Although survival rates are very useful for monitoring the effects of early cancer detection and treatment, at present there are only limited population-based estimates of long-term survival rates in Korea. Furthermore, published data are only available for 5-year survival; 10-year survival rates have hitherto not been reported. We therefore analysed data from the Korean National Cancer Incidence Database between 1993 and 2007 and followed through into 2008 to estimate long-term survival rates and trends at 5 and 10 years after diagnosis of all cancers combined. Further analysis was conducted on the 19 most common cancers in Korea. From 1993 to 2007, the 10-year relative survival rates (RSRs) for all cancer types combined were 36.3% and 56.4% in Korean men and women, respectively. The 10-year RSRs for all cancers combined improved from 29.5% and 50.5% during 1993-1998 to 39.2% and 58.9% during 1999-2007 in Korean men and women, respectively. From 1993 to 2007, the 5-year and 10-year RSRs thus improved in both sexes for the most common cancers. In the 75 years and older group, increases of the 5-year and 10-year RSR for all combined, and for most of the major cancers were lower than all other age groups. This study provides population-based estimates of long-term survival and confirms improvements of long-term survivals for all cancer sites and for most of the major cancer sites. Improvements of survival for young patients are more significant than for older patients. The results may help clinicians and patients assess long-term prognosis.
This study was conducted to evaluate whether or not tumor spread and the diagnostic process in non-small cell lung cancer (NSCLC) is different based on smoking history.Associations between smoking status and clinical presentation were evaluated controlling for the effect of histology. Lung cancer with delayed diagnosis (LCDD) and incidental detection (LCID) were determined based on medical records.Of 914 patients, frequency of distant metastases was more common in never-smokers than in smokers (59% and 36%, respectively; P<0.001). Although never-smokers were more likely to have LCDD than smokers (18% and 11%, respectively; P=0.038), LCDD were not significantly associated with frequency of distant metastases [49% (LCDD) vs. 42% (non-LCDD); P=0.189] as well as tumor [29% (T3-4) vs. 24% (T1-2); P=0.134] and node [43% (N2-3) vs. 44% (N0-1); P=0.838] stage. Interestingly, never-smokers are more likely to have LCID than smokers (31% and 19%, respectively; P=0.010). In survival analysis, LCID (P=0.001; HR, 0.63) remained a prognostic factor, while LCDD did not.This study suggests distinct metastatic pattern and diagnostic processes of never-smokers. The link between survival and incidental detection was also indicated.
Objective: To analyze the relationship of clinical factors and gait parameters of patients with failed back surgery syndrome. Method: We investigated 25 male patients with back and /or lower limb pain who underwent lumbar spine operation. The following data were evaluated: clinical symptoms, physical examination, duration from operation to the gait analysis, number and level of operation, Visual Analogue Scales (VAS), modified Dallas pain questionnaire, psychological evaluations (Beck Depression Inventory, BDI) and gait parameters through 3 dimensional gait analysis. Results: Walking velocity was inversely correlated with scores of modified Dallas pain questionnaire and BDI. Stride length was inversely correlated with scores of return to work, neurogenic claudication, VAS, modified Dallas pain questionnaire and BDI. Range of pelvic obliquity was inversely correlated with scores of modified Dallas pain questionnaire and BDI. There was no significant differences between findings of physical exam and gait parameters. Conclusion: Results of the gait analysis of patients with failed back surgery syndrome showed significant relationship with clinical factors reflecting psychosocial background of patients.
Early-life experiences play a crucial role in the development of the fronto-limbic regions, influencing both macro- and microstructural changes in the brain. These alterations profoundly impact cognitive, social-emotional functions. Recently, early limbic structural alterations have been associated with numerous neurological and psychiatric morbidities. Although identifying normative developmental trajectories is essential for determining brain alterations, only a few studies have focused on examining the normative trajectories in the fronto-limbic regions during preschool-aged children. The aim of this study was to investigate the structural-developmental trajectory of the fronto-limbic regions using the cortical thickness, volume, and subcortical volume in 57 healthy and typical preschool-aged children between 1 and 5 years and examined the early lateralization patterns during the development of the fronto-limbic regions. Regarding brain lateralization, remarkable asymmetry was detected in the volume of thalamus and the cortical regions excluding the lateral orbitofrontal cortex in the fronto-limbic regions. This study of preschool-aged children may fill the knowledge gaps regarding the developmental patterns and hemispheric asymmetries of the fronto-limbic regions between newborns and adolescents.
