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Prognostic Factors for Lymph Node Negative Stage I and IIA Non-small Cell Lung Cancer: Multicenter Experiences

  • Ustaalioglu, Bala Basak Oven;Unal, Olcun Umit;Turan, Nedim;Bilici, Ahmet;Kaya, Serap;Eren, Tulay;Ulas, Arife;Inal, Ali;Berk, Veli;Demirci, Umut;Alici, Suleyman;Bal, Oznur;Benekli, Mustafa;Gumus, Mahmut
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6287-6292
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    • 2013
  • Background: Surgery is the only curative treatment for operable non-small lung cancer (NSCLC) and the importance of adjuvant chemotherapy for stage IB patients is unclear. Herein, we evaluated prognostic factors for survival and factors related with adjuvant treatment decisions for stage I and IIA NSCLC patients without lymph node metastasis. Materials and Methods: We retrospectively analyzed 302 patients who had undergone curative surgery for prognostic factors regarding survival and clinicopathological factors related to adjuvant chemotherapy. Results: Nearly 90% of the patients underwent lobectomy or pneumonectomy with mediastinal lymph node resection. For the others, wedge resection were performed. The patients were diagnosed as stage IA in 35%, IB in 49% and IIA in 17%. Histopathological type (p=0.02), tumor diameter (p=0.01) and stage (p<0.001) were found to be related to adjuvant chemotherapy decisions, while operation type, lypmhovascular invasion (LVI), grade and the presence of recurrence were important factors in predicting overall survival (OS), and operation type, tumor size greater than 4 cm, T stage, LVI, and visceral pleural invasion were related with disease free survival (DFS). Multivariate analysis showed operation type (p<0.001, hazard ratio (HR):1.91) and the presence of recurrence (p<0.001, HR:0.007) were independent prognostic factors for OS, as well visceral pleural invasion (p=0.01, HR:0.57) and LVI (p=0.004, HR:0.57) for DFS. Conclusions: Although adjuvant chemotherapy is standard for early stage lymph node positive NSCLC, it has less clear importance in stage I and IIA patients without lymph node metastasis.

High School Students' Knowledge and Attitude about Smoking according to Their Smoking Status (일 지역 고등학생의 흡연상태에 따른 흡연지식과 흡연태도)

  • Choi, Yeon-Hee;Paek, Kyung-Shin
    • Research in Community and Public Health Nursing
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    • v.15 no.2
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    • pp.277-288
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    • 2004
  • Purpose: This study was to provide basic information for preventing high school students from smoking by examining their actual smoking condition and their knowledge and attitude about smoking. Method: The subjects were 515 students selected from six(6), high schools in Jecheon. Data were collected using a questionnaire from the 1st to the 17th of December 2002. The author prepared the tool by modifying the scale of knowledge and attitude about smoking developed by Moon(2001). Data were analyzed with SPSS/WIN program using frequencies, percentages, $x^2$-test, t-test, ANOVA. Duncan test and Pearson's correlation coefficient. Result: 1. The percentage of ex-smoking students was 29.9% of male students and 18.6% of female ones. The percentage of currently smoking students was 23.9% of male students and 3.0% of female ones. The percentage of non-smoking students was 46.2% of male students and 78.4% of female ones, 2. There were not significant differences in smoking knowledge according to smoking status in male and female students. 3. There were significant differences in smoking attitude according to smoking status in male(F=32.70, p=.000) and female(F=11.15, p=.000) students. 4. In smoking status according to general characteristics, there were significant differences according to the type of school($x^2$=32.93, p=.000), grade($x^2$=11.91, p=.018), educational level of the father($x^2$=30.52, p=.000) and the mother($x^2$=14.23, p=.027), monthly allowance($x^2$=17.19, p=.028), harmony of family members($x^2$=15.23, p=.019), school life($x^2$=26.96, p=.00l) and school record($x^2$=30.24, p=.000). 5. In smoking status according to smoking-related characteristics, there were significant differences according to experience in cigarette purchase($x^2$=150.04. p=.000), experience in errands for cigarette($x^2$=20.00, p=.000), knowledge of cigarette price($x^2$=72.52, p=.000), close friends' smoking($x^2$=107.41. p=.000) and smoking of brothers and sisters($x^2$=16.97, p=.002). 6. There were significant correlation between knowledge and attitude about smoking in the whole students(r=.337. p=.000), ex-smokers(r=.324. p=.000), non-smokers(r=.369. p=.000) but there was not a significant correlation between knowledge and attitude about smoking in current smokers(r=.128. p=.30l). Conclusion: Smoking prevention education should considered students' smoking status. Current smokers need smoking prevention education aiming to change their attitude toward smoking in order for them to reduce smoking and to practice smoking cessation.

