFR Expression in Ovarian Carcinoma - is here a Prognostic Phenotype?

  • Demir, Lutfiye;Yigit, Seyran;Sadullahoglu, Canan;Akyol, Murat;Cokmert, Suna;Kucukzeybek, Yuksel;Alacacioglu, Ahmet;Cakalagaoglu, Fulya;Tarhan, Mustafa Oktay
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9739-9745
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    • 2014
  • Purpose: We aimed to evaluate the effects of hormone receptor, HER2, and epidermal growth factor receptor (EGFR) expression on epithelial ovarian cancer (EOC) prognosis and investigate whether or not phenotypic subtypes might exist. Materials and Methods: The medical records of 82 patients who were diagnosed with EOC between 2003 and 2012 and treated by platinum-based chemotherapy were retrospectively evaluated. Expression of EGFR, oestrogen (ER), progesterone (PR), and cerbB2 (HER2) receptors were assessed immunohistochemically on paraffin-embedded tissues of these patients. Three phenotypic subtypes were defined according to ER, PR, and HER2 expression and associations of these with EGFR expression, clinicopathologic features, platinum sensitivity, and survival were investigated. Results: When we classified EOC patients into three subtypes, 63.4% had hormone receptor positive (HR(+)) (considering breast cancer subtypes, luminal A), 18.3% had triple negative, and 18.3% had HER2(+) disease. EGFR positivity was observed in 37 patients (45.1%) and was significantly more frequent with advanced disease (p=0.013). However, no significant association with other clinicopathologic features and platinum sensitivity was observed. HER2(+) patients had significantly poorer outcomes than HER2(-) counterparts (triple negative and HR positive patients) (p=0.019). Multivariate analysis demonstrated that the strongest risk factor for death was residual disease after primary surgery. Conclusions: Triple negative EOC may not be an aggressive phenotype as in breast cancer. The HER2 positive EOC has more aggressive behaviour compared to triple negative and HR(+) phenotypes. EGFR expression is more frequent in advanced tumours, but is not related with poorer outcome. Additional ovarian cancer molecular subtyping using gene expression analysis may provide more reliable data.

Compound K induced apoptosis via endoplasmic reticulum Ca2+ release through ryanodine receptor in human lung cancer cells

  • Shin, Dong-Hyun;Leem, Dong-Gyu;Shin, Ji-Sun;Kim, Joo-Il;Kim, Kyung-Tack;Choi, Sang Yoon;Lee, Myung-Hee;Choi, Jung-Hye;Lee, Kyung-Tae
    • Journal of Ginseng Research
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    • v.42 no.2
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    • pp.165-174
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    • 2018
  • Background: Extended endoplasmic reticulum (ER) stress may initiate apoptotic pathways in cancer cells, and ER stress has been reported to possibly increase tumor death in cancer therapy. We previously reported that caspase-8 played an important role in compound K-induced apoptosis via activation of caspase-3 directly or indirectly through Bid cleavage, cytochrome c release, and caspase-9 activation in HL-60 human leukemia cells. The mechanisms leading to apoptosis in A549 and SK-MES-1 human lung cancer cells and the role of ER stress have not yet been understood. Methods: The apoptotic effects of compound K were analyzed using flow cytometry, and the changes in protein levels were determined using Western blot analysis. The intracellular calcium levels were monitored by staining with Fura-2/AM and Fluo-3/AM. Results: Compound K-induced ER stress was confirmed through increased phosphorylation of $eIF2{\alpha}$ and protein levels of GRP78/BiP, XBP-1S, and $IRE1{\alpha}$ in human lung cancer cells. Moreover, compound-K led to the accumulation of intracellular calcium and an increase in m-calpain activities that were both significantly inhibited by pretreatment either with BAPTA-AM (an intracellular $Ca^{2+}$ chelator) or dantrolene (an RyR channel antagonist). These results were correlated with the outcome that compound K induced ER stress-related apoptosis through caspase-12, as z-ATAD-fmk (a specific inhibitor of caspase-12) partially ameliorated this effect. Interestingly, 4-PBA (ER stress inhibitor) dramatically improved the compound K-induced apoptosis. Conclusion: Cell survival and intracellular $Ca^{2+}$ homeostasis during ER stress in human lung cancer cells are important factors in the induction of the compound K-induced apoptotic pathway.

