Objectives: Smoking remains the leading cause of preventable disease. However, smokers have shown poor compliance with smoking cessation clinics. Smartphone applications present a promising opportunity to improve this compliance. This study aimed to explore the relationship between nicotine dependence, smartphone usage patterns, and anticipated compliance with a smoking cessation application among smokers, with the goal of informing future development of such applications. Methods: A total of 53 current smokers were surveyed using a questionnaire. Nicotine dependence was assessed using the Fagerstrom Test for Nicotine Dependence (FTND). Variables included the number of hours spent using a phone, willingness to quit smoking, number of previous quit attempts, desired number of text messages about smoking cessation, expected duration of application usage, and FTND scores. Kendall’s partial correlation, adjusted for age, was employed for the analysis. Results: The amount of time smokers spent on their mobile devices was negatively correlated with the number of smoking cessation text messages they wanted to receive (τ coefficient = –0.210, p = 0.026) and the duration they intended to use the cessation application (τ coefficient = –0.260, p = 0.006). Conversely, the number of desired text messages was positively correlated with the intended duration of application usage (τ coefficient = 0.366, p = 0.00012). Conclusions Smokers who spent more time on their mobile devices tended to prefer using the cessation application for shorter periods, whereas those who desired more text messages about smoking cessation were more inclined to use the application for longer durations.

BACKGROUND: Although Helicobacter pylori infection is now known to be the most common cause of various gastrointestinal diseases and progress in our knowledge about H. pylori is remarkable, whether this knowledge is transferred to general community of practicing physicians is questionable. We wished to investigate the clinical practice and prescribing patterns for dyspepsia and H. pylori infection in primary care in Korea. METHODS: We obtained information about the patterns of practice from reply to questionnaire by mail to physician. We restricted our study to the primary care physicians registered on the Korean Association of Internal Medicine Practitioners. The questionnaire was made of three compartments, which were diagnostic evaluation of dyspepsia, indication and methods of diagnosis and management in H. pylori infection. RESULTS: In case with initial visit of dyspeptic patient, 64.1% of physicians prescribe prokinetics (85.7%), antacid (61.5%), histamine-2-receptor blockers (59.4%), initially. The indications of H. pylori test were as follows; 91.6% in gastric ulcer including scar, 85.3% in duodenal ulcer, 59% in patient-want cases, 51.9% in gastric cancer, 42.7% in gastritis, and 22.8% in gastro-oesophageal reflux disease. And the indications of H. pylori eradication were as follows; 90.6% in gastric ulcer, 88.7% in duodenal ulcer, 35% in gastric cancer, 30.7% in gastritis, 23.5% in patient-want cases, and 24.8% in gastro-oesophageal reflux disease. In addition, 79.7% of physicians prescribe triple therapy including clarithromycin and amoxicillin for H. pylori eradication. CONCLUSION: From this study, we obtained more information about the clinical practice and prescribing patterns about dyspepsia and H. pylori related diseases. More studies are needed to prepare the guidelines for H. pylori under close cooperation between primary care physicians and tertiary hospitals.
Amoxicillin ; Cicatrix ; Clarithromycin ; Diagnosis ; Duodenal Ulcer ; Dyspepsia* ; Gastritis ; Gastroesophageal Reflux ; Gastrointestinal Diseases ; Helicobacter pylori* ; Helicobacter* ; Humans ; Internal Medicine ; Korea ; Physicians, Primary Care* ; Postal Service ; Primary Health Care* ; Stomach Neoplasms ; Stomach Ulcer ; Tertiary Care Centers ; Surveys and Questionnaires

BACKGROUND/AIMS: Some studies showed the higher prevalence of H. pylori infection in the patients with colon adenoma and carcinoma than control subjects. The association between H. pylori infection and colonic diseases is controversial. We evaluated H. pylori infection rate and the related upper gastrointestinal lesions in the patients with colon polyp and cancer. METHODS: Ninety-four subjects, 67 with colonic lesions and 27 without colonic lesions were enrolled. Colon polyp and cancer were confirmed by colonoscopic biopsy or polypectomy. The enrolled subjects were received gastroduodenoscopic examination. H. pylori infection was evaluated serologically and/or with rapid urease test. The fasting serum gastrin level was measured. RESULTS: H. pylori infection rates in the patients with and without colonic lesions were 67.2% and 44.4%, respectively (p<0.05). Upper gastrointestinal lesions were observed in 27 of 67 patients (40.3%) with colonic lesions and in 11 of 27 patients (40.7%) without colonic lesions (p=1.0). Mean levels of serum gastrin with and without colonic lesions were 91.7+/-31.1 pg/mL and 88.1+/-37.7 pg/mL, respectively (p=0.15). CONCLUSIONS: Our study supports the relationship between H. pylori infection, colorectal neoplasia. Although there was no significant difference, the possibility of the simultaneous presence of upper gastrointestinal lesions in the patients with colorectal polyp and cancer was suggested. But the relationship between serum gastrin and the development of colorectal polyp and cancer was not documented.
Adenoma ; Biopsy ; Colon* ; Colonic Diseases ; Colonic Neoplasms ; Fasting ; Gastrins ; Helicobacter pylori* ; Helicobacter* ; Humans ; Polyps ; Prevalence ; Urease

BACKGROUND/AIMS: Dyspepsia is remarkably common in the general population. Although upper gastrointestinal endoscopy is the investigation of choice for dyspepsia, the selection of the patients who need endoscopy is very difficult. This study was aimed to investigate the usefulness of the various parameters for the selection of the patients who need endoscopy in Korean population. METHODS: An analysis of the endoscopic findings was carried out in 141 patients with dyspepsia according to parameters including H. pylori IgG seropositivity, age and alarm signs, such as dysphagia, weight loss, vomiting, anemia, family history of upper gastrointestinal malignancy, hematemesis or melena, abdominal mass and anorexia. RESULTS: The positive rates of stomach cancer and peptic ulcer in patients above 35 years of age were 3% (4/118) and 30% (35/118), respectively. The positive rates of stomach cancer and peptic ulcer in patients with alarm signs were 2% (2/94), 36% (34/94) and the rates