Bautista, Marita C.;Jiang, Sheng-Fang;Armstrong, Mary Anne;Postlethwaite, Debbie;Li, Dan
Journal of Gastric Cancer
/
v.14
no.4
/
pp.238-245
/
2014
Purpose: Gastric cancer often occurs in the elderly but is uncommon in young individuals. Whether young patients have different clinical behaviors and outcomes from those of older patients remain unclear. Materials and Methods: We identified 1,366 cases of newly diagnosed noncardia gastric adenocarcinoma from the Kaiser Permanente Northern California Cancer Registry between 2000 and 2010. We then compared the clinicopathological features and survival among the different age groups. Results: The male : female ratio differed significantly between the younger and older patient groups (0.84 in age <50 years vs. 1.52>60 years, P<0.01). More younger patients were Hispanic (54% patients <40 years vs. 19% patients ${\geq}70$ years, P<0.0001), while more older patients were Caucasian (49% patients ${\geq}70$ years vs. 15% patients <40 years; P<0.0001). The diffuse/mixed histological type was more prevalent in younger patients (70% patients <40 years vs. 27% patients ${\geq}70$ years; P<0.0001), whereas the intestinal type was more frequent in older patients (71% in patients ${\geq}70$ years vs. 30% in patients <40 years; P<0.0001). Poorly differentiated adenocarcinoma was more common in the younger patients (80% in patients <40 years vs. 60% in patients ${\geq}70$ years; P=0.016). Survival rates at 1, 2, and 5 years gradually declined with increasing age (overall P=0.0002). Conclusions: Young patients with gastric cancer had more aggressive disease but higher overall survival rates than older patients. Younger Hispanic patients and older Caucasian patients were more likely to be diagnosed with gastric cancer. These differences may be due to biological predisposition and/or environmental exposure.
Yoo, Tae Hyun;Lee, Min Ho;Park, Min;Lee, Jaewang;Woo, Hyun Jun;Kim, Hyun Woo;Yang, Ji Yeong;Kwon, Hye Jin;Yeon, Min Ji;Kim, Jong-Bae
Biomedical Science Letters
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v.21
no.4
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pp.227-232
/
2015
Epstein-Barr virus (EBV) has a pathogenic role in several lymphomas including diffuse large B-cell lymphoma (DLBCL). In this study, we detected EBV from formalin-fixed paraffin embedded (FFPE) tissues of DLBCL patients by RT-PCR and compared the sensitivity of the RT-PCR method to in situ hybridization (ISH) method. The RNA was extracted from 91 FFPE samples with DLBCL and amplified with primers targeting EBV-encoded small RNA (EBER) by RT-PCR. When using the RT-PCR method, 13 of 91 patients (14.3%) were positive and among these 13 cases, 7 cases (7.7%) were from > 50-year-old patients that is classified as EBV positive DLBCL of the elderly. In previous results using ISH method, 3 of 91 patients (3.3%) were positive and 2 case (2.4%) were older than 50-year-old. These results indicate that RT-PCR method used in this study shows a higher sensitivity than ISH method. The ratio of male versus female among the EBV positive samples was 1.2:1 with the ratio of male higher. If RT-PCR method having high sensitivity is used simultaneously as well as the ISH method providing the information of the EBV positive cellular location, it is expected that EBV will be more accurately detected.
The aim of this study is to develop Casual Hanbok design made of Hanji yarn textiles for New Silver generation women. The New silver generation is a coined word which has meaning of a newly silver generation and it is distinguished from pre-silver generation. New silver generation is a generation that is independent and given active role by their age groups and generational characteristic. The concept of silver generation was introduced from maturity market in Japan. This study was based on analysis about their preference of forms, colors, and materials of Casual Hanbok. The survey target were 270 female over age 50 living in Daejeon City. The analysis methods used frequency and percentage. The results were summarized as following. Although almost of them haven't worn Casual Hanbok, they had the positive recognition on wearing one. They preferred longer length jacket to traditional Korean style, shorter length of skirt. They also preferred the traditional sleeve shape and knotted buttons. On the foundation of this fact, 2 styles consist of 5 Casual Hanbok design items made of functional material - Hanji yarn textiles that have antimicrobial, deodorant, quick drying, far infrared radiation which are not harmful to health - for New silver women were suggested. One style was 3 items - blouse, vest, skirt - which are the sense of Korean tradition with activity by patch. The other was 2 items - jacket and skirt - which are the sense of Korean tradition with modern way by quilting. Lastly, these garments were evaluated by 13 experts, they were satisfied with 2 styles and all items. As this study were based on the Elderly women living in Daejeon city, it had the limitation on applying of preference styles to all the New silver generation.
