Purpose: This study reviewed screening and assessment tools that are used to measure delirium in patients with cancer in hospice and palliative care settings and examined their psychometric properties. Methods: Four databases were searched for studies using related search terms (delirium, tools, palliative care, cancer, and others). The inclusion criteria were a) studies that included screening/assessment tools for measuring delirium in cancer patients receiving hospice/palliative care, and b) studies published in English or Korean. The exclusion criteria were a) studies that were conducted in an intensive care setting, and b) case studies, qualitative studies, systematic reviews, or meta-analyses. Results: Out of the 81 studies identified, only 10 examined the psychometric properties of tools for measuring delirium, and 8 tools were ultimately identified. The psychometric properties of the Memorial Delirium Assessment Scale (MDAS) were the most frequently examined (n=5), and the MDAS showed good reliability, concurrent validity, and diagnostic accuracy. The Delirium Rating Scale had good reliability and diagnostic accuracy. The Delirium Rating Scale-Revised 98 also showed good reliability and structural validity, but its diagnostic performance was not examined in hospice/palliative care settings. The Nursing Delirium Screening Scale showed relatively low diagnostic accuracy. Conclusion The MDAS showed evidence of being a valid assessment tool for assessing delirium in patients with cancer in palliative care. Few studies examined the diagnostic performance of delirium tools. Therefore, further studies are needed to examine the diagnostic performance of screening/assessment tools for the optimal detection of delirium in patients with cancer in hospice/palliative care.

OBJECTIVES: With the increase in cancer prevalence, the health behavior of cancer survivors has become an important issue. This study was conducted to examine the psychosocial correlates of behavior changes after cancer diagnosis. METHODS: 95 patients completed questionnaires assessing depression, anxiety, insomnia, posttraumatic stress symptoms, social constraints, personal beliefs about cancer cause and health-related behavior changes after cancer diagnosis. RESULTS: In the multiple logistic regression analysis, insomnia was the only significant predictor of positive change in physical behavior : normal sleep group(Odds ratio=9.462, 95% CI 1.738-51.509) and subthreshold insomnia group(Odds ratio=10.529, 95% CI 1.701-65.161) showed a larger increase compared to the insomnia group. In psychosocial behavior, low age, religion and causal belief in hormonal factors were independent factors that predicted increase in positive change. CONCLUSIONS: This study showed a difference between predictors of physical and psychosocial health behavior change after breast cancer diagnosis. Multi-faceted approaches are required to promote positive change in health behavior in cancer patients.
Anxiety ; Breast ; Breast Neoplasms ; Depression ; Health Behavior ; Humans ; Logistic Models ; Prevalence ; Questionnaires ; Sleep Initiation and Maintenance Disorders ; Survivors

Matrix metalloproteinases are believed to play an important role in tumor invasion and metastasis. But little is known about the role of them in the gastric adenocarcinoma. We investigated the expression of matrix metalloproteinase-1,2,3 in eighty paraffin blocks of the primary gastric adenocarcinoma tissues with immunohistochemistry and analysed their correlation with lymph node metastasis and survival. MMP-1,2,3 were expressed most intensely in the fibroblasts around the tumor stroma. In our study the increased immunoreactivity of MMP-2 only showed statistically significant correlation with lymph node metastasis (P=0.0517, Odd's ratio=2.274). But MMP-1,2,3 all were correlated with survival. Type IV collagen was observed in the vascular basement membranes and tumor basement membranes and showed statistically significant correlation with lymph node metastasis (P=0.0002, Odd's ratio=0.194) and prognosis (P=0.0001). The immunoreactivity of MMP-2 and type IV collagen was inversely correlated (Kendall's Tau-b correlation = 0.37482, P=0.0001). Our results suggest that in human gastric adenocarcinoma the increased immunoreactivity of MMP-2 and the decreased immunoreactivity of type IV collagen has an important role in lymph node metastasis and prognosis. MMP-1,3 are not correlated with lymph node metastasis but correlated with survival. The mechanism responsible for the production of MMP by the host fibroblasts remains obscure and requires further investigation.
Adenocarcinoma* ; Basement Membrane ; Collagen Type IV* ; Fibroblasts ; Humans ; Immunohistochemistry ; Lymph Nodes* ; Matrix Metalloproteinases ; Neoplasm Metastasis* ; Paraffin ; Prognosis*

