• Asian Pacific Journal of Cancer Prevention
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• v.13 no.5
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• pp.1809-1817
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• 2012

Background: Gastric cancer is frequently lethal despite aggressive multimodal therapies, and new treatment approaches are therefore needed. Retinoids are potential candidate drugs: they prevent cell differentiation, proliferation and malignant transformation in gastric cancer cell lines. They interact with nuclear retinoid receptors (the retinoic acid receptors [RARs] and retinoid X receptors [RXRs]), which function as transcription factors, each with three subclasses, ${\alpha}$, ${\beta}$ and ${\gamma}$. At present, little is known about retinoid expression and influence on prognosis in gastric cancers. Patients and Methods: We retrospectively analyzed the expression of the subtypes RARa, $RAR{\beta}$, $RAR{\gamma}$, RXRa, $RXR{\beta}$, $RXR{\gamma}$ by immunohistochemistry in 147 gastric cancers and 51 normal gastric epithelium tissues for whom clinical follow-up data were available and correlated the results with clinical characteristics. In addition, we quantified the expression of retinoid receptor mRNA using real-time PCR (RT-PCR) in another 6 gastric adenocarcinoma and 3 normal gastric tissues. From 2008 to 2010, 80 patients with gastric cancers were enrolled onto therapy with all-trans-retinoic acid (ATRA). Results: RARa, $RAR{\beta}$, $RAR{\gamma}$ and $RXR{\gamma}$ positively correlated with each other (p < 0.001) and demonstrated significantly lower levels in the carcinoma tissue sections (p < 0.01), with lower $RAR{\beta}$, $RAR{\gamma}$ and RXRa expression significantly related to advanced stages (p < =0.01). Tumors with poor histopathologic grade had lower levels of RARa and $RAR{\beta}$ in different histological types of gastric carcinoma (p < 0.01). Patients whose tumors exhibited low levels of RARa expression had significantly lower overall survival compared with patients who had higher expression levels of this receptor (p < 0.001, HR=0.42, 95.0% CI 0.24-0.73), and patients undergoing ATRA treatment had significantly longer median survival times (p = 0.007, HR=0.41, 95.0% CI 0.21-0.80). Conclusions: Retinoic acid receptors are frequently expressed in epithelial gastric cancer with a decreased tendency of expression and RARa may be an indicator of a positive prognosis. This study provides a molecular basis for the therapeutic use of retinoids against gastric cancer.

• Korean Journal of Clinical Pharmacy
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• v.25 no.2
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• pp.68-73
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• 2015

With the changes in the pharmacy curriculum from a 4 year program to a 6 year program in 2009, a new subject called Pharmacy Practice Experience (PPE) has been launched into the curriculum. The purpose of introducing this subject is to increase the competency of new pharmacy graduates in providing quality healthcare to the community. This study has been done, via comparison among different pharmacy schools in Canada and Korea, to ensure that the competency of future Korean pharmacists can be increased with the introduction of this subject. In general, the Introductory Pharmacy Practice Experience (IPPE) in Korea consists of 60 hours while Canada consists of 320 hours (minimum). Furthermore, the Advanced Pharmacy Practice Experience (APPE) required in Korea is 1340 hours while Canada requires minimum of 960 hours. Specifically, comparing the Korean PPE curriculum to the PPE curriculums of University of Toronto (UT) and University of Waterloo (UW), UT and UW required a minimum of 75% and 89% direct clinical patient care experience respectively, either in hospital or community setting, compared to 45% in Korea; the remaining percentage in any of the universities can be fulfilled by taking other electives that may not require direct patient care experience. Observing these differences, it seems clear that the current PPE experience in Canada takes more of a patient focused approach than in Korea. Thus, with the recent movement in the Korean pharmacy community towards a more patient focused approach rather than a product focused approach, it would be beneficial to learn the differences between the PPE curriculums in Korea and Canada and apply any new understandings to the relatively newly introduced PPE program in Korea to further enhance the value of the new curriculum in helping to deliver quality patient care.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.211-216
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• 2012

Background: Patients' demographics, presenting clinical and histopathological features for colo-rectal cancer (CRC) are important factors for patients' outcome and disease prognosis. This study aimed to describe the pattern of CRC in terms of patients' demographics, main presenting symptoms and histopathological features in Al Hassa region of Saudi Arabia. Subjects and Methods: A retrospective hospital records-based study which included reviewing of patients' records diagnosed with CRC at three general hospitals in Al Hassa region, Saudi Arabia. A compilation form was designed to collect information regarding socio-demographics, age at diagnosis; referral sites and the main presentations at CRC diagnosis. sites and the main presentations at CRC diagnosis. Histopathological reports were reviewed to delineate the main cytopathologic features, prominent cytological characteristics, the presence of predisposing pathology, and disease stage. Results: Of the 142 cases with CRC, 15.5% and 33.1% were affected before 40 and 50 years of age respectively. Emergency rooms were main referral sites for CRC cases (31.0%). Right colon was affected in 16.9% while left colonic lesions accounted for 62.7%. Intestinal obstruction was the main presentations (41.5%), and 26.1% presented with symptoms indicating distant metastastic lesions. Adenocarcinoma was the predominant pathological lesions (86.6%). Metastastic CRC was diagnosed in 62.7%. Duke's staging showed that 22.5% and 40.1% of lesions were classified into C and D categories respectively. Conclusion: Saudi patients with CRC present late with distant metastasis, and advanced disease stage. A sizeable proportion of patients developed the lesions at relatively young age. Screening recommendations should be enacted and revised in response to current change with younger age of affection.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.5
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• pp.2695-2697
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• 2016