한국 농촌지역의 임신효율 (Reproductive Efficiency)에 관한 연구 : 충남 서산지역을 중심으로

  • An, Mun-Yeong
    • Journal of agricultural medicine and community health
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    • v.7 no.1
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    • pp.74-79
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    • 1982
  • Recently in Korea, integration of F.P. & MCH programs for effective and efficient implementation of the health programs has been discussed actively. In fact, categorical health workers in fields have been trained and changed as an integrated health workers by government. But one of the most important problems that had to be solved for successful integration of F.P. and MCH programs, is that there must be a common indicator for the evaluation of the two health services (integrated indicator). We regarded reproductive efficiency (=R.E.) that had been proposed by Charlotter M$\ddot{u}$ller et al, as the good integrated indicator. The object of this brief article is to introduce the meaning of reproductive efficiency and to illustrate the usefulnesses of R.E. as the integrated health indicator by applying this indicator to the data from preliminary survey of Seosan demonstration project for integration of F.P. & MCH service supported by WHO. The results and conclusions are as follows 1) Definition of R.E. is the percentage of pregnancies that succeed in production normal, surving children after taking into account the frequency of all measurable types of adverse outcomes (End point for evaluation of survival is one year of age). 2) On the basis of the past pregnant history, reproductive efficiency of the 2,484 eligible women (15-44 years) was roughly 75% (But, in the concept of good births, it is not regarded whether the survived infant is normal health or not). 3) Compared with the results of the other two surveys of the rural area in Korea, reproductive efficiency has been slightly decreased than before, in spite of family planning and MCH services for past 20 years. Because the quantity of increased abortion rate overwhelmed that of the decreased infant mortality rate. 4) Reproductive efficiency has the object for measure many events during the period from the conception (Wanted pregnancy) to an normal surviving children as an 1 year of age. So these heterogenous adversities, ie, induced abortion, still births, spontaneous abortion, neonate & infant death, are aggregated as R.E. However, if the information of these important events and reproductive efficiency were given, R.E. is used as the comprehensive evaluation indicator for F.P. and M.C.H. after meticulous analysis the various components of R.E. 5) Economic loss for adverse outcomes of preg were pregnancy were calculated applying the medical cost at the relatively small sized hospital of small city. Economic loss for 100 cases of adverse outcome is 10,420,000 won, and economic loss for infant death is 46.1% of the total loss. So, it is rational to invest much more effort and than before to MCH programs.

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Detection of PIK3CA Gene Mutations with HRM Analysis and Association with IGFBP-5 Expression Levels in Breast Cancer

  • Dirican, Ebubekir;Kaya, Zehra;Gullu, Gokce;Peker, Irem;Ozmen, Tolga;Gulluoglu, Bahadir M.;Kaya, Handan;Ozer, Ayse;Akkiprik, Mustafa
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.21
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    • pp.9327-9333
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    • 2014
  • Breast cancer is the second most common cancer and second leading cause of cancer deaths in women. Phosphatidylinositol-3-kinase (PI3K)/AKT pathway mutations are associated with cancer and phosphatidylinositol-4, 5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) gene mutations have been observed in 25-45% of breast cancer samples. Insulin growth factor binding protein-5 (IGFBP-5) can show different effects on apoptosis, cell motility and survival in breast cancer. We here aimed to determine the association between PIK3CA gene mutations and IGFBP-5 expressions for the first time in breast cancer patients. Frozen tumor samples from 101 Turkish breast cancer patients were analyzed with high resolution melting (HRM) for PIK3CA mutations (exon 9 and exon 20) and 37 HRM positive tumor samples were analyzed by DNA sequencing, mutations being found in 31. PIK3CA exon 9 mutations (Q546R, E542Q, E545K, E542K and E545D) were found in 10 tumor samples, exon 20 mutations (H1047L, H1047R, T1025T and G1049R) in 21, where only 1 tumor sample had two exon 20 mutations (T1025T and H1047R). Moreover, we detected one sample with both exon 9 (E542Q) and exon 20 (H1047R) mutations. 35% of the tumor samples with high IGFBP-5 mRNA expression and 29.4% of the tumor samples with low IGFBP-5 mRNA expression had PIK3CA mutations (p=0.9924). This is the first study of PIK3CA mutation screening results in Turkish breast cancer population using HRM analysis. This approach appears to be a very effective and reliable screening method for the PIK3CA exon 9 and 20 mutation detection. Further analysis with a greater number of samples is needed to clarify association between PIK3CA gene mutations and IGFBP-5 mRNA expression, and also clinical outcome in breast cancer patients.