Park, Jae-Young;Chae, Yoo-Mi;Jung, Sang-Hyuk;Moon, Ki-Tae
Journal of Preventive Medicine and Public Health
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v.41
no.1
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pp.51-60
/
2008
Objectives : We examined the effect of sociodemographic factors, cancer, and psychiatric disorders on suicide by gender and age-specific patterns in South Korea. Methods : The study is a case-control study. Claim data was obtained from the national health insurance database and national death registration database. The number of people who committed suicide was 11,523, which was matched with a control group consisting of ten times as many people at 115,230 selected from the national health insurance and medical aids beneficiaries. The medical utilization of the case group was one year before death and that of the control group was from July 1,2003 to June 30, 2004. Four variables-address, economic status, presence of a psychiatric disease, and cancer-were used in multiple logistic regression analyses. Results : Living in cities or in rural areas showed a greater risk for suicide than living in a metropolitan city. Low economic status, the presence of a psychiatric disorder, and cancer were also statistically meaningful risk factors for suicide. The three major psychiatric diseases, schizophrenia, alcohol abuse, and bipolar disorder, were meaningful in all age groups, but the scale of the odds ratio differed by the age group. Only the psychiatric disorder variable was meaningful in the adolescent group, whereas a psychiatric disorder and economic status were meaningful for the young adult group, and all variables were meaningful for the middle-aged group. A psychiatric disorder and cancer were meaningful in the elderly group, economic status was meaningful for male subjects, and address was meaningful for female subjects. Conclusions : Factors such as living in city or rural areas, low economic status, the presence of a psychiatric disorder, and cancer were statistically meaningful risk factors in suicide. These factors also differed by age group. Therefore, policymakers should establish policies for suicide prevention that are relevant for each age group.
Purpose: The purpose of this study was to examine the effects of physical activity on glycemic control among Koreans with type 2 diabetes. Methods: A total of 215 patients with type 2 diabetes (82 male and 133 female) were recruited (mean age = $59.0{\pm}9.7$ years). The amounts of physical activity was assessed using the physical activity scale for elderly (PASE). Fasting blood glucose (FBG), Hemoglobin A1c ($HbA_1c$), and 2 hours post-prandial glucose (2hrPG) were measured. Results: The highest PASE score was housework-related physical activity. However, the amounts of walking was significantly higher in good FBG level (Z = 1.39, p=.041) and the amounts of leisure-time physical activity was higher in good HbA1 and 2hrPG level than in the poor glycemic control group (Z = 2.29, p<.001; Z = 1.99, p=.001). A logistic regression analysis showed that patients with leisure-time physical activity in the top quartile more likely presented with good glycemic control in $HbA_1c$, OR=3.84 (95% Confidence Interval (CI) = 1.65~8.95) and in 2hrPG, OR=4.06 (95%CI = 1.77~9.27), compared to patients in the lowest quartile. Conclusion: Leisure-time physical activity is effective for controlling the glucose levels, especially $HbA_1c$ and 2hrPG among type 2 diabetic patients. It is suggested that health providers need to more focus on providing aggressive recommendations on physical activity considering physical activity patterns by individuals.
Background: Essential thrombocythemia (ET) is a Philadelphia chromosome-negative myeloproliferative neoplasm characterized by sustained thrombocytosis and megakaryocytic hyperplasia. It is an uncommon hematological malignancy which primarily affects elderly individuals. The rational of this study was to determine its clinico-hematological profile along with risk stratification in Pakistan patients. Materials and Methods: In this retrospective cross sectional study, 21 patients with ET were enrolled from January 2011 to December 2014. Data was analyzed with SPSS version 21. Results: The mean age was $56.7{\pm}19.0years$ (range 18-87) and the male to female ratio was 1:1.1. Of the total, 62% of patients were above 50 years of age. Overall 61.9% were diagnosed incidentally and were asymptomatic. In symptomatic patients, major complaints were weakness (19%); erythromelalgia (14.2%), transit ischemic attack (9.5%) and gastrointestinal bleed (4.7%). The mean hemoglobin count was $11.7{\pm}2.4g/dl$ with a total leukocyte count of $13.3{\pm}8.1{\times}10^9/l$ and platelets count of $1188.8{\pm}522.2{\times}10^9/l$. Serum lactate dehydrogenase, serum creatinine and uric acid were $454.3{\pm}127.8$, $1.2{\pm}0.5$ and $7.4{\pm}3.4$ respectively. According to risk stratification, 57.1% were in high risk; 23.8% in intermediate risk while 19.1% in low risk group. Conclusions: ET in our patients in Pakistan, unlike in the West, is seen in a relatively young population. Primarily patients were asymptomatic and risk stratification revealed predominance of high risk disease in our setting.
