OBJECTIVETo evaluate the differences in clinicopathological characteristics and severity between American and Chinese patients with colorectal Crohn disease(CD).

METHODSBetween March 1985 and September 2004, 68 patients with colorectal CD in Cleveland Clinic Florida (America) and 85 patients with colorectal CD in the 301 Hospital(China) were enrolled in the study. Data of two groups,including demographics, clinical characteristics, extraintestinal manifestations, presenting symptoms, location and pathological characteristics,were compared.

RESULTS60.3% of American patients and 36.5% of Chinese patients were female(P=0.003). 11.8% of American patients and 1.2% of Chinese patients had a family history of CD(P=0.016). American patients had a significantly higher rate of extraintestinal disease (39.7% vs 20.0%), abscess(19.0% vs 0), and anorectal fistulas(51.5% vs 0). American patients had significantly more extensive disease than Chinese patients(pancolitis: 44.1% vs 4.7%, P<0.01). American patients had a significantly higher rate of disease involving the ascending colon, transverse colon, descending colon, sigmoid colon, anorectal area compared with Chinese patients(all P<0.05).

CONCLUSIONSAmerican patients with colorectal Crohn disease seem to have a female predominance, a higher rate of CD family history, to involve the distal intestinal tract more often, and have more severe clinical manifestation and pathological process, as compared with Chinese patients.

Adolescent ; Adult ; China ; Crohn Disease ; ethnology ; pathology ; Female ; Humans ; Male ; Middle Aged ; United States ; Young Adult

Adult ; Antisocial Personality Disorder ; Homicide ; psychology ; Humans ; Korea ; ethnology ; Male ; Mass Casualty Incidents ; psychology ; Suicide ; psychology ; United States ; Universities ; Virginia

This essay examines the period between 1897 and 1910, when trachoma, a contagious eye disease, became an "Oriental" problem that justified exclusionary immigration policy against Asians entering the United States. It also investigates the ways in which the public fear and alleged threat of the eye disease destabilized and undermined the rights of Asian immigrants. Many scholars have explored the link between trachoma and southern and eastern European newcomers, in particular Jews, but they have not paid much attention to Chinese or Japanese immigrants, for whose exclusion trachoma played a significant role. This is primarily because the number of Asian immigrants was much smaller than that of their European counterparts and because the Chinese Exclusion Acts, which had already been in place, functioned as a stronger and more lasting deterrent to Asian immigration than exclusion or deportation through medical inspection. Moreover, into the 1910s, medical and scientific innovations for detecting parasitic diseases (e.g. hookworm) helped American authorities exclude Asians in larger numbers. Still, the analysis of the discourses surrounding trachoma and immigration from Asia, though short-lived, demonstrates the role of medical inspection in controlling and regulating Asian immigrants, in particular Chinese and Japanese, into the United States and in constructing their legal and political rights. In 1906, the fear of trachoma justified an order to segregate Japanese students from white children in San Francisco even at the cost of compromising their rights as citizens. Along with fierce criticisms against immigration officials by the American public, the 1910 investigation of the San Francisco Immigration Office problematized the admission of trachoma-afflicted Asian immigrants. Those critical of the Immigration Office and its implementation of American immigration policy called for exclusionary measures to limit the privileges of exempt classes and domiciled aliens and hinder the exertion of their rights to leave and reenter their adopted country. The two examples show that trachoma was a convenient excuse to condemn inefficient immigration policy and regulate allegedly diseased Asian bodies. In 1910, the federal government made a decision to relegate to steamship companies full responsibility for medical inspection at Asian ports. Since they had to pay a fine for every immigrant excluded at American borders for medical reasons, including trachoma, steamship companies carried out more rigorous examinations. With medical advancements and growing interest in parasitic diseases, trachoma soon lost its appeal to immigration authorities. However, the association of immigration, race, and disease has continued to provide a rationale for immigration control beyond American borders.
Emigrants and Immigrants/*history/legislation & jurisprudence ; Emigration and Immigration/*history/legislation & jurisprudence ; Far East/ethnology ; History, 19th Century ; History, 20th Century ; Humans ; Trachoma/ethnology/*history/prevention & control ; United States

This study was conducted to assess the psychosocial adjustment of Korean-American physicians in the aspect of personal satisfaction after returning to Korea. A questionnaire was mailed to 72 Korean-American physicians who were practicing medicine in Korea and forty physicians responded. These physicians, typically in their 50s, lived in America for 21-30 years before coming back to Korea. The most frequent motives for them to come back to Korea were giving back to their native country, longing for their native country, filial duty, and suggestions from their colleagues or professors to move back. Eighty percent of them were extremely satisfied or slightly satisfied with their work in Korea, and only 10% are extremely or slightly dissatisfied with their decision to return. Although most of them are content for the time being in Korea, only 12.5% have definite plans to stay in Korea after retirement. The variables that were most significantly related to personal satisfaction of returning to Korea were how well treated at work and how much satisfied with job rather than other factors such as motives for returning, duration of staying in America and in Korea, and family situation.
Adaptation, Psychological* ; Adult ; Emigration and Immigration ; Human ; Job Satisfaction ; Korea/ethnology ; Middle Age ; Personnel Selection ; Physicians/supply & distribution ; Physicians/psychology* ; Quality of Life ; Retirement* ; Schools, Medical/manpower ; United States/ethnology