Intermediate and Long Term Results for Extracardiac Conduit Repair Between Right Ventricle and Pulmonary Artery in Congenital Cardiac Defect (선천성 심장기형의 우심실-폐동맥 인조혈관 연결 수술후 중장기 성적)

  • 조범구
    • Journal of Chest Surgery
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    • v.28 no.6
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    • pp.571-578
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    • 1995
  • Rastelli operation in which right ventricle[RV and pulmonary artery[PA is connected with an artificial graft is effective in increasing the pulmonary blood flow in certain types of congenital heart disease but, in many, it requires a reoperation because of the relative stenosis of graft that develops as the patients become old. The purpose of this study is to evaluate the various factors which many influence the long term outcome of such patients following a Rastelli operation. A total of 47 patients underwent a Rastelli operation during a 15 year period between November, 1978 and October 1993. The mean follow-up period is 76.1 51.3 months.1 Among the 47 patients, a valved conduit was used in 30[63.8% , and non-valved conduit in 17[36.2% patients. In the 8 patients[17.0% who died postoperatively, a valved conduit was used in 5 [16.6% and a non-valved conduit in 3[17.6% . There was no statistical difference in mortality between the 2 groups. There was a good linear correlation between the body surface area[X and the conduit size[Y [Y=3.86X + 14.6, R=0.55, P=0.01 .2 Ten patients underwent replacement of the conduit during the follow-up period. The type of conduit used and the frequency of subsequent replacement were as follows: Ionescu-Shiley, valved-33.3%, Carpentier-Edwards, valved-30.8%, Hancock, valved-80% and non-valved conduit-9.1%. The median period free of reoperation was 110 months for the valved and 79 months for the non-valved group, there being no statistical difference between the 2 groups. 3 The patients who did not require reoperation are all doing well [New York Heart Association Functional Classification: Class I . Pressure gradient between the RV and the PA was 20 mmHg in 10 randomly selected patients who did not require reoperation and 92 9 mmHg in 10 patients who did require reoperation.4 In the 10 patients who underwent a conduit replacement procedure.5 Among patients undergoing reoperation, 2 died from endocarditis.The remaining 8 patients are doing well without limitation in physical activity at a mean follow-up period of 32.7 33.9 months [range 2 to 89 months . 6 At 5, 7, and 10 years, the reoperation-free rates among all patients were 96%, 91% and 29% and the survival rates were 82%, 82% and 71%. In conclusion, Rastelli operation is an effective procedure in ameliorating symptoms in a select group of patients with congenital heart disease. Because of the inherent nature of relative graft stenosis and degeneration, a long-term follow-up is required under the proper selection of the graft material.

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A Study on the Divorce Experienced by Marriage Immigrant Women (결혼이주여성 이혼경험 연구)

  • Park, Mijeong;Um, Myungyong
    • Korean Journal of Social Welfare
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    • v.67 no.2
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    • pp.33-60
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    • 2015
  • The purpose of this study was to analyze the life experiences of fifteen marriage immigrant Asian women who went through running away from their home countries, marrying with Korean men, divorcing from their husbands, and coping with many difficulties after their divorce in Korean society. In order to conduct this study grounded theory methods have been employed. The central phenomenon digged out from this study was 'resistance to baffled reality' (i. e. dislocation). The causal conditions which brought about the central phenomenon were 'escaping for survival' and 'experiencing the gap between reality and expectation. 'The intervening conditions included 'getting to know the reality of their husbands,' 'losing hope,' and 'not being able to pull themselves together.' The contextual conditions consisted of 'being treated as maids,' 'becoming victims of family violence,' 'making up their minds to survive,' 'securing future life,' 'being marginalized,' and 'being aware of themselves as strangers.' The action/interaction strategies on the central phenomenon were 'building support systems,' 'building up will for new life,' and 'reconstructing social identity.'The final outcome was 'arranging places of new settlement.' The divorce was classified as four types: 'coping and growth,' 'emancipation and settling down,' 'being overwhelmed by livelihood,' and 'continuous wandering.' Based on these results, this study provided a few political and practice suggestions to prevent family violence and divorces among multi-cultural families, and also to bumper the impacts of divorce.

