Cancer, including gastric cancer, occurs predominantly in older patients. Although there is no single internationally accepted standard chemotherapy regimen for unresectable or metastatic gastric cancer (MGC), doublet combination chemotherapy using fluoropyrimidine and platinum is regarded as the reference treatment. However, most of the clinical trials that were based on the current treatment guidelines were performed in patients < 70 years of age with good performance status (PS). Therefore, the clinical application of these guidelines to elderly individuals is limited. The available data suggest that older patients with good PS are able to tolerate the same chemotherapy regimens as younger patients with MGC, and that they achieve a similar efficacy. In contrast, some studies showed that the same efficacy was achieved at the expense of increased toxicity in older patients, emphasizing the importance of patient selection. Many studies have actively investigated elderly patients with MGC, including randomized phase 3 studies comparing fluoropyrimidine and platinum doublets with fluoropyrimidine alone. Although an advanced age alone should not preclude the use of effective chemotherapy in MGC, more data regarding age-specific clinical trials are needed to guide optimal treatment in elderly patients.
Aged* ; Drug Therapy* ; Drug Therapy, Combination ; Humans ; Patient Selection ; Platinum ; Stomach Neoplasms*

In gastric cancer, the only potentially curative treatment is surgery that attempts to achieve curative (R0) resection. However, despite the use of curative resection, a recurrence develops in a high percentage of patients, especially in cases of serosa and/or lymph node involvement. As a strategy to improve the survival of the patients with resectable advanced gastric cancer, neoadjuvant chemotherapy has been evaluated in several phase II trials and a few phase III trials. The results of these trials have confirmed the feasibility and safety of this approach with no apparent increase in surgical complications. Recently, the findings of a large phase III randomized trial (MAGIC trial) have indicated that compared to the use of surgery alone, perioperative chemotherapy, using both a neoadjuvant and adjuvant strategy, decreased the number of T and N stage cancers and improved survival. The results of another recent phase III trial (FNLCC 94012/FFCD 9703) also showed that compared to the use of surgery alone, perioperative chemotherapy improved the R0 resection rate and survival. In both trials, the improved outcomes may be attributed to the use of neoadjuvant chemotherapy because of poor compliance with adjuvant chemotherapy. These results cannot be directly translated to clinical practice in Korea due to differences in surgical techniques and outcomes. However, the findings of a few small phase II and III trials performed in patients with locally advanced gastric cancer in Korea have also suggested that neoadjuvant chemotherapy would result in the improvement of the R0 resection rate and down-staging of the disease. More effective chemotherapy regimens are needed in future large randomized trials to determine the subset of patients that will benefit from neoadjuvant chemotherapy and to determine the extent of benefit.
Chemotherapy, Adjuvant ; Compliance ; Humans ; Korea ; Lymph Nodes ; Recurrence ; Serous Membrane ; Stomach ; Stomach Neoplasms

Although surgical resection remains the only curative treatment for gastric cancer, locoregional and distant recurrence are still common after surgical resection with curative intent underscoring the importance of a multimodal approach. In recent decades, there have been notable improvements in multidisciplinary treatments for gastric cancer that influence clinical decision and treatment algorithms; these include surgery, chemotherapy, and radiotherapy. Notably, multimodal and multidisciplinary approaches to gastric cancer have developed in various ways according to geographical regions in the context of variations in disease incidence, etiology/epidemiology, clinical features, and treatment outcome. Differences in surgical techniques, curative resection rate, survival outcomes after curative resection, and relapse patterns between the East and West lead to different perioperative multidisciplinary strategies. In Western countries, low rates of curative resection and high rates of locoregional recurrence following suboptimal surgery, in addition to systemic spread after surgery, provide a rationale for perioperative chemotherapy (preoperative and postoperative chemotherapy) and postoperative chemoradiation. In contrast, Eastern countries have focused on reducing systemic failures by emphasizing postoperative chemotherapy after curative resection. To further improve perioperative treatment in localized gastric cancer, more sophisticated risk stratification and novel therapeutic strategies such as molecularly targeted agents need to be investigated, based on an understanding of the molecular pathogenesis of the disease.
Chemoradiotherapy ; Drug Therapy ; Incidence ; Radiotherapy ; Recurrence ; Stomach Neoplasms* ; Survival Rate ; Treatment Outcome

Although surgical resection remains the only curative treatment for gastric cancer, locoregional and distant recurrence are still common after surgical resection with curative intent underscoring the importance of a multimodal approach. In recent decades, there have been notable improvements in multidisciplinary treatments for gastric cancer that influence clinical decision and treatment algorithms; these include surgery, chemotherapy, and radiotherapy. Notably, multimodal and multidisciplinary approaches to gastric cancer have developed in various ways according to geographical regions in the context of variations in disease incidence, etiology/epidemiology, clinical features, and treatment outcome. Differences in surgical techniques, curative resection rate, survival outcomes after curative resection, and relapse patterns between the East and West lead to different perioperative multidisciplinary strategies. In Western countries, low rates of curative resection and high rates of locoregional recurrence following suboptimal surgery, in addition to systemic spread after surgery, provide a rationale for perioperative chemotherapy (preoperative and postoperative chemotherapy) and postoperative chemoradiation. In contrast, Eastern countries have focused on reducing systemic failures by emphasizing postoperative chemotherapy after curative resection. To further improve perioperative treatment in localized gastric cancer, more sophisticated risk stratification and novel therapeutic strategies such as molecularly targeted agents need to be investigated, based on an understanding of the molecular pathogenesis of the disease.
Chemoradiotherapy ; Drug Therapy ; Incidence ; Radiotherapy ; Recurrence ; Stomach Neoplasms* ; Survival Rate ; Treatment Outcome