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A Study on the Recognition Level of Employment and Overseas Employment among Students Majoring in Dental Technology (일부 치기공과 대학생들의 해외취업에 관한 의식 조사 연구)

  • Park, Nam-Gyu;Jung, Hyo-Kyung
    • Journal of Technologic Dentistry
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    • v.29 no.2
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    • pp.17-34
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    • 2007
  • This study was conducted to research into the recognition level of employment and overseas employment on 173 students majoring in dental technology at two colleges in Daegu metropolitan city and Jeju self-governing island through questionnaires which are recorded individually. The results are as follows. 1. About 31.8% students chose dental technician department taking their aptitude into consideration when they entered college. 52% students gained information about dental technology through internet, and 57.3% students among them, which was the highest level, were under age 20. 2. 48.6% students responded that they thought the level of satisfaction with major was average and there was a difference according to their ages among the level of satisfaction or dissatisfaction with their major and the previous knowledge of major they had gained before entering college. 75.1% students said they wouldn't transfer to other major even if they were given the chance, which was much higher than the opposite case. And only 2.3% students had dissatisfaction at their major, which means students majoring dental technology evaluate their major positively. 3. Most students(58.4%) wanted to get a job for living cost and 53.2% students took advice from their seniors or elderly people in choosing their jobs. 64.7% students answered they should have professional skills to get a good job, which was different according to their ages. In addition, 51.4% students of dental technology department regarded the opportunities to exert their abilities as the most important element in choosing their jobs. That means students value self-decision and selfrealization when they choose their jobs. 4. The majority of students(32.9%) preferred to work at the dental laboratory in dental college hospital as their workplace. Moreover, seniors over age 21 wanted to work in the field of porcelain and juniors under age 20 preferred to work in the implant part concerning the field which students wants to work. 5. About 91.3% students have ever heard about overseas employment and wanted to work abroad if given the opportunities(77.5%). This points out students have much interest in overseas employment and positive attitude. And there was a difference according to age and grade in case of the preferred country when they work abroad 6. The main barrier to overseas employment was a lack of communication ability(63.0%), therefore, students thought foreign language education should be activated to improve overseas employment(26.0%). To show this more specifically, juniors thought foreign language education and internship are most important factors(both are 21.4% alike), while seniors thought foreign language education is essential(24.6%) as a way to improve overseas employment. Students also thought that participation in language study club helps to prepare for overseas employment(69.4%). When putting all these survey results together, it's very important to develop people in advance who have job ability and language ability necessary for overseas employment as well as to improve job awareness in the field of dental technology. Consequently, it's needed to seek for various ways to get a overseas job through foreign language education and overseas internship.

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Secondary Traumatic Stress(STS) and related factors of Emergency Medical Technicians (응급구조사의 이차 외상성 스트레스 정도와 관련요인)

  • Choi, Hee-Jeong;Park, Jeong-Mi;Suh, Soon-Rim
    • The Korean Journal of Emergency Medical Services
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    • v.13 no.2
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    • pp.5-15
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    • 2009
  • Purpose : This study was to examine the secondary traumatic stress(STS) and related factors of emergency medical technicians. Methods : This study was conducted among 190 emergency medical technicians, over the age of 25, with the 1st or 2nd grade qualification, who serve at fire stations in U and P city of Korea. The collected data for this study was analyzed using SPSS 12.0. Result : The average character type of A-type personality technicians was 43.25 points and the average of B-type personality technicians was 37.82 points. It suggested that the former was higher than the latter. State anxiety did not show statistically significant difference between A-Type group and B-Type group with the score of 48.51 for A-Type and 47.91 for B-Type. Physical symptoms showed statistically significant difference between the two groups with the higher score of 28.45 for A-type group than that of 28.13 for B-Type group. The level of STS related to the volunteers' job characteristics was found to be low when the volunteers were satisfied with their job and didn't want to transfer to another division. Those on duty who had slept more than seven hours that day had the highest points. The number of points was highest when the frequency for the onset of trauma was between 20~30 times. Furthermore it was found that for most technicians, 71.05%, the period of symptoms lasted for a few weeks at most, and this was where the STS was the lowest, whereas on the other hand the highest STS occurred when the symptoms lasted for a period of up to six months. The findings showed significant correlations with a relation of r=.24 between STS and level of anxiety and r=.45 between STS and physical symptoms. However, no significant correlation was found between the level of anxiety and physical symptoms. Conclusion : The more emergency medical technicians are exposed to accidents, the more serious the STS are. Those with an A-type personality are especially prone to have higher STS. The higher the STS level is, the higher the level of physical states and anxiety is.