PURPOSE: This study was conducted to provide basic data for developing education and health promotion programs for the prevention of cancer by identifying the relation between optimistic bias about cancer and cancer preventive behavior in Korean, Chinese, American, and Japanese residents in Korea. METHODS: Using a questionnaire administered by the researcher, data were collected from a convenience sample of 600, 19 to 64-yr-old male and female Korean, Chinese, American, and Japanese residents in Korea. Data was collected between February 6 and 28, 2009. RESULTS: Scores for optimistic bias about cancer by nationality were: Koreans, -1.03; Chinese, -0.43; Americans, -0.23; and Japanese, 0.05. The cancer preventive behavior scores were: Koreans, 43.17; Chinese, 71.84; Americans, 71.71; and Japanese, 73.97. Optimistic bias about cancer and cancer preventive behavior showed a significantly positive correlation in all participants: Koreans (r=.223, p=.006); Chinese (r=.178, p=.029); Americans (r=.225, p=.006); and Japanese (r=.402, p<.001). CONCLUSION: The greater the optimistic bias about cancer is, the lower the cancer preventive behavior. The findings suggest that nursing interventions are needed to reduce optimistic bias about cancer and to form a positive attitude towards cancer prevention because an optimistic bias about cancer adversely affects cancer preventive behavior.
Adult ; Asian Continental Ancestry Group ; China/ethnology ; Cross-Cultural Comparison ; Female ; *Health Behavior ; Health Promotion ; Humans ; Japan/ethnology ; Male ; Middle Aged ; Neoplasms/ethnology/*prevention & control ; Prejudice ; Questionnaires ; Republic of Korea ; United States/ethnology ; Young Adult

The incidence rate of gastric cancer in Korean Americans is over five times higher than that in non-Hispanic whites, and is similar to the incidence of colorectal cancer in the overall United States population. In Korea, the National Cancer Screening Program recommends endoscopy or upper gastrointestinal series for people aged 40 years and older every 2 years. However, the benefit of gastric cancer screening in Korean Americans has not been evaluated. Based on epidemiologic studies, Korean Americans appear to have more similar gastric cancer risk factors to Koreans as opposed to Americans of European descent, though the risk of gastric cancer appears to decrease for subsequent generations. Therefore, in accordance with recent recommendations regarding screening for gastric cancer in Korea, endoscopic screening for gastric cancer in Korean Americans should be considered, especially in those with known atrophic gastritis/intestinal metaplasia or a family history of gastric cancer. In the future, additional studies will needed to assess whether a screening program for gastric cancer in Korean Americans will result in a survival benefit.
*Asian Americans ; Early Detection of Cancer/*methods ; *Endoscopy, Gastrointestinal ; Humans ; Incidence ; Predictive Value of Tests ; Prognosis ; Program Development ; Republic of Korea/ethnology ; Risk Assessment ; Risk Factors ; Stomach Neoplasms/*diagnosis/*ethnology ; United States/epidemiology

Prostate cancer is the most prevalent cancer in males in Western countries. The reported incidence in Asia is much lower than that in African Americans and European Caucasians. Although the lack of systematic prostate cancer screening system in Asian countries explains part of the difference, this alone cannot fully explain the lower incidence in Asian immigrants in the United States and west-European countries compared to the black and non-Hispanic white in those countries, nor the somewhat better prognosis in Asian immigrants with prostate cancer in the United States. Soy food consumption, more popular in Asian populations, is associated with a 25% to 30% reduced risk of prostate cancer. Prostate-specific antigen(PSA) is the only established and routinely implemented clinical biomarker for prostate cancer detection and disease status. Other biomarkers, such as urinary prostate cancer antigen 3 RNA, may increase accuracy of prostate cancer screening compared to PSA alone. Several susceptible loci have been identified in genetic linkage analyses in populations of countries in the West, and approximately 30 genetic polymorphisms have been reported to modestly increase the prostate cancer risk in genome-wide association studies. Most of the identified polymorphisms are reproducible regardless of ethnicity. Somatic mutations in the genomes of prostate tumors have been repeatedly reported to include deletion and gain of the 8p and 8q chromosomal regions, respectively; epigenetic gene silencing of glutathione S-transferase Pi(GSTP1); as well as mutations in androgen receptor gene. However, the molecular mechanisms underlying carcinogenesis, aggressiveness, and prognosis of prostate cancer remain largely unknown. Gene-gene and/or gene-environment interactions still need to be learned. In this review, the differences in PSA screening practice, reported incidence and prognosis of prostate cancer, and genetic factors between the populations in East and West factors are discussed.
Asia ; epidemiology ; Asian Continental Ancestry Group ; ethnology ; genetics ; European Continental Ancestry Group ; ethnology ; genetics ; Gene Silencing ; Gene-Environment Interaction ; Genetic Predisposition to Disease ; Glutathione S-Transferase pi ; genetics ; Humans ; Incidence ; Male ; Polymorphism, Genetic ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; blood ; epidemiology ; ethnology ; genetics ; Survival Rate ; United States ; epidemiology