The purpose of this study was to assess several indices of diet quality based on nutrient, food and food group intake of Korean adolescents based on several indices on diet quality according to residence area and body size. Using the data from the 1998 National Health and Nutrition Survey, twenty-four-hour-dietary recalls of a total of 1,110 Korean adolescents aged 13-19 years (male 543, female 567) were analyzed for nutrient adequacy ratio (NAR), index of nutritional quality (INQ), the number of foods (Dietary Variety Score, DVS) and food group consumed (Dietary Diversity Score, DDS). In doing that, it was attempted to apply only the minimum amount of solid foods of Kant's without inclusion of liquid foods because of the very limited variety in Korean foods. Based on weight length index, 13.1% of the subjects were categorized as obese, 14.2%, overweight, 44.4%, normal and 28.3%, underweight. Only vitamin B2 intake was higher in the obese group than in the underweight group. There was no meaningful difference in energy, protein and fat intakes according to the grade of the body size. In terms of residence area, intake of fat, niacin, vitamin B6 and folic acid were lower in the rural areas than in the metropolitan city. Only vitamin E intake was higher in the rural areas. Mean value of NARs (MAR) and INQs (mINQ) was also higher in the metropolitan city than in the rural areas, but there was no significant difference of these two values according to body size of the subjects. Mean DVS was 21.02 for total subjects, and has no difference between male and female and between metropolitan city and other medium-small city. But, the rural areas showed the lowest DVS of 19.05. Mean DDS in which five is a maximum score was 3.3 with no significant difference by sex and by residence area in male subjects. However, in female subjects, DDS in the rural areas was the lowest. According to body size of the subjects, there was no meaningful difference in both scores of DVS and DDS. In conclusion, most indices of nutrient intake and food and food group intake were not significantly different by body size of the subjects, while most indices were significantly different by residence areas: higher in the metropolitan city than in the rural area.
Adolescent* ; Body Size* ; Diet* ; Female ; Folic Acid ; Humans ; Male ; Niacin ; Nutrition Surveys ; Nutritive Value ; Overweight ; Riboflavin ; Thinness ; Vitamin B 6 ; Vitamin E ; Vitamins

Prologation of the corrected QT(QTc) has been shown to increase the period of vulnerability of the heart to arrhythmias as well as to increase the incidence of ventricular premature beats. Previous studies indicate that inhalation anesthetics may prolong the QTc interval, because of the decrease in slow channel-medicated current. Therefore this study was performed to evaluate the effects of halothane and/or intervals in the cat. Adult male of female cats weighing 2-4kg were divided into verapamil-treated group(group l), halothane-treated group(group lla) and halothane-and verapamil-treated group(group llb). The QTc blood pressures and heart rates were measured with EKG lead ll to compare those at pretreatment with at post-treatment. The results are follows: 1) The QTc intervals at the post-treatment period are significantly longer than those at the pre-treatment period in all groups(p<0.05). 2) In group ll, the systolic and diastolic blood pressures, and the heart rates after administration were decreased(p<0.05). 3) the QTc intervals in group llb were more prolonged than in group lla(p<0.05). 4) No correlation between thredd different doses of verapamil and the degree of prolongation of QTc intervals was shown. It was concluded that either halothane or verapamil prolonged the QTc intervals and simultaneous administration of both agents resulted in even more prolongation of QTc intervals. However, the size of dose of verapamil was not related to the degree of prolongation of QTc intervals.
Adult ; Anesthetics, Inhalation ; Animals ; Arrhythmias, Cardiac ; Cardiac Complexes, Premature ; Cats* ; Electrocardiography ; Female ; Halothane* ; Heart ; Heart Rate ; Humans ; Incidence ; Male ; Verapamil*

