• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.4895-4900
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• 2015

Physician recommendation is an important predictor of HPV vaccine acceptance; however, physician willingness and preferences regarding HPV vaccination may be influenced by factors including patient age, vaccine type, and cost. A cross-sectional survey was administered to a convenience sample of health care providers in Da Nang, Vietnam, to evaluate awareness, perceptions about HPV and HPV vaccines, and willingness to vaccinate a female patient. Willingness to vaccinate was evaluated using a full-factorial presentation of scenarios featuring the following factors: vaccine cost (free vs 1,000,000 VND), patient age (12, 16, or 22 years), and HPV vaccine type (bivalent vs quadrivalent). Responses from 244 providers were analyzed; providers had a mean age of $34{\pm}11.9$ years; a majority were female, married, and had children of their own. Thirty-six percent specialized in obstetrics/gynecology and 24% were providers in family medicine. Of the three factors considered in conjoint analysis, vaccine cost was the most important factor in willingness to vaccinate, followed by patient age, and vaccine type. The most favorable scenario for vaccinating a female patient was when the vaccine was free, the patient was 22 years of age, and the HPV4 vaccine was described. In multivariable analysis, older age, being a physician, being married, and having children were all associated with increased willingness to recommend HPV vaccination (p<0.05). Provider willingness is an important aspect of successful HPV vaccination programs; identifying preferences and biases in recommendation patterns will highlight potential areas for education and intervention.

• Biomolecules & Therapeutics
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• v.24 no.4
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• pp.402-409
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• 2016

It has been found that 4-isopropyl-2,6-bis(1-phenylethyl)phenol (KTH-13), a novel compound isolated from Cordyceps bassiana, is able to suppress tumor cell proliferation by inducing apoptosis. To mass-produce this compound, we established a total synthesis method. Using those conditions, we further synthesized various analogs with structural similarity to KTH-13. In this study, we aimed to test their anti-cancer activity by measuring anti-proliferative and pro-apoptotic activities. Of 8 compounds tested, 4-methyl-2,6-bis(1-phenylethyl)phenol (KTH-13-Me) exhibited the strongest anti-proliferative activity toward MDA-MB 231 cells. KTH-13-Me also similarly suppressed the survival of various cancer cell lines, including C6 glioma, HCT-15, and LoVo cells. Treatment of KTH-13-Me induced several apoptotic signs in C6 glioma cells, such as morphological changes, induction of apoptotic bodies, and nuclear fragmentation and chromatin condensation. Concordantly, early-apoptotic cells were also identified by staining with FITC-Annexin V/PI. Moreover, KTH-13-Me highly enhanced the activation of caspase-3 and caspase-9, and decreased the protein level of Bcl-2. In addition, the phosphorylation levels of Src and STAT3 were diminished in KTH-13-Me-treated C6 cells. Therefore, these results suggest that KTH-13-Me can be developed as a novel anti-cancer drug capable of blocking proliferation, inducing apoptosis, and blocking cell survival signaling in cancer cells.

• Journal of Preventive Medicine and Public Health
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• v.49 no.6
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• pp.349-366
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• 2016

Objectives: We conducted a systematic review and meta-analysis to summarize current evidence regarding the association of parity and duration of breastfeeding with the risk of epithelial ovarian cancer (EOC). Methods: A systematic search of relevant studies published by December 31, 2015 was performed in PubMed and EMBASE. A random-effect model was used to obtain the summary relative risks (RRs) and 95% confidence intervals (CIs). Results: Thirty-two studies had parity categories of 1, 2, and ${\geq}3$. The summary RRs for EOC were 0.72 (95% CI, 0.65 to 0.79), 0.57 (95% CI, 0.49 to 0.65), and 0.46 (95% CI, 0.41 to 0.52), respectively. Small to moderate heterogeneity was observed for one birth (p<0.01; Q = 59.46; $I^2=47.9%$). Fifteen studies had breastfeeding categories of <6 months, 6-12 months, and >13 months. The summary RRs were 0.79 (95% CI, 0.72 to 0.87), 0.72 (95% CI, 0.64 to 0.81), and 0.67 (95% CI, 0.56 to 0.79), respectively. Only small heterogeneity was observed for <6 months of breastfeeding (p = 0.17; Q = 18.79, $I^2=25.5%$). Compared to nulliparous women with no history of breastfeeding, the joint effects of two births and <6 months of breastfeeding resulted in a 0.5-fold reduced risk for EOC. Conclusions: The first birth and breastfeeding for <6 months were associated with significant reductions in EOC risk.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5889-5897
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• 2015