The presence of severe pulmonary arterial hypertension (PAH) in patients with atrial septal defect (ASD) is still thought to preclude shunt closure, although there are several reports of good clinical outcomes after vasodilator therapy. We report the case of a young woman with ASD and severe PAH who was able to successfully undergo percutaneous shunt closure following 1 year use of the oral endothelin receptor antagonist, bosentan.
Branch duct intraductal papillary mucinous neoplasms of the pancreas (BD-IPMN) showed good prognosis. However, invasive carcinoma is more aggressive than that derived from main duct-type IPMN, once invasive morphological change takes place. We report three patients with invasive carcinoma derived from BD-IPMN who showed grave clinical courses. The patients` medical records and image studies were retrospectively analyzed based on clinical symptoms, biochemical data, and hospital courses. All patients were diagnosed as BD-IPMN without any malignant stigmata by MRCP, EUS, or abdominal CT scan at the initial diagnosis. Invasive ductal adenocarcinoma was detected at 3.2, 3.6, and 4.1 years later in each patient. All patients showed locally advanced invasive ductal adenocarcinoma and pathologic diagnosis was done by EUSFNA in 2 patients and brush cytology by ERCP in one patient. All patients were treated with only conservative management and they died at 2, 3, and 6 months after the diagnosis of invasive ductal adenocarcinoma. Further studies are needed about proper follow up interval and identifi cation of risk factors in the patients with BD-IPMN of the pancreas. Metachronous or transformed invasive ductal carcinoma from BD-IPMN are not rare and they showed aggressive clinical course.
Background/Aims Sleep duration affects health in various ways. The objective of this study was to investigate the associations of sleep duration with chronic kidney disease (CKD) in a Korean adult population. Methods This cross-sectional analysis was conducted for total of 1,360 participants who completed baseline health examinations for the Korean Genome and Epidemiology Study-Kangwha study in 2010 to 2011. Sleep habits were measured by an interviewer-assisted questionnaire. Sleep duration was calculated based on the number of hours per day participants had slept over the past 1 year. CKD was defined as either proteinuria or estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2. Multiple logistic regression models were applied to examine associations between sleep duration and CKD. Results Women with very long sleep duration (≥ 9 hours/day) were at significantly increased odds for having high serum creatinine (odds ratio [OR], 2.936; 95% confidence interval [CI], 1.176 to 7.326), low eGFR (OR, 3.320; 95% CI, 1.372 to 8.034), and CKD (OR, 3.112; 95% CI, 1.315 to 7.363), compared those with a typical sleep duration (7 to < 8 hours/day), after adjusting for sociodemographic status, socioeconomic status, health behaviors, comorbidities, and sleep quality. Among women, for every 1 hour increase in sleep duration per day, there was a 24.6% increase in the presence of CKD (OR, 1.246; 95% CI, 1.019 to 1.523). However, among men, sleep duration was not significantly associated with CKD. Conclusions Very long sleep duration was independently associated with a higher prevalence of CKD among Korean women. Gender may influence this association.
Purpose To estimate the current cancer burden in Korea, cancer incidence and mortality rates were projected for the year 2012. Materials and Methods The cancer incidence data from 1999 to 2009 were obtained from the Korea National Cancer Incidence Database, and the cancer mortality data from 1993 to 2010 were obtained from Statistics Korea. Cancer incidence in 2012 was projected by fitting a linear regression model on observed age-specific cancer incidence rates against observed years, then multiplying the projected age-specific rates by the age-specific population. For cancer mortality, a similar procedure was applied, except that a Joinpoint regression model was used to determine at which year the linear trend significantly changed. Results A total of 234,727 new cancer cases and 73,313 cancer deaths are projected to occur in Korea in 2012. For all sites combined, the crude incidence rates are projected to be 465.6 and 459.7, and the age-standardized incidences to be 345.1 and 300.9 per 100,000 respectively for males and females. Conclusion Cancer has become an important public health concern in Korea, and as the Korean population ages, the cancer burden will continue to increase. Key words: Incidence, Mortality, Neoplasms, Prediction, Korea, 2012
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