Background: Gastric cancer, the fifth most common malignancy in the world, usually affects older individuals but can occur in younger age groups. In this study we compared the clinicopathological profile of young patients of gastric cancer with that of older patients. Materials and Methods: It is a prospective study of gastric cancer patients treated over three year period (January 2012 to December 2014). Data of patients were obtained from the medical record. Clinical and pathological characters of younger patients (age 40 years or less) were compared with older patients (age more than 40 years). Results: There were total of 152 patients treated during the study period. Twenty patients (13.2%) were less than 40 years of age and 132 (86.8%) were older. The male to female ratio in younger patients was 1:1.5 whereas in older patients it was 1:0.6. In the younger age group 14 patients (70%) had poorly differentiated adenocarcinoma in contrast to 45% in the older age group (p<0.01). Some 55% of younger and 42% of older patients had stage IV disease at presentation and curative surgery was not possible. Palliative surgery for gastric outlet obstruction or bleeding from the tumor was performed on 25% and 21% respectively. Conclusions: Gastric cancer in young people aged less than 40 years has unique characters like female predominance, unfavorable tumor biology, and advanced stage at presentation. There should be a high index of suspicion of gastric cancer even in young patients.

• The Korean Journal of Pain
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• v.13 no.2
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• pp.224-231
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• 2000

Background: Currently, the number of patients visiting pain clinics is increasing with the augmented concerns of the patients about management of pain. We conducted this study in order to comprehend the characteristics of the patients visiting pain clinics and to find a method to further raises the public's awareness about pain treatment. Methods: We surveyed 497 new patients who had visited pain clinic of Kyungpook national university hospital from August 1998 to July 1999. We analysed these patients about their age, sex, chief complaint, duration of pain complaints, resident district, educational level and route of visiting pain clinic by use of questionnaire. Results: In age distribution, the largest proportion (29.8%) were in their 60's. Low back pain was the most common chief complaint (33.0%), the highest (43.7%) percentage of patients had complained of pain for over 6 months. Two thirds of the patients lived in urban area. Patients who were educated to only elementary school level made up the largest group with 35.3%. Referrals from former patients who had visited our pain clinic and had received treatment. Conclusions: As increasing patients who have pain complaints are related to social advanced age, it is prudent to consider the characteristics of age related pain complaints. And we have to guide the pain patients to have more earlier treatments using mass media because there is still insufficient general information about pain clinic and pain managements.

• Journal of the Korea Convergence Society
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• v.11 no.6
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• pp.311-318
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• 2020

This was a basic study to ascertain the changes in sleep patterns and the factors disrupting sleep in hospitalized children. The participants were children aged 6 years or younger who had been hospitalized in an advanced general hospital in a particular region. A total of 81 participants were included, and for data analysis using SPSS/WIN 21.0. The results showed that children's sleep duration decreased significantly after hospitalization compared to before (p<.001), and there were significant differences in sleep onset latency (p<.001) and frequency of sleep deprivation (p<.001). Factors perceived by the children's mothers to disrupt sleep included the child's health state, noise in the ward, nurses' treatments, and lighting in the ward. This study verified that children's sleep quality and duration decreases during hospitalization, demonstrating the need to prepare measures to improve sleep in hospitalized children based on an understanding of changes in sleep patterns and disrupting factors.

• Journal of Oral Medicine and Pain
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• v.40 no.4
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• pp.155-162
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• 2015

Purpose: The association between pain and sleep is described as a vicious cycle and psychological distress is well known as comorbid condition in the patients with pain and sleep problems. The aim of the study was to evaluate the prevalence of self-reported sleep disturbance and its relationship to clinical and psychological profiles in temporomandibular disorder (TMD) patients. Methods: The sample consisted of 123 TMD patients (90 women and 33 men), with a mean age of $39.9{\pm}15.4years$. Self-report measures of sleep quality, pain and psychological profile were conducted via the Pittsburgh Sleep Quality Index (PSQI), the Brief Pain Inventory and the Symptom Checklist-90-Revision at the initial visit. The primary diagnosis of TMD were categorized as TMD with internal derangement without pain, TMD with joint pain, TMD with muscle pain and TMD with joint-muscle combined pain. The chi-square test, independent t-test, oneway ANOVA and multiple linear regression analysis were used for statistics. Results: The patients was grouped as good sleepers (n=32, scores of 5 and lower) and poor sleepers (n=91, scores of 6 and higher) according to the recommended cutoff point of the global PSQI score (>5). TMD patients with pain showed poor sleep quality than TMD patients with internal derangement without pain. Poor sleepers had high pain interference and elevated psychological distress. Among them, pain interference and depression were significant predictors to sleep quality. Conclusions: The results suggest that sleep disturbance is a prevalent complaint in TMD patients, and sleep problems in TMD patients are associated with pain and psychological distress.