We evaluated the inappropriateness of metformin use in patients with type 2 diabetes and chronic medical conditions to identify the frequency of the prescription metformin in violation of the food and drug administration (FDA) black box warning. We reviewed medical records of 307 outpatients who received metformin at endocrinology department in a hospital setting between January 1, 2005 and August 30, 2009. Of the 307 outpatients, 25 discontinued treatment of metformin due to elevated serum creatinine level (Scr${\geq}$1.5 mg/dl in male, Scr${\geq}$1.4 mg/dl in female), cancers, and/or liver disease. 5 were lost to follow-up. 89 (29.0%) of the patients had cardiovascular disease, 54.1% for hypertension, 9.8% for liver disease, and 60 (20.8%) for chronic kidney disease. 12 patients (3.9%) with chronic kidney disease and/or elevated serum creatinine level, and 1 patient (0.3%) with lactic acidosis were contraindicated to metformin use. Metformin should be avoided in 7 outpatients (2.3%) with active hepatitis and 1 patient (2.6%) with liver cirrhosis. Of the 307 outpatients, 13 (4.2%) patients who received metformin at the first visit and 16 (8.7%) patients who received metformin at the last visit violated to black box warning. 8 (2.6%) of the patients were in precautionary conditions to metformin use. Adjusted mean difference of serum creatinine was -0.16 mg/dl [95% CI: -0.22 to -0.11 (p<0.05)] and adjusted mean difference of alanine aminotransferase was 4.46 IU/l [95% CI: 2.47 to 6.44 (p<0.05)] between the first visit and the last visit. Critical number of elderly patients who are at the high risks of drug-disease and drug-laboratory interaction is exposed to the inappropriate metformin use in violation of black box warning. The periodic evaluation of metformin use and monitoring prescription through drug utility review (DUR) system is needed to improve patients' safety and to reduce adverse drug events.
Background: This paper describes the relationship and effect of health examination on personal medical cost by identifying the difference of the cost for medical care in physician visit between the population without and with health examination. Methods: After classifying into three cohorts in which, independent variables were designed according to the Andersen's behavioral model, the association of personal medical cost for medical care and prescription drugs which is dependent variable was analyzed by t-test and Mann-Whitney test for description and gamma regression model for inference. Results: In personal average medical cost, the population with health examination paid significantly more than without health examination, 11.6% more in cohort 2008, 26.6% more in cohort 2009, and 48.0% more in combined cohort. The odds ratio on medical expenditure of outpatients with health examination was 1.067, 1.126, 1.398 significantly in cohort 2008, 2009, and combined cohort respectively, comparing to the group without health examination. In independent variables, that is female, the elderly, never married, non-working, non-metropolitan, the higher family income, the smaller family size, people with disability, the people with chronic disease, and people with health examination have significantly being paid more tendency showing positive association with medical cost. Conclusion: This result showed that medical expenditure in physician visit has been increased after taking a health examination. Therefore reasonable limitation of getting preventive medical service is suggested to avoid medical shopping around and reduce being repeated health examination by unifying control to find out easily the clinical results from various medical facilities.
Using Korean Labor and Income Panel Study (wave 1~11) database, this study analyzed the poverty duration of the poor as a whole and by households' characteristics. For this purpose, I first estimated poverty exit rates and reentry rates applying discrete-time hazard model to the sample, and then calculated poverty duration combining these two probability rates. The results show that about a half of poor households are transitory (short-term) poor with 1~2 years of poverty duration. A quarter is chronic (long-term) poor lasting for 5 or more years of poverty duration. The remained quarter can be categorized as the recurrent or mid-term poor. The socioeconomic characteristics of households greatly affect poverty duration. Long-term poverty is prevalent among female-head households, elderly households, single households, or households headed by a person with a lower level of education. If households' heads do not work, or work as temporary or daily-employed workers, the poverty duration tends to be longer. The findings suggest that the poor consist of various social classes with different characteristics. Efficient anti-poverty policy should be based on thoroughly identifying the specific characteristics and needs of each class.
Objectives: This study furthers the currents understanding of mental health status and stress level among Seoul citizens and to identify differences according to socio-demographic variables for developing mental health programs. Methods: The study subjects using cluster-stratified sampling method were 1234 adults over 19 years old from 17 dong, S-Ku in Seoul City. A cross-sectional study with face-to-face interview was used to collect data. A questionnaire measuring socio-demographic variables, Symptom Checklist-90-Revised (SCL-90-R) and psychosocial wellbeing index-short form (PWI-SF) was utilized. Results: Three findings in this study were discussed: (1) The rate of clinical mental health was low in contrary to that of border group which was high and the rate of high risk group of stress was 68.1% (men 67.0%, women 69.0%); (2) The mental health and the stress level was significantly higher among female, elderly, lower education level, divorced, and lower family income; and (3) In Pearson correlation analysis, stress were correlated to all 9 symptoms of SCL-R. Conclusion: The findings suggest that the future intervention of Mental Health programs should be carefully designed and tailored by socio-demographic variables.
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