Despite its fall in incidence, gastric adenocarcinoma remains a common disease with dismal prognosis worldwide. A better understanding of its tumorigenesis and biologic properties of tumor cells related to invasion and metastasis is crucial to improving diagnosis and treatment. Conflicting results concerning the relationships between overexpression of PAI-1, c-erbB2, and p53 protein and biologic behavior of gastric carcinoma have been noted. The aim of this study was to evaluate the value of overexpression of PAI-1, c-erbB2, and p53 protein as prognostic factors in gastric adenocarcinoma. Overexpression of PAI-1, c-erbB2, and p53 protein by immunohistochemistry was correlated with variable clinicopathological parameters and patients' survival in 80 cases of gastric adenocarcinoma. Overall PAI-1 expression rate was 63.7% (51/80) and higher in advanced cancer (p=0.0003) and nodal metastasis (p=0.003) groups. Overall c-erbB2 expression rate was 43.8% (35/80) and higher in antral (p=0.03), differentiated (p=0.001), intestinal (p=0.0007), and expanding (0.03) groups. The p53 protein overexpression was 37.5% (30/80) and higher in early cancer (p=0.02), differentiated (p=0.006) and intestinal groups (p=0.009). Patients with PAI-1, c-erbB2, and p53 protein positive tumors tended to have poorer survival rates than patients with PAI-1, c-erbB2, and p53 protein negative tumors, but the difference was not statistically significant (p=0.25, 0.37, 0.52). Our data indicated that PAI-1 overexpression is one of the poor prognostic factors in gastric adenocarcinoma and c-erbB2 and p53 protein seem to be involved in the early stage of carcinogenesis of intestinal type-gastric adenocarcinoma.
Adenocarcinoma* ; Carcinogenesis ; Diagnosis ; Humans ; Immunohistochemistry ; Incidence ; Neoplasm Metastasis ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators* ; Plasminogen* ; Prognosis* ; Staphylococcal Protein A ; Stomach Neoplasms ; Survival Rate

Purpose: This study aimed to evaluate symptom experience and quality of life (QoL) and to identify the predictors of QoL among colorectal cancer patients undergoing chemotherapy. Methods: A cross-sectional study was conducted on 107 colorectal cancer patients at a university-affiliated hospital between June 1 and July 30, 2021. Functional Assessment of Cancer Therapy-Colorectal (FACT-C), Memorial Symptom Assessment Scale-Short Form (MSAS-SF) were used to assess symptom experience and QoL of these patients. Data were analyzed using Pearson’s correlation, t-test, ANOVA, and hierarchical multiple regression. Results: The mean QoL score for colorectal cancer patients was 88.78±20.08. The most frequently experienced physical and psychological symptoms were numbness/tingling and worrying. Physical and psychological symptoms have a significant negative association with QoL. Perceived economic status was significantly associated with QoL in patients’ general characteristics. The regression analyses showed that high psychological symptoms (β=-.63, p<.001), middle perceived economic status (β=-.22, p=.009) and low perceived economic status (β=-.36, p<.001) were statistically significant in predicting patients’ low QoL. Conclusion Symptom experience and QoL are essential variables that should be acknowledged when delivering health care to colorectal cancer patients. More attention to the reduction and comprehensive symptom management of psychological distress could improve QoL among colorectal cancer patients.

Purpose: This study aimed to investigate the influences of teamwork and job burnout on patient safety management activities (PSMA) among operating room nurses. Methods: We collected cross-sectional data from 144 operating room nurses with at least 1 year of clinical experience. Teamwork had five subscales (team structure, leadership, situation monitoring, mutual support, and communication) and burnout had two subscales (exhaustion and disengagement). We used descriptive statistics, t-tests, analysis of variance, Pearson’s correlation coefficients, and multiple linear regression. Results: PSMA had significant positive correlations with all subscales of teamwork and had a significant negative correlation with disengagement. Multiple regression analysis revealed that gender, clinical career in operating room, number of patient safety education, accreditation evaluation experience, team structure, and situation monitoring were associated with PSMA. Specifically, we found significant positive associations of team structure (β=.31, p<.001) and situation monitoring (β=.23, p=.039) with PSMA. Disengagement was not associated with PSMA after adjusting for confounders despite a significant correlation. Conclusion To improve operating room nurses’ PSMA, it is important to improve their awareness of the team structure and their ability to monitor the operating room situation.