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Communication Between Mother and her Adolescents (어머니와 정년기여자와의 커뮤니케이션에 관한 연구)

  • 김진숙;유영주
    • Journal of Families and Better Life
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    • v.3 no.1
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    • pp.77-91
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    • 1985
  • This study was carried out to learn about the contents of communication between mother and her adolescents in this country, and possible differences in the contents of communication with demographic variables. In particular, I wanted to find out the following; 1)contents of communication between mother and her adolescents. 2)Contents of communication between parents with adolescents. 3)Possible differences in the contents of communication with differences in the level of education, employment status, and age of mother, family income level, and sex, and birth order of children. To test these hypotheses, I distributed questionnaires to 600 mothers of selected high school juniors(11th grade) in Seoul. Four hundred and fourty-eight questionnaires were returned, and the results were analyzed using frequency distribution, percentage, and x2-test. The results were as following; 1) In general, mothers communicated well with their adolescents, especially in topics related to studying, friends, school, parents and family, and future career. Communication on sex-education or sex-role, however, was rather limited in contents. ool, parents and family. Communication on sex-education or sex-role of adolescent was almost never attempted. This result showed similarity with 1 above. 3) (1) contents of communication and educational level of mother; contents of communication between mother and her adolescents differed significantly with educational level on all topics except parents and family, indicating that the educational level of mother, the more diverse was contents of communication between mother and her adolescents. (2) Contents of communication and employment status of mother: On all topics except sex-education, communication between mother and her adolescents differed significantly between employed and unemployed mothers, indicating that unemployed mothers communicate on greater number of topics with their adolescents than employed mothers do. (3) contents of communication and family income level; Family income level did not affect contents of communication between mother and her adolescents significantly. (4) contents of communication and age of mother; Age of mother did not affect a contents of communication between mother and her adolescents significantly. (5) contents of communication and sex of adolescent; Thee were significant differences in contents of communication on certain topics; On virginity, sex, marriage, and dating, mother communicate more diversely with daughters than with sons. This result certainly reflects the deep-rooted traditional value system among koreans, with permissive attitude toward males, and far more strict attitude toward females, on sex-related matters. (6) Contents of communication and birth order of adolescents; The birth order of adolescents did not affect contents of communication between mother and her adolescents significantly.

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Health Promoting Lifestyle Behaviour in Medical Students: a Multicentre Study from Turkey

  • Nacar, Melis;Baykan, Zeynep;Cetinkaya, Fevziye;Arslantas, Didem;Ozer, Ali;Coskun, Ozlem;Bati, Hilal;Karaoglu, Nazan;Elmali, Ferhan;Yilmaze, Gulay
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8969-8974
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    • 2014
  • Background: The aim of this study was to determine the predictors of health promoting lifestyle behaviour among medical students attending seven of the medical schools in Turkey. Materials and Methods: This crosssectional descriptive study was performed during the second semester of the first and last (sixth) years of study from March to May 2011. A questionnaire with two sections was specifically designed. The first section contained questions on demographic characteristics; the second consisted of the Health Promoting Lifestyle Profile II (HPLP) Scale. From a total of 2,309 medical students, 2,118 (response rate 91.7%) completed the questionnaire. Data were analyzed using descriptive statistics, t, Anova, Tukey test and binary logistic regression analysis. The research was approved by the Ethics Committee of Erciyes University. Results: The mean age was $20.7{\pm}2.9$ years and it was found that 55.1% were men, 62.3% were in the first year. The overall prevalence of smoking was 19.1%, and for drinking alcohol was 19.4%. HPLP point averages of the first year students were $129.2{\pm}17.7$, and for last year $125.5{\pm}19.0$. The overall mean score for the HPLP II was $2.5{\pm}0.4$. They scored highest on the spiritual growth subscale ($2.9{\pm}0.5$), interpersonal relations ($2.8{\pm}0.5$), health responsibility subscale ($2.3{\pm}0.5$), nutrition subscale ($2.3{\pm}0.5$), stress management subscale ($2.3{\pm}0.4$), and the lowest subscale physical activity ($2.0{\pm}0.5$). It is established that student's grade, educational level of parents, economic status of family, marital status, smoking and general health perception of the students resulted in a significant difference in HPLP Scale total score average and the mean score of majority of subscales. There was no statistically significant difference between the total HPLP when evaluated for gender, chronic disease, alcohol drinking status and BMI. Conclusions: Based on these results, particularly in the curriculum of medical students in order to increase positive health behaviours including physical activity, health promotion issues, and giving more space to aim at behaviour change in these matters is recommended.