• Journal of Gastric Cancer
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• v.1 no.1
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• pp.24-31
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• 2001

Purpose: Despite knowledge of the adverse effects of resection-line disease, surgeons continue to perform inadequate resections. This demonstrates the need for a more aggressive approach to assessment of resection margins at operation. Materials and Methods: Seven hundred fifteen gastric cancer patients who were operated on at our hospital from 1992 to 1998 were included in this analysis. Various clinicopathological factors, including resection-line involvement, were ascertained from the surgical and histopathological records. Results: Of the 715 evaluable patients, 27 patients ($3.8\%$) had involvement of one or both resection lines; in 10 patients the proximal resection line only, in 16 the distal resection line only, and 1 both resection lines were involved. Presence of resection-line involvement was significantly associated with T3 and T4 stage, N (+) stage, M (+) stage, type of operation (total gastrectomy), tumor location (entire stomach), size$\geq$11 cm), and gross type of tumor (Borrmann 4 type). When performing a distal subtotal gastrectomy, no involvement was found when the cranial and caudal distances between the lesion and the line of transection was equal to or greater than 2 cm and 3 cm, respectively, for early cancer and 7 cm and 3 cm, respectively, for advanced cancer. When performing a total gastrectomy for upper 1/3 or middle 1/3 gastric cancer, no involvement was found when the cranial distances between the lesion and the line of transection were equal to or greater than 3 cm and 4 cm, respectively, without distinction of the presence of serosal invasion. Conclusions: The difference in survival between positive and negative margin patients is limited to the group of patients with curative surgery. An important principle of treatment is that the entire tumor must be removed with a 3 cm distal margin and a 2- to 7 cm margin depending on the location and the depth of wall invasion of the tumor, to provide histologically negative margins.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.5
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• pp.2299-2304
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• 2012

Since there is evidence that human papillomavirus (HPV) may play some role in oral carcinogenesis, we investigated the presence of HPV in a group of Pakistani subjects with normal oral cavity using real-time PCR analysis. Two-hundred patients attending the Dental Department, Sandaman Provincial Hospital, Balochistan, Pakistan, were recruited. After interview, oral epithelial cells were collected by scraping and subjected to DNA extraction. The HPV-positive DNA samples were further analyzed using primer sets specific for HPV-16 and -18. It was found that out of 200 DNA samples, 192 were PCR-positive for the ${\beta}$-globin gene and these were subsequently examined for the presence of HPV DNA. Among these, 47 (24.5%) were HPV-positive with the virus copy number ranged between 0.43-32 copies per 1 ${\mu}g$ of total DNA (9-99 copies per PCR reaction). There were 4 and 11 samples containing HPV-16 and -18, respectively. Additionally, one sample harbored both types of HPV. Among the investigated clinical parameters, smoking habit was associated with the presence of HPV (p = 0.001) while others indicated no significant association. The prevalence of HPV in normal oral cavity in our Pakistani subjects appears to be comparable to other studies. However, the association between the presence of HPV and smoking warrants further investigations whether both of these factors can cooperate in inducing oral cancer in this group of patients.

• Health Policy and Management
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• v.19 no.1
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• pp.49-61
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• 2009

Background: The appropriate management of diabetes mellitus(DM) can help reduce its relapse and economic burden, but the level of management of DM in Korea is reported to be insufficient. This study aims to identify the management level of DM by figuring out the HbA1c examination performance rate of the diabetics and analyzing the variation according to the characteristic of a diabetic. Methods: This study used the Korean National Health Insurance Database which includes E10-14(ICD-10 code) as a primary or secondary disease as of 2006. Study population is 1,892,062 diabetics excluding 393,784 patients with the first attack of DM in 2006, 33,440 diabetics who died in 2006, and 21,299 patients with DM having no record of ambulatory care among the 2,340,585 DM patients in total. Results: The HbA1c examination performance rate of all DM patients in our country is estimated to be 41.5% as of 2006 and shows variation according to the characteristic of individual DM patients. The highest performance odds was shown by the patients who were below 19 of age, insured for health insurance, attended more than 3 ambulatory care providers, made ambulatory care visits more than 10 times annually, attended a specialized general hospital as their main attending medical institution, had a record of hospitalization or had co-morbidity. Conclusion: This study propose that is necessary to make politic preparations for the appropriate management of diabetes at a national level, and particularly, the patients with advanced age, the ones dependent on Medical Aid, and the ones using hospitals or clinics, whose appropriate management seems vulnerable, demand a careful management.