Ki, Young-Jun;Ji, Sun-Hee;Min, Jae Seok;Jin, Sung-Ho;Park, Sunhoo;Yu, Hang-Jong;Bang, Ho-Yoon;Lee, Jong-Inn
Journal of Gastric Cancer
/
v.13
no.4
/
pp.214-225
/
2013
Purpose: Peritoneal lavage cytology is part of the routine staging workup for patients with advanced gastric cancer. However, no quality assurance study has been conducted to show variations or biases in peritoneal lavage cytology results. The aim of this study was to demonstrate a test execution variation in peritoneal lavage cytology between investigating surgeons. Materials and Methods: A prospective cohort study was designed for determination of the positive rate of peritoneal lavage cytology using a liquid-based preparation method in patients with potentially curable advanced gastric cancer (cT2~4/N0~2/M0). One hundred thirty patients were enrolled and underwent laparotomy, peritoneal lavage cytology, and standard gastrectomy, which were performed by 3 investigating surgeons. Data were analyzed using the chi-square test and a logistic regression model. Results: The overall positive peritoneal cytology rate was 10.0%. Subgroup positive rates were 5.3% in pT1 cancer, 2.0% in pT2/3 cancer, 11.1% in pT4a cancer, and 71.4% in pT4b cancer. In univariate analysis, positive peritoneal cytology showed significant correlation with pT stage, lymphatic invasion, vascular invasion, ascites, and the investigating surgeon. We found the positive rate to be 2.1% for surgeon A, 10.2% for surgeon B, and 20.6% for surgeon C (P=0.024). Multivariate analysis identified pT stage, ascites, and the investigating surgeon to be significant risk factors for positive peritoneal cytology. Conclusions: The peritoneal lavage cytology results were significantly affected by the investigating surgeon, providing strong evidence of test execution variation that could be related to poor diagnostic accuracy and stage migration in patients with advanced gastric cancer.
Chronic pain is one of the leading causes of hospital visits. It not only affects the patients themselves but also has a major negative impact on their families and society. In this study, we investigated epidemiology of musculoskeletal disorders induced chronic pain among general population based on Korea National Health and Nutrition Examination Survey database and also analysed how it influenced on the use of medical services. This study was done by using the data of 5th Korea National Health and Nutrition Examination Survey (KNHANES V), taking aged 20 years and over adults as research subjects. The EuroQoL-5 Dimension Index(EQ-5D) was used as a survey instrument. T-test, chi-square test and multivariate logistic regression were used for statistical analysis. Subjects with chronic pain had a higher likelihood than control group to use medical services(odds ratio : 5.858, confidence interval 3.636-9.438). Controlling for existence of chronic pain, more women were likely to use medical services than men(1.156, 0.707-1.889). Age, gender and household income level did not affect the use of medical services. Proper control of chronic pain is very helpful in improving patient's quality of life and it also accounts for a large proportion in suppressing excessive consumption of medical services. Anesthesia and pain medicine specialists have superior knowledge about analgesics and anticonvulsants than other physicians do and also have specialized skills to perform procedures like nerve blocks in treating chronic pain. Therefore Anesthesia and pain medicine specialists need to play a leading role in managing chronic pain.
This cross-sectional study assessed household food insecurity among low-income rural communities and examined its association with demographic and socioeconomic factors as well as coping strategies to minimize food insecurity. Demographic, socioeconomic, expenditure and coping strategy data were collected from 200 women of poor households in a rural community in Malaysia. Households were categorized as either food secure (n=84) or food insecure (n=116) using the Radimer/Cornell Hunger and Food Insecurity instrument. T-test, Chi-square and logistic regression were utilized for comparison of factors between food secure and food insecure households and determination of factors associated with household food insecurity, respectively. More of the food insecure households were living below the poverty line, had a larger household size, more children and school-going children and mothers as housewives. As food insecure households had more school-going children, reducing expenditures on the children's education is an important strategy to reduce household expenditures. Borrowing money to buy foods, receiving foods from family members, relatives and neighbors and reducing the number of meals seemed to cushion the food insecure households from experiencing food insufficiency. Most of the food insecure households adopted the strategy on cooking whatever is available at home for their meals. The logistic regression model indicates that food insecure households were likely to have more children (OR=1.71; p<0.05) and non-working mothers (OR=6.15; p<0.05), did not own any land (OR=3.18; p<0.05) and adopted the strategy of food preparation based on whatever is available at their homes (OR=4.33; p<0.05). However, mothers who reported to borrow money to purchase food (OR=O.84; p<0.05) and households with higher incomes of fathers (OR=O.99; p<0.05) were more likely to be food secure. Understanding the factors that contribute to household food insecurity is imperative so that effective strategies could be developed and implemented.