Chinese Patients with Gastric Cancer Need Targeted Adjuvant Chemotherapy Schemes

  • Shi, Wen-Tao;Wei, Lei;Xiang, Jin;Su, Ke;Ding, Qiong;Tang, Meng-Jie;Li, Ji-Qiang;Guo, Yi;Wang, Pu;Zhang, Jing-Wei
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.10
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    • pp.5263-5272
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    • 2012
  • Background: Gastric cancer (GC) is one of the most common cancers in China. Adjuvant chemotherapy (AC) is a routine auxiliary treatment for GC recommended by the guidelines issued in 2011 by the Ministry of Health of the People's Republic of China, but the relevant credible consequences in China have been insufficient because of China's late start and ethical concerns. Methods: A series of databases, including Cochrane Library, MEDLINE, EMBASE, the Chinese database of the National Knowledge Infrastructure and the VIP database, were searched by 2 reviewers independently for studies investigating AC for GC through March 2012. The retrieved literature was screened according to the eligibility criteria. Results: A total of 35 randomized control trials (RCTs) were subjected to the final analysis, including 4,043 patients in treatment group and 3,884 in the control group, as well as 4 clinical-control trials (CCTs), which accessed the final analysis with 238 and 252 patients, respectively. AC reduced the risk of death as a protective treatment with statistical significance (HR=0.91, 95%CI: [0.85, 0.97], P=0.002), and it seemed more effective for Asian than non-Asian patients. The effects of AC were not influenced by the starting time (P>0.05). D2 lymphadenectomy-based chemotherapy was effective (HR=0.89, 95%CI: [0.80, 0.99], P=0.04). Oral S-1 40 mg/m2 after D2 lymphadenectomy might be a better choice for Asians with advanced GC and might result in a greater reduction of adverse events than in non-Asian patients. GRADE quality assessment determined that the strength of the evidence from foreign studies from Europe, the United States and Asian countries other than China was high, while it was moderate for Chinese studies. Conclusion: AC was effective or even curative in Chinese patients in general, although it is still necessary to optimize a targeted AC scheme for Chinese patients with GC.

Management Outcome and Clinical Manifestation of Posterior Circulation Aneurysms VS. Anterior Circulation Aneurysm (후순환계 뇌동맥류의 임상양상과 치료예후 - 전순환계 동맥류와의 비교분석을 중심으로 -)

  • Jeong, Je Hoon;Kim, Gook Ki;Koh, Jun Seok;Lim, Young Jin;Kim, Tae Sung;Leem, Won;Rhee, Bong Arm
    • Journal of Korean Neurosurgical Society
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    • v.30 no.9
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    • pp.1086-1093
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    • 2001
  • Object : With the recent variable treatment modalities and the development of microsurgical techniques, outcomes of surgical and medical management of aneurysm have shown much progress in the last 10 years. However, the management of posterior circulation aneurysm is still a debatable due to its difficulty in limited surgical approach, complicated anatomical structure and many small perforators to vital structure. The purpose of this study is to compare the results of clinical manifestation and outcome of surgery with respect to anterior and posterior circulation aneurysms. Material and Methods : We evaluated the 33 patients with PCAs(posterior circulation aneurysm) and 359 patients with ACAs(anterior circulation aneurysm) treated between 1994 and 1999, retrospectively. Results : Posterior circulation aneurysms showed higher tendency(5 cases, 14.7%) to have unusual shapes, such as dissecting or fusiform compared with anterior circulation aneurysm(15 cases, 4.2%). There were more multiple aneurysms in posterior circulation aneurysm(8 cases, 26.5%) than anterior circulation aneurysm(59 cases, 16.2%). The number of patients with Hunt-Hess grade III or IV on admission were 91(25.3%) in anterior circulation aneurysms, and 14(42.4%) in posterior circulation aneurysms. There were higher incidences of vasospasm and acute hydrocephalus in patients with posterior circulation aneurysm. In cases of anterior circulation aneurysm, neck clipping was possible in 97%. But, in posterior circulation aneurysm, neck clipping was possible only in 67.7% of each. Two hundred forty four cases(85.0%) of all anterior circulation aneurysms and 22 cases(78.6%) of all posterior circulation aneurysms showed good recovery(GR) or moderate disability(MD). The postoperative mortality rates of anterior and posterior circulation aneurysms were 4.9% and 10.7%, respectively. Conclusion : These results indicate that there exist substantial differences with respect to that there were few difference in the aspect of surgery and management outcome between posterior circulation aneurysms and anterior circulation aneurysms.