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Presentation of Retinoblastoma Patients in Malaysia

  • Subramaniam, Shridevi;Rahmat, Jamalia;Rahman, Norazah Abdul;Ramasamy, Sunder;Bhoo-Pathy, Nirmala;Pin, Goh Pik;Alagaratnam, Joseph
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7863-7867
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    • 2014
  • Background: Retinoblastoma is a rare type of cancer that usually develops in early childhood. If left untreated it can cause blindness and even death. The aim of this study is to determine sociodemographic and clinical features of retinoblastoma patients and also to determine the treatment pattern and outcome in Malaysia. Materials and Methods: Data for this study were retrieved from the Retinoblastoma Registry of the National Eye Database (NED) in Malaysia. Hospital Kuala Lumpur, Hospital Umum Kuching, Sarawak and Hospital Queen Elizabeth, Kota Kinabalu were the major source data providers for this study. Data collected in the registry cover demography, clinical presentation, modes of treatment, outcomes and complications. Results: The study group consisted of 119 patients (162 eyes) diagnosed with retinoblastoma between 2004 and 2012. There were 68 male (57.1%) and 51 (42.9%) female. The median age at presentation was 22 months. A majority of patients were Malays (54.6%), followed by Chinese (18, 5%), Indians (8.4%), and indigenous races (15.9%). Seventy six (63.8%) patients had unilateral involvement whereas 43 patients had bilateral disease (36.1%). It was found that most children presented with leukocoria (110 patients), followed by strabismus (19), and protopsis (12). Among the 76 with unilateral involvement (76 eyes), enucleation was performed for a majority (79%). More than half of these patients had extraocular extension. Of the 40 who received chemotherapy, 95% were given drugs systemically. Furthermore, in 43 patients with bilateral involvement (86 eyes), 35 (41%) eyes were enucleated and 17 (49%) showed extraocular extension. Seventy-two percent of these patients received systemic chemotherapy. The patients were followed up 1 year after diagnosis, whereby 66 were found to be alive and 4 dead. Sixteen patients defaulted treatment and were lost to follow-up, whereas follow-up data were not available in 33 patients. Conclusions: Patients with retinoblastoma in this middle-income Asian setting are presenting at late stages. As a result, a high proportion of patients warrant aggressive management such as enucleation. We also showed that a high number of patients default follow-up. Therefore, reduction in refusal or delay to initial treatment, and follow-up should be emphasized in order to improve the survival rates of retinoblastoma in this part of the world.

Clinical Outcome of Parosteal Osteosarcoma (방골성 골육종의 임상결과)

  • Song, Won Seok;Jeon, Dae-Geun;Cho, Wan Hyeong;Kong, Chang Bae;Cho, Sang Hyun;Lee, Kwang Ryul;Lee, Soo-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.19 no.1
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    • pp.20-27
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    • 2013
  • Purpose: The purpose of this study was to evaluate the oncologic outcomes of parosteal osteosarcoma (POS) and to ascertain the fates of patients after local recurrence (LR). Materials and Methods: The authors retrospectively reviewed 22 POS patients with an average follow-up of 114 months (range: 36-235 months). Seven of the 22 patients were referred after LR. There were 17 Stage IB and 5 Stage IIB (G2, 2; dedifferentiation, 3). Tumors were located in the femur (11) and in other locations (11). Initial surgical margins were wide in 10, marginal in 5, and intralesional in 7. Correlations between clinico-pathologic variables and LR and clinical courses after LR were evaluated. Results: The 10-year overall survival rate was 85.7%. Three (14%) patients developed distant metastasis and all of them succumbed to the disease. Nine (41%) patients developed LR. Tumor location, resection type, and surgical margin were found to be correlated with LR. At final follow-up, 7 of the 9 patients that experienced local failure achieved no evidence of disease. Conclusion: A substantial risk of misdiagnosis exists, especially for POS in other than a femoral location. Recurrent tumor re-excision is possible in most cases; however, patients with an aggressive recurrence pattern deserve special attention.