The results of our study will help develope the education programs for a child-care teacher. The study was conducted to investigate the job request questionnaire. The subjects of the questionnaire were 257 people who are teachers, directors of child care centers and students. Frequency analysis, t-test, Chi-square, ANOVA, and Sch$\acute{e}$ffe were used to analyze the questionnaire as statistical tools. Firstly, public child care centers positively recruit teachers who graduate from college and consider their ability and sincerity to be the most important factors. Secondly, directors and teachers in public child care centers tend to consider preparing education, advice with child's parents, and managing facility the most important duties. Based on the results, the development of the education program will be focused on the child care field.
Congenital diaphragmatic hernia (CDH) in the past was considered a surgical emergency requiring immediate operation. Several groups now advocate preoperative stabilization and delayed surgery. The treatment strategy for CDH in this institution is delayed surgery after preoperative stabilization. The aim of this study was to evaluate the results of delayed surgery. A retrospective review of 16 neonates with CDH was performed. Surfactant. conventional mechanical ventilation. high frequency oscillation. and nitric oxide were utilized for preoperative stabilization as necessary. The difference in outcome between two groups differentiated by the duration of the preoperative stabilization periods with mechanical ventilation (${\leq}$ 8 hours and > 8 hours) was determined. Chi-square test was used to analyze the data. There were 7 right-sided hernias and 9 left. The average duration of stabilization was 32.4 hours. Hepatic herniation through the defect was found in 6 cases and all died. The most common postoperative complication was pneumothorax. The mortality rate of the right side hernia was higher than the left (85.7% vs. 33.3%. p=0.036). Mortality rate of the group (N=8) whose preoperative stabilization period was 8 hours or less was better than that (N=6) whose preoperative stabilization period was more than 8 hours (25.0% vs. 83.3%. p=0.031). The overall mortality rate was 56.3%. The better prognosis was noticed in left side hernia. no liver herniation, or shorter preoperative stabilization period.
Cancer is a multi-factorial disease and variation in genetic susceptibility, due to inherited differences in the capacity to repair mismatches in the genome, is an important factor in the development of gastric cancer (GC), for example. Epigenetic changes, including aberrant methylation of 5/CpG islands in the promoter regions of mismatch repair (MMR) genes like hMLH1, have been implicated in the development of various types of GC. In the present study we evaluated the role of hMLH1 promoter hypermethylation in Kashmiri GC patients and controls, and assessed correlations with various dietary and lifestyle factors. The study included 70 GC patients (56 males and 14 females; age ($mean{\pm}S.D$) $50{\pm}11.4$ years). Distinction between methylated and unmethylated was achieved with MS-PCR and DNA band patterns. The Chi-square test was applied to assess the risk due to promoter hypermethylation. We found a strikingly high frequency of promoter hypermethylation in GC cases than in normal samples (72.9% (51/70) in GC cases vs 20% (14/70) in normal samples (p=0.0001).We also observed a statistically significant association between methylated hMLH1 gene promoter and smoking, consumption of sundried vegetables and hot salted tea with the risk of GC. This study revealed that hMLH1 hypermethylation is strongly associated with GC and suggested roles for epigenetic changes in stomach cancer causation in the Kashmir valley.
The purpose of this study is to explore whether wives communicate differently over the family life cycle(FLC), and whether their communication contents and frequencies are differently over the FLC. Marital communication scales are composed of six subfactors such as The selectivity of channel (SC), Channel direction (CD), communication style(CS), Comprehension of nonverbal communication (CNC), Communication contents and frequencies(CCF) and Olson's marital communication (LCQ). The number of the subjects are 582, who are living in Pusan in 1987 and they divided into six stages family life cycle; The newly married (FLC 1). The family with preschoolers(FLC 2), The family with schoolages (FLC3), The family with teenages(FLC4), The family with launching children(FLC 5) and The postparenthood (FLC 6). This study is surveyed by Frequencies and Mean score from six subfactors and tested by chi-square test and ANOVA. the results are as follows; 1) There are a few significant differences in CS and CNC by FLC. The wives from FLC 1 and FLC 2 use the most open communication style and them form FLC5 use the most closed style. There are revealed that comprehension of nonverbal communication is the highest of FLC2, but on FLC 1 it is the lowest. 2) There are significant difference in CCF. Children, Wive's life, Husband's life, Affection and sex and Empathy show significant differences over the over the FLC. Regardless of FLC, there are conclueded that Children, Wive's and husband's life and economy management are the most frequence communicative contents. These results suggest that there needs to be further investigation on Olson's marital communication scale for comparing another country with ours and on the training and programs for couple's skillful communication ability.