No abstract available.
Pregnancy*

PURPOSE: The goal of this study was to compare the effects of treatment of newborn babies with two different surfactants, Curosurf(R) and Surfacten(R). METHODS: We retrospectively reviewed the medical records from 2007 to 2009 and divided the patients into two groups: those who received Curosurf(R) (n=20) and those who received Surfacten(R) (n=21). We compared the groups for sex, gestational age (GA), birth weight, type of delivery, apgar score, maternal history, age at treatment, bronchopulmonary dysplasia (BPD), administration indomethacin for patent ductus arteriosus(PDA), necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), periventricular leucomalacia (PVL), retinopathy of prematurity (ROP), pulmonary hemorrhage (PH), pneumothorax (PTX), duration of ventilation, need for oxygen, and administration. RESULTS: The demographic and clinical variables were similar in both groups. The gestational age for Curosurf(R) and Surfacten(R) were 32.7+/-3.1 and, 30.5+/-4.3 weeks, respectively (P=0.08). Six newborns in the Curosurf(R) group and 8 in the Surfacten(R) group developed BPD (P=0.59). No significant differences were noted for NEC, IVH, PVL, ROP, PH, PTX between the two groups (IVH, P=0.14; PVL, P=0.94; ROP P=0.94; PTX P=0.34). The mean duration of ventilation was 16.8 days with Curosurf(R) and 23.7 days with Surfacten(R), but these differences were not statistically significant (P=0.43). The differences in duration of need for oxygen and administration were also not statistically significant (P=0.92, 0.91, respectively). CONCLUSION: This study indicated no significant differences between Curosurf(R) and Surfacten(R). However, because of its convenience and the merit of minimal touching of the babies, the use of Curosurf(R) is recommended.
Apgar Score ; Birth Weight ; Bronchopulmonary Dysplasia ; Diterpenes ; Enterocolitis, Necrotizing ; Gestational Age ; Hemorrhage ; Humans ; Hydrogen-Ion Concentration ; Indomethacin ; Infant, Newborn ; Leukomalacia, Periventricular ; Medical Records ; Oxygen ; Pneumothorax ; Retinopathy of Prematurity ; Retrospective Studies ; Surface-Active Agents ; Ventilation

Teratocarcinoma is a form of mixed germ cell tumor composed of a mixture of teratoma and embryonal carcinoma. It is rarely found in the brain, but when present it is most commonly found in the pineal region. We investigated a case of primary teratocarcinoma in the pineal region. The patient was a 10 year old boy who had suffered from a bitemporal headache for one month. Brain CT and MRI revealed a rather well defined ovoid heterogenous mass in the pineal gland region, measuring 4.3 x 3.8 x 3.0 cm in size. Microscopically the tumor contained areas of immature teratoma and embryonal carcinoma. Immunohistochemical staining revealed positive reactions for cytokeratin, epithelial membrane antigen, carcinoembryonic antigen, and alpha-fetoprotein in the embryonal carcinoma component.

Hydranencephaly is a term used to describe a group of brain malformations in regard to developing any brain remnants. With most of the cerebral cortex absent, the cerebral hemispheres are replaced by cerebrospinal fluid (CSF), covered with leptomeninges and dura. Hydranencephaly is a rare isolated abnormality occurring in less than 1 per 10,000 births. With the cutting edged sonography, most of the hydranencephalies are screened in antenatal care. Therefore, it is very rare to observe a living preterm with hydranencephaly. From a history of a young, 19-year-old pregnant woman who did not look for the antenatal care, we found out that it was her first pregnancy, she was unmarried and intermittently had alcohol during the pregnancy. After home delivery, a preterm newborn assumed to be 28 weeks of gestational age was placed under surfactant therapy because of respiratory distress syndrome, and then received a mechanical ventilation. Brain sonography showed that most of the cerebral parenchyma, cortical tissue was absent at the 5th day after the birth. Magnetic resonance images (MRI) of brain showed that almost complete absence of cerebrum which was replaced by CSF, hydranencephaly at 81th days from birth. In summary, we report a preterm newborn with hydranencephaly from an adolescent, unmarried woman who had no antenatal care.
Adolescent ; Brain ; Cerebral Cortex ; Cerebrum ; Female ; Gestational Age ; Humans ; Hydranencephaly ; Illegitimacy ; Infant, Newborn ; Magnetic Resonance Spectroscopy ; Parturition ; Pregnancy ; Pregnant Women ; Respiration, Artificial ; Single Person ; Young Adult

This report presents an unusual case of primary malignant melanoma in the midesophagus. The patient was a 36-year-old woman presenting with dysphagia and odynophagia. The resected esophagus and proximal stomach showed a dark purple large polypoid mass, measuring 6.0 3.3 2.0 cm, with a diffuse tan pigmentation of surrounding mucosa in the mid-esophagus and two small daughter nodules, up to 1.2 0.3 cm, in the lower esophagus near the gastro-esophageal junction. A microscopic examination revealed a malignant melanoma of epithelioid cell type confined to mucosa and submucosa with a diffuse melanosis. Cytoplasmic immunoreactivity for HMB 45 and S-100 protein were noted. An electron microscopic examination revealed large, loosely cohesive variable shaped cells with a few cytoplasmic premelanosomes.
Adult ; Cytoplasm ; Deglutition Disorders ; Epithelioid Cells ; Esophagus* ; Female ; Humans ; Melanoma* ; Melanosis ; Mucous Membrane ; Nuclear Family ; Pigmentation ; S100 Proteins ; Stomach ; Triacetoneamine-N-Oxyl

We have corrected the conclusion in abstract.

This report describes a primary malignant melanoma which developed in the anus, as documented by light microscopy and immunohistochemistry. A 53-year-old woman had a 4 month history of a protruding mass in the anal canal. The mass was located in the squamo-columnar junction of the anal canal, measuring 5.0x4.5 cm. Its cut surface was dark brown and poorly circumscribed. The histologic appearance was characterized by epithelioid or spindle cells with prominant nucleoli and frequent atypical mitosis. Melanin pigments were strongly seen in Fontana-Masson stain. Immunoreactivity revealed that the cytoplasm of tumor cells was strongly positive with antibody directed against S-100 protein, vimentin and it was focally positive with neuron specific enolase.
Female ; Humans