Hypertension is a well-known degenerative disease whose prevalence rate increases with age. Management of high blood pressure is a critical concern in preventive strategies to reduce the morbidity and mortality for cardiovascular disease. The purpose of this study was to examine the dietary characteristics of hypertensive program participants, and to establish strategies based on their nutritional needs. Hypertensive patients were enrolled in the program in a public health center or in a local elderly center, at Suwon, in 1999-2000. Trained dietitians interviewed 62 enrollees(24-hour recall) and related variables. Mean body mass index of the subjects was 25.0kg/m2. 30.7% of the subjects had a family history of hypertension. The majority of them ate regularly and partook of all available side dishes. They consumed grains and vegetables regularly, but seldom ate dairy products or food prepared with oil. Male enrollees frequently consumed more processed food and animal fat than did female enrollees(p<0.05). An analysis of the percentage of RDA(Recommended Dietary Allowances of Korea 1995) showed that but for ascorbic acid, enrollees consumed nutrients below the RDA. The food group intake pattern was not diverse, thus only 8.1% of enrollees consumed all food groups in a day. An analysis of eating attitude showed that 64.5% of enrollees always added salt to beef soup. Male enrollees showed low food-related self-efficacy compared to female enrollees, especially with reference to reduction of instant food intake(p<0.01), increase in vegetable intake(p<0.01), reduction of monosodium glutamate(MSG) intake(p<0.01). and not overeating(p<0.05). Their perceived barriers for participating in hypertension nutrition programs included lack of time, program necessity non-recognition, and program comprehension difficulty. These results suggest that nutrition education program necessity non-recognition, and program comprehension difficulty. These results suggest that nutrition education programs for community hypertensive patients should focus on increasing participant consumption of foods, expecially dairy products, and desirable eating attitudes. It also suggests that the program should consider should consider encouraging self-efficacy in changing eating behavior.
Aged ; Animals ; Ascorbic Acid ; Body Mass Index ; Cardiovascular Diseases ; Edible Grain ; Comprehension ; Dairy Products ; Eating ; Education* ; Feeding Behavior ; Female ; Gyeonggi-do ; Humans ; Hypertension ; Korea ; Male ; Mortality ; Nutritionists ; Prevalence ; Public Health* ; Self Efficacy ; Vegetables

The prognosis of gastric cancer with hepatic metastasis is very poor, even though several treatment modalities exist, such as surgical resection. Indeed, a standard therapy has not been established in such patients. Recently, attempts were made to treat hepatic metastasis of gastric cancer with radiofrequency (RF), which was originally used in primary or metastatic liver cancer. RF has been reported to show similar survival compared to surgical resection and is emerging as a new treatment modality even though it is still not conclusive with respect to efficacy and safety due to the paucity of reports. A prospective study is warranted to evaluate the efficacy of RF in the treatment of gastric cancer with hepatic metastasis compared with conventional modalities.
Humans ; Liver Neoplasms ; Neoplasm Metastasis ; Prognosis ; Stomach Neoplasms

OBJECTIVES: This study was conducted to investigate the status and need for nutrition and dietary life education among nutrition teachers at schools. These characteristics were analyzed if they were different between elementary schools and middle-high schools. METHODS: Subjects were 151 nutrition teachers from 70 elementary schools, 41 middle schools and 40 high schools in 17 cities nationwide selected by two-stage stratified cluster sampling process. Survey questionnaires included the items on general characteristics, status and need assessment for nutrition and dietary life education. Chi-square test or t-test was used for data analysis by school groups. RESULTS: Nutrition education was implemented at 65.7% of elementary schools and 51.9% of middle-high schools. Nutrition education was mainly performed in 'discretionary activities·extracurricular activities' at elementary school and through 'newsletters, school homepage, foodservice bulletin board' at middle-high school (p<0.001). The most needed topic for nutrition education in nutrition teachers was 'healthy dietary habits and table manners' and this was not significantly different by school groups. Responses on adequate frequency (p<0.01), methods used for nutrition education (p<001), materials for nutrition education (p<0.001), information sources for nutrition education (p<0.001) were significantly different by school groups. Major tasks for activating nutrition education included 'securing the time for implementing nutrition education by reducing work loads' and 'developing standardized nutrition education materials' in schools. CONCLUSIONS: Nutrition education at schools might be activated by improving working conditions of nutrition teachers and developing the practical programs that reflect the needs of nutrition teachers.
Adolescent ; Child ; Education* ; Food Habits ; Humans ; Needs Assessment ; Statistics as Topic

Objective: This study aimed to identify the clinical characteristics for differential diagnosis of Parkinson’s disease dementia (PDD) and dementia with Lewy bodies (DLB) by analyzing the differences in cognitive function and caregiver burden between the patient groups. Methods: We conducted a retrospective cross-sectional study with idiopathic Parkinson’s disease patients and DLB patients. Differences in cognitive function were measured using the standardized neuropsychological test battery (Seoul Neuropsychological Screening Battery-II). Differences in the caregiver burden were measured by the Neuropsychiatric Inventory-Questionnaire (NPIQ) for behavioral psychological symptoms of dementia (BPSD) and Korean-Instrumental Activities of Daily living (K-IADL) for daily living activities. For statistical analysis, chi-square test and multivariate analysis of variance and binary logistic regression and correlation analysis were conducted using SPSS 22. Results: Nine Parkinson’s disease-Normal cognition (PD-NC), 25 Parkinson’s disease-mild cognitive impairment (PD-MCI), 20 PDD and 11 DLB patients were included. Compared with PDD and DLB, attentional deficit correlated more strongly with DLB, but language dysfunction showed more correlation with PDD. Caregiver burden correlated more strongly with DLB than PDD. Delusion and aberrant motor behaviors of NPI-Q and taking medicine of K-IADL were strongly related with the caregiver burden of both PDD and DLB. Conclusion This study identified that neuropsychological profile and caregiver burden in comparison of BPSD and ADL can contribute to the differential diagnosis of PDD and DLB.