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Clinical Analysis of Atypical and Malignant Meningiomas : A study of 52 Cases (비정형성 및 악성 뇌수막종의 임상분석 : 52례 연구)

  • Park, Hong-Jun;Gwak, Ho-Shin;Hwang, Sung-Kyun;Kim, Jeong Eun;Lee, Sang Hyung;Jung, Hee-Won;Kim, Dong Gyu;Cho, Byung-Kyu
    • Journal of Korean Neurosurgical Society
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    • v.30 no.9
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    • pp.1103-1107
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    • 2001
  • Objective : Atypical and malignant meningiomas(AM, MM) are known to be rare and show aggressive behavior. Limited data are available concerning the clinical features, effectiveness of surgical removal and role of radiation therapy with AM, MM. The authors report our experience of AM, MM, with respect to clinical features. Methods : Twenty-four cases of AM and 28 cases of MM, who were operated between 1988 and 1999 were retro-spectively studied review of medical records and radiological findings. These were compared with control group of 24 cases of menigiomas manifestating usual clinical course, which are selected arbitrarily among operative cases between Apr. 1999 and Dec. 1999. Mean follow-up periods were 26(1-91) months for AM and 23(1-62) for MM. Authors analyzed the prognostic factors for survival, and statistical analysis were accomplished by Kaplan-Meier method and log-rank test. Results : Differences of clinical features between control groups and these atypical and malignant meningioma group were not significant. However, the location of MM was frequent in non-basal area(p<0.01). In AM, there were 4 patients of recurrence, and 3 patients of mortality. Among mortality cases, only one patient died of tumor progression, the other patients died of other causes. The survival at 2 year and 5 year in this group were 88% and 74% respectively, and in MM, 11 patients died due to tumor progression and 2 had spinal metastasis. The survival at 2 year and 5 year were 72% and 20%, respectively. For extent of resection, total removal(Simpson grade 1 or 2) was less often achieved in MM compared with AM(50% vs. 83%). Extent of resection of tumor and postoperative radiation therapy did not affect survival in both AM, MM. Conclusions : Clinical behavior of AM showed more benign than that of MM. Prognostic factor for survival is not related extent of resection of tumor and postoperative radiation therapy. However, further investigation with long-term follow-up and additional cases is mandatory.

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Study of Heterophoria Using Torrington Method in Third-year Student High School (토링톤법을 이용한 고 3 수험생들의 사위에 대한 고찰)

  • Ryu, Geun-Chang;Seong, Jeong-Sub
    • Journal of Korean Ophthalmic Optics Society
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    • v.12 no.4
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    • pp.91-94
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    • 2007
  • This research was investigated to find out the examinees' refractive problems within heterophoria using Torrington method. The number of subjects ware approximately 327 and subjects were sourced from the 12th grade student at high school in Kwang-Ju city. Result obtained shows 21.4% of emmetropia and 78.6% of ametropia. Most of refractive errors were myopia and due to it's condition, frequency of ametropia and emmetropia at the similar rate. However, one that consist of refractive problems, it's myopia contains 74.9% of heterophoria. Due to emmetropia, horizontal heterophoria have 45.7% of exophoria and 4.3% of esophoria. Myopia shows 11.4% of esophoria and 63.5% of exophoria. Hozizonda heterophoria shows 5.7% of emmetropia and myopia of 22.4%, than average of esophoria shows $4.3P{\Delta}$ and case of myopia, it was $3.4P{\Delta}$. Case of Exphoria, emmetropia have $8.8P{\Delta}$ and within myopia $8.0P{\Delta}$. Vertical heterophoria owns $2.2P{\Delta}$ within emmetropia and case of myopia $4.3P{\Delta}$ was shown. Which shows myopia result value higher than emmetropia.

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