Lung cancer is the leading cause of cancer death worldwide, with large variation of the incidence and mortality across regions. Although the mortality of lung cancer has been decreasing, or steady in the US, it has been increasing in Asia for the past two decades. Smoking is the leading cause of lung cancer, and other risk factors such as indoor coal burning, cooking fumes, and infections may play important roles in the development of lung cancer among Asian never smoking women. The median age of diagnosis in Asian patients with lung cancer is generally younger than Caucasian patients, particularly among never-smokers. Asians and Caucasians may have different genetic susceptibilities to lung cancer, as evidenced from candidate polymorphisms and genome-wide association studies. Recent epidemiologic studies and clinical trials have shown consistently that Asian ethnicity is a favorable prognostic factor for overall survival in non-small cell lung cancer (NSCLC), independent of smoking status. Compared with Caucasian patients with NSCLC, East Asian patients have a much higher prevalence of epidermal growth factor receptor (EGFR) mutation (approximately 30% vs. 7%, predominantly among patients with adenocarcinoma and never-smokers), a lower prevalence of K-Ras mutation (less than 10% vs. 18%, predominantly among patients with adenocarcinoma and smokers), and higher proportion of patients who are responsive to EGFR tyrosine kinase inhibitors. The ethnic differences in epidemiology and clinical behaviors should be taken into account when conducting global clinical trials that include different ethnic populations.
Adenocarcinoma ; ethnology ; genetics ; metabolism ; Asian Continental Ancestry Group ; genetics ; Carcinoma, Non-Small-Cell Lung ; ethnology ; genetics ; metabolism ; European Continental Ancestry Group ; genetics ; Far East ; epidemiology ; Female ; Genetic Predisposition to Disease ; Humans ; Lung Neoplasms ; ethnology ; genetics ; metabolism ; Mutation ; Oncogene Proteins, Fusion ; metabolism ; Receptor, Epidermal Growth Factor ; genetics ; metabolism ; Risk Factors ; Smoking ; adverse effects ; United States ; epidemiology ; ras Proteins ; genetics ; metabolism

Esophageal cancer is a common cancer worldwide and has a poor prognosis. The incidence of esophageal squamous cell cancer has been decreasing, whereas the incidence of esophageal adenocarcinoma has been increasing rapidly, particularly in Western men. Squamous cell cancer continues to be the major type of esophageal cancer in Asia, and the main risk factors include tobacco smoking, alcohol consumption, hot beverage drinking, and poor nutrition. In contrast, esophageal adenocarcinoma predominately affects the whites, and the risk factors include smoking, obesity, and gastroesophageal reflux disease. In addition, Asians and Caucasians may have different susceptibilities to esophageal cancer due to different heritage backgrounds. However, comparison studies between these two populations are limited and need to be addressed in the near future. Ethnic differences should be taken into account in preventive and clinical practices.
Adenocarcinoma ; ethnology ; etiology ; genetics ; Alcohol Drinking ; adverse effects ; Asia ; epidemiology ; Asian Continental Ancestry Group ; genetics ; Carcinoma, Squamous Cell ; ethnology ; etiology ; genetics ; Esophageal Neoplasms ; ethnology ; etiology ; genetics ; European Continental Ancestry Group ; genetics ; Gastroesophageal Reflux ; complications ; Genetic Predisposition to Disease ; Humans ; Incidence ; Obesity ; complications ; Polymorphism, Single Nucleotide ; Risk Factors ; Smoking ; adverse effects ; United States ; epidemiology

PURPOSE: The purpose of this review is to explore cultural influences on the experiences of Korean, Korean American, and Caucasian American family caregivers caring for frail older adults in terms of the selection of a primary caregiver, caregiving motivation, support/help-seeking, and negative emotional responses(depression and burden). METHODS: Seven electronic databases were searched to retrieve studies from 1966 to 2005. Thirty-two studies were identified. RESULTS: This review supported cultural influences on the selection of primary caregiver, caregiving motivation, and support/help-seeking among the three caregiver groups. In Korean caregivers, the major primary caregivers were daughters-in-law while among Korean American and Caucasian American caregivers, the major primary caregivers were daughters or spouses. As a major caregiving motivation, Caucasian American caregivers reported filial affection while Korean caregivers and Korean American caregivers reported filial obligation. Korean caregivers reported higher extended family support, while Caucasian American caregivers reported higher utilization of formal support. Korean caregivers showed the highest levels of depression followed by Korean American caregivers and Caucasian American caregivers. CONCLUSION: In order to develop culturally appropriate interventions and policies, more research is needed to further explain these differences among the three groups, especially regarding support/help-seeking and negative emotional responses.
Adaptation, Psychological ; Aged ; Asian Americans ; *Asian Continental Ancestry Group ; *Caregivers/psychology ; *Cross-Cultural Comparison ; Decision Making ; *European Continental Ancestry Group ; *Frail Elderly ; Humans ; Korea/ethnology ; Motivation ; Social Support ; United States