Background: The performance of combined testing visual inspection with acetic acid (VIA) and cervical cytology tests might differ from one setting to another. The average estimate of the testing accuracy across studies is informative, but no meta-analysis has been carried out to assess this combined method. Objective: The objective of this study was to estimate the average sensitivity and specificity of the combined VIA and cervical cytology tests for the detection of cervical precancerous lesions. Materials and Methods: We conducted a systematic review and a meta-analysis, according to the Cochrane Handbook for Systematic Review of Diagnostic Test Accuracy. We considered two cases. In the either-positive result case, a positive result implies positivity in at least one of the tests. A negative result implies negativity in both tests. In the both-positive case, a positive result implies having both tests positive. Eligible studies were identified using Pubmed, Embase, Website of Science, CINHAL and COCRANE databases. True positive, false positive, false negative and true negative values were extracted. Estimates of sensitivity and specificity, positive and negative likelihood (LR) and diagnostic odds ratios (DOR) were pooled using a hierarchical random effect model. Hierarchical summary receiver operating characteristics (HSROC) were generated and heterogeneity was verified through covariates potentially influencing the diagnostic odds ratio. Findings: Nine studies fulfilled inclusion criteria and were included in the analysis. Pooled estimates of the sensitivities of the combined tests in either-positive and both-positive cases were 0.87 (95% CI: 0.83-0.90) and 0.38 (95% CI: 0.29-0.48), respectively. Corresponding specificities were 0.79 (95% CI: 0.63-0.89) and 0.98 (95% CI: 0.96-0.99) respectively. The DORs of the combined tests in either-positive or both-positive result cases were 27.7 (95% CI: 12.5-61.5) and 52 (95% CI: 22.1-122.2), respectively. When including only articles without partial verification bias and also a high-grade cervical intraepithelial neoplasia as a threshold of the disease, DOR of combined test in both-positive result cases remained the highest. However, DORs decreased to 12.1 (95% CI: 6.05-24.1) and 13.8 (95% CI: 7.92-23.9) in studies without partial verification bias for the combined tests in the either-positive and both-positive result cases, respectively. The screener, the place of study and the size of the population significantly influenced the DOR of combined tests in the both-positive result case in restriction analyses that considered only articles with CIN2+ as disease threshold. Conclusions: The combined test in the either-positive result case has a high sensitivity, but a low specificity. These results suggest that the combined test should be considered in developing countries as a primary screening test if facilities exist to confirm, through colposcopy and biopsy, a positive result.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.2
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• pp.497-501
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• 2016

Aim: To evaluate the relationship between pre-operative CA-125 levels and myometrial invasion in patients with early-stage endometrioid-type endometrial cancer. Materials and Methods: Two-hundred and sixty patients were diagnosed with endometrial cancer between January 2007 and December 2012. Of these, 136 patients with stage 1 endometrioid histologic-type and documented pre-operative serum CA-125 levels were included in the study. Age, preoperative CA-125 level, histologic grade, surgical grade, and presence of deep myometrial invasion were recorded. Additionally, 16, 20, and 35 IU/ml cutoff values were used and compared to evaluate the relationship between pre-operative CA-125 levels and myometrial invasion. Results: The average serum CA-125 level was $35.4{\pm}36.7$ in patients with deep myometrial invasion, and $21.5{\pm}35.8$ in cases without deep myometrial invasion. The relationship between the presence of deep myometrial invasion and CA-125 cut-off values (16, 20, 35 IU/ml) was statistically significant, although the correlation was weak (p<0.05). When the relationship between 16, 20 and 35 IU/ml CA-125 cut-off values and the presence of deep myometrial invasion was studied, specifity and sensitivity values were identified as: 0.60-0.68 for 16 IU/ml; 0.73-0.48 for 20 IU/ml; and 0.89-0.33 for 35 IU/ml. The sensitivity of 16 IU/ml cut-off value was higher when compared to other values. Conclusions: This study demonstrates that preoperative serum CA-125 values maybe used as a predictive test in patients with early stage endometrioid-type endometrium cancer, and as a prognostic factor alone. Further studies should be conducted to identify different CA-125 cut-off values in patients with low risk endometrial cancer.

• The Journal of Internal Korean Medicine
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• v.37 no.4
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• pp.631-644
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• 2016

Objectives: The purpose of this study was to evaluate the reliability and validity of an instrument for pattern identification and evaluation in chemotherapy-induced peripheral neuropathy (CIPN).Methods: The study consisted of 66 patients with CIPN (visual analog scale ≥30 mm, Eastern Cooperative Oncology Group ≤2). The test-retest reliability of the instrument for pattern identification and evaluation in CIPN was tested twice with the same patients in one week.Results: Pearson’s coefficient test-retest reliability of the instrument was 0.601-0.777. The internal reliability of each part was 0.619-0.811. To confirm the validity of the instrument for pattern identification and evaluation for CIPN, the correlation between the score for each identification pattern and that of other CIPN instruments was analyzed. The results revealed a positive correlation between the Functional Assessment of Cancer Therapy-General and CIPN-20.Conclusion: The reliability of the instrument for pattern identification and evaluation in CIPN was moderate, and the validity analysis revealed a positive correlation.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4525-4529
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• 2012

Objectives: To determine the prevalence and predicting factors of ovarian metastasis, and evaluate the histology of other ovarian neoplasms in women with early-stage cervical cancer. Methods: The medical records of women with cervical cancer stage IA-IIA who underwent primary surgical treatment at Siriraj Hospital, Mahidol University from January 2007 to December 2011 were used for the study. Demographic, clinical and histopathologic data of the women who underwent salpingo-oophorectomy were reviewed. Results: Of 264 women, the mean age was 52.3 years. The types of hysterectomy procedures were composed of 210 radical hysterectomy, 9 modified radical hysterectomy, 40 simple hysterectomy, and 5 abandoned hysterectomy. The prevalence of ovarian metastasis was 0.76% (2/264). All of ovarian metastatic patients were older than 60 years old, postmenopause, and had macroscopical stage IB1 cervical cancer. Others ovarian tumors were found in 7 patients including 1 synchronous ovarian carcinoma, 1 serous cystadenoma, 1 fibroma, and 4 teratoma. Conclusions: In cases of early-stage cervical carcinoma of the population studied, ovarian preservation could be another option in <60-year-old patients, with non-neuroendocrine cell type, stage IA, and no extracervical or ovarian lesions.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.1
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• pp.305-308
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• 2014

Background: To investigate the indications of loop electrosurgical excision procedure (LEEP) and its overtreatment rates for the see and treat and three step strategies in cases of atypical squamous cells of undetermined cytology (ASC-US) and low grade intraepithelial neoplasia (LGSIL) cytology. Materials and Methods: We retrospectively analyzed colposcopy directed biopsy (CDB) and LEEP results of 176 paients with ASC-US or LGSIL cytologies who underwent colposcopic examination. Results: Initial cytologies were ASCUS in 120 women and LGSIL in 56. According to the see and treat approach immediate LEEP was performed for38 women. Among the remaining 138 women, LEEP was performed for 32 whose CDB results revealed CIN2/3 lesions. In the see and treat group the recognition of CIN2/3 was found to be 39.4%. The overtreatment rate was 60% as compared to 25% in the three step group. In CDB group detection of CIN 2 or greater lesions increased with 3 or more biopsies. Conclusions: In patients with ASC-US/LGSIL cytologies CDB should be performed before LEEP to prevent overtreatment, with attention to all suspected areas and more than 2 biopsies taken.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8647-8650
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• 2014

Background: Ovarian cancer is the most common cancer cause of gynecologic cancer deaths. In order to increase the likelihood of patient survival through primary operation by gyneco-oncologists, an appropriate algorithm for referral is considered here. Materials and Methods: Suspicious adnexal mass cases including ovarian malignancy probability score-1 (OMPS1) scores between 2.3-3.65 are re-evaluated by OMPS2. Sensitivity and specificity of each score were determined. Results: Sensitivity and specificity with a 3.82 score of OMPS2 in the studied subgroup (OMPS1 scores between 2.3-3.65) were 64% and 76.9% respectively. Conclusions: Management of OMPS1 scores of below 2.3 with sensitivity of 100% and above 3.65 with specificity of 72.9% is clear. In the subgroup of cases with OMPS1 score between 2.3-3.65, OMPS2 is helpful for triage with a cutoff score of 3.82.

• Journal of Korean Biological Nursing Science
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• v.24 no.2
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• pp.86-94
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• 2022

Purpose: Patients experiencing chemotherapy-induced peripheral neuropathy (CIPN) apply various palliative care as well as drugs in their daily life to alleviate symptoms. There is a need to identify the influence of these efforts and patients' psychosocial status on the relief of CIPN symptoms. This short-term prospective study investigated how prescription drugs, non-pharmacological behaviors (exercise, massage, and heat therapy), and psychological states (social support, depression, and anxiety) affected CIPN symptoms. Methods: Participants scheduled to receive postoperative platinum or taxane-based chemotherapy were enrolled consecutively. CIPN was measured with the Neurotoxicity-12 subscale of the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity-12 instrument. Data were collected three times during the 4 or 5 cycles of chemotherapy. Results: At the end of the 2nd chemotherapy cycle, 93.1% of participants reported CIPN symptoms. Multiple regression analyses showed that a heat therapy (β= -.34, p< .001), massage (β= -.21, p= .012), and walking 5 times or more per week (β= -.26, p= .021) provided relieve for CIPN symptoms. Depression (β= .19, p= .027) significantly exacerbated CIPN symptoms. Conclusion: These results suggested that a comprehensive management program that includes walking, heat therapy, massage, and mood therapy should be encouraged. Moreover, patients should be educated at chemotherapy initiation to understand appropriate interventions that can relieve CIPN symptoms.