Background: Breast cancer is a heterogeneous disease that represents a major public health problem. The immunohistochemical determination of breast cancer subtypes with regard to estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor (HER2) status can contribute to improved selection of therapy and patientcare. The purpose of this study was to determine the prevalence of the molecular breast cancer subtypes and to assess their associations with classical clinicopathologic parameters for better therapeutic decisions in women with breast cancer in the Ivory Coast. Materials and Methods: Formalin-fixed and paraffin-embedded blocks of patients diagnosed with primary breast carcinoma were subjected to immunohistochemical assay for the assessment of ER/RP and HER2 expression. The one-way analysis of variance evaluated the difference between breast cancer subtypes and mean age of patients. The Chi-square Test was used to compare standard clinicopathologic prognostic parameters with tumor subtypes. Results. Among 302 patients, 57% were premenopausal and 43% were postmenopausal. The invasive ductal carcinoma not otherwise specified (IDC NOS) (82.8%) was the most frequent histological type, and the tumor grade 2 (56%) was predominant followed by grade 3 (20.9%). The proportion of positivity of ER, PR, and HER2 was 56%, 49%, and 15.6%, respectively. Half of patients of this study (51.6%) had luminal A breast tumor type followed by TN (32.1%). Other subtypes were luminal B (10.1% ) and non-luminal HER2+ (6.3%). Conclusions. The findings of the present study are in line with the literature and should assist in management of breast cancer in our country.
This study was conducted to determine major factors underweight and obesity by comparing and analyzing dietary habits, exercise and weight control of obesity and underweight of Adolescents. The subjects were 26,039 students and they were divided according Body Mass Index(BMI). The collected data was analyzed through frequency, percentage, chi-square test. The results were as follows. 1) Among the male students 67.3%, 32.7% and among the female ones 82.7% and 17.3% were included in the underweight and the obese groups, respectively. 2) For dietary habits, the rate of skipping breakfast(12.5%, 13.6%) was considerably higher than those of skipping lunch and dinner. 3) The females and the obese group received more stress, felt more unhappiness, grief, depression and thought more suicide than the males and the underweight group, respectively. 4) The underweight group had higher rate of strengthening exercise of males and females. 5) For self-recognized body shape, while in the underweight group had a wrong image of their body shape, while more males in the obese group had a distorted self body image. 6) Measures to control weight were regular exercise, reduced amount of diet, and the obese group controled their weight more actively than the underweight group of the male and the female students. 7) From these results, appropriate mental health programs and education programs about health knowledge, properly self-recognized body shape and measures to control weight were considered to be necessary.
The purpose of this study was to identify middle-school boys' purchase behavior according to their shoes shopping orientation. A self-administered questionnaire was used to collect from 314 subjects. Factor analysis, Chi-square test, and one-way ANOVA were done using SPSS PC (Ver. 18.0). Most middle-school boys selected shoes that were 255~270mm, possessed on to two pairs of school shoes, searched for information for about five days before purchase, had spent 50,000~150,000 won on one to two pairs of shoes during the previous six months, saw design, comfort, and brand as their selection criteria, chose their shoes by themselves, shoes specialty stores, had favorite brands, preferred athletic shoes made of achromatic canvas, and bought new shoes when their old ones wore out. Factors of shoe shopping orientation were fashion and brand, economy, conformity, and comfort, and students were grouped into an active shopping group, an underdeveloped shopping orientation group, and a value pursuit group. The active shopping group bought more shoes, spent more on shoes, selected their shoes themselves, patronized discount shoe stores or specialty stores, and preferred national brand shoes. The underdeveloped shopping orientation group accepted their friends' opinions when selecting shoes and bought cheaper shoes. The value pursuit group accepted their parents' opinions when selecting shoes, patronized internet shopping malls or traditional markets, and selected cheaper shoes. The shoe shopping orientation of middle-school boys was immature, but they showed strong consumption needs.
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