Early detection of gastric cancer is crucial because the survival rate can be improved through curative treatment. Although surgery and gastrectomy with lymph node dissection remain as the gold standard for curative treatment, early gastric cancer (EGC) with negligible risk of lymph node metastasis can be treated with endoscopic resection (ER), such as endoscopic submucosal dissection. Among gastric cancers, undifferentiated-type cancer is distinguished from differentiated-type cancer in various aspects in terms of clinical features and pathophysiology. The undifferentiated-type cancer is also known to be associated with an aggressive behavior and a poor prognosis. Therefore, the indication of ER for undifferentiated EGC is limited compared with differentiated-type. Recent studies have reported that ER for undifferentiated EGC is safe and shows favorable short- and long-term outcomes. However, it is necessary to understand the details of the research results and to selectively accept them. In this review, we aimed to evaluate the current practice guidelines and the short-term and long-term outcomes of ER for undifferentiated type EGC.

Matrix producing carcinoma of the breast is a variant of heterologous metaplastic carcinoma which is defined as "overt carcinoma with direct transition to a cartilagenous and/or osseous stromal matrix without an intervening spindle cell zone or osteoclastic cells". This tumor is very rare, occuring in less than 0.2% of total breast carcinoma, but the prognosis is better than other metaplastic carcinoma. We experienced a case of fine needle aspiration(FNA) cytologic finding of matrix producing carcinoma of the breast. A 75-year old woman, who presented a right huge breast mass(9x8cm) during 10months, was examined. Mammography reveals right lateral mass with even density without calcification. Breast ultrasonography shows multifocal hypoechogenic cystic change in the huge mass, suggesting resolving hematoma or carcinoma or sarcoma with necrosis. On cytologic finding of FNA, myxoid matrix was the dominant feature and the rest of the material was composed of scanty isolated atypical cells with large irregular nuclei. The histologic finding was moderately differentiated adenocarcinoma with abundant cartilagenous matrix and focal squamous metaplasia.
Adenocarcinoma ; Aged ; Biopsy, Fine-Needle* ; Breast Neoplasms ; Breast* ; Female ; Hematoma ; Humans ; Mammography ; Metaplasia ; Necrosis ; Needles ; Osteoclasts ; Prognosis ; Sarcoma ; Ultrasonography, Mammary

Mycoses refer to infectious diseases caused by fungi. Fungal infections are rare and mainly occur as opportunistic infections in immunocompromised patients. Candida species are the most common cause of mycosis; however, members of the order Mucorales or genus Aspergillus may also cause serious fungal infections in immunocompromised hosts. Fungal infections of the gastrointestinal (GI) tract can be asymptomatic or may present with abdominal pain, bloating, diarrhea, or GI bleeding. Although rare, thorough understanding of fungal infections of the upper GI tract encountered in real-world clinical settings can enable early diagnosis and prompt initiation of treatment to improve patient prognosis.

OBJECTIVES: This study was conducted to compare the object relations and parenting behavior of the mothers of children with attention-deficit hyperactivity disorder (ADHD) with that of the mothers with normal children. METHODS: In this study, we studied 64 mothers of children who were diagnosed with ADHD and 90 mothers of normal children. The mothers completed the Bell Object Relations Inventory (BORI), the Parenting Behavior Inventory (PBI), the Parenting Stress Index (PSI) and the Parenting Sense of Competence (PSOC) scale. RESULTS: As compared with the mothers of normal children, the mothers of children with ADHD showed significantly different results for the parenting stress and parenting efficacy. For parenting behavior, the mothers of children with ADHD perceived their mothering as being more neglectful. On the other hand, the mothers of the normal control group perceived their mothering as being more affectionate and the fathers as being more reasonable and monitoring. CONCLUSION: This study suggests there is a significant difference of object relation between the mothers of children with ADHD and the mothers with normal children. The object relation pathology of the mothers of children with ADHD might contribute to impaired parenting behavior. The result of the present study indicate that inadequate grandparental rearing behavior affects the insecure object relation of their child (the mother), and a mother's insecure object relation affects their parental stress and parenting efficacy.
Child ; Fathers ; Hand ; Humans ; Mental Competency ; Mothers ; Object Attachment ; Parenting ; Parents

OBJECTIVES: This study was conducted to compare the object relations and parenting behavior of the mothers of children with attention-deficit hyperactivity disorder (ADHD) with that of the mothers with normal children. METHODS: In this study, we studied 64 mothers of children who were diagnosed with ADHD and 90 mothers of normal children. The mothers completed the Bell Object Relations Inventory (BORI), the Parenting Behavior Inventory (PBI), the Parenting Stress Index (PSI) and the Parenting Sense of Competence (PSOC) scale. RESULTS: As compared with the mothers of normal children, the mothers of children with ADHD showed significantly different results for the parenting stress and parenting efficacy. For parenting behavior, the mothers of children with ADHD perceived their mothering as being more neglectful. On the other hand, the mothers of the normal control group perceived their mothering as being more affectionate and the fathers as being more reasonable and monitoring. CONCLUSION: This study suggests there is a significant difference of object relation between the mothers of children with ADHD and the mothers with normal children. The object relation pathology of the mothers of children with ADHD might contribute to impaired parenting behavior. The result of the present study indicate that inadequate grandparental rearing behavior affects the insecure object relation of their child (the mother), and a mother's insecure object relation affects their parental stress and parenting efficacy.
Child ; Fathers ; Hand ; Humans ; Mental Competency ; Mothers ; Object Attachment ; Parenting ; Parents

BACKGROUND/AIMS: Along with the expansion of the field of laparoscopic surgery, many laparoscopic instruments have been developed and these all together made laparoscopic surgery possible in many operative procedures which used to be considered impossible to be done using a laparoscope. Suturing is a technique quite often required during laparoscopic surgery and so far we have used imported suture material. In this article, we have compared the safety and harmfulness of suture material developed domestically in Korea with those imported using house rabbits. METHODS: A total of 40 white house rabbits from New Zealand weighing 3.0-3.4 Kg were used from July 1, 2000 until April 30, 2001. Under general anesthesia, we created a pneumoperitoneum using a veress needle with a pressure of 10 mmHg followed by insertion of a 5mm laparoscope right above the umbilicus and two 5mm trocars were inserted in the right and left midclavicular lines 5cm below the costal margin. After perforating the pylorus of the stomach using laparoscopic scissors, we sutured two sites using Laploop and then perforated the body of the stomach and again sutured two sites but this time using Vicryl #3-0 for comparison with Laploop. 10 house rabbits were sacrificed each on post operation days 10, 20, 30 and 40 and tissues obtained from those house rabbits were compared using the Sewell method. RESULTS: Suturing and ties were done without any problems and there were no postoperative complications or deaths. On postoperation days 10 and 20, Laploop showed a moderate degree of tissue reaction proved by a Sewell score of 57 and 48 respectively and on postoperation days 30 and 40, a mild to moderate degree of tissue reaction occurred with a S score of 36 and 33 respectively. In models using Vicryl, the S scores were 67 an 62 on postoperation days 10 and 20 respectively showing a moderate degree of tissue reaction and on postoperation days 30 and 40, it showed a mild to moderate degree of tissue reaction with a S score of 52 and 44 respectively which is similar to the results obtained by Laploop. CONCLUSION: Imported Vicryl and Laploop were both applicable in terms of biologic compatibility but Laploop was easier to apply, more cost effective compared to Vicryl but most of all, there were no complications such as a loosening of a knot or a knot being undone. Therefore it could be concluded that Laploop shows a promising future as a suture material in laparoscopic surgery.
Anesthesia, General ; Korea ; Laparoscopes ; Laparoscopy ; Needles ; New Zealand ; Pneumoperitoneum ; Polyglactin 910 ; Postoperative Complications ; Pylorus ; Rabbits* ; Stomach ; Surgical Instruments ; Surgical Procedures, Operative ; Sutures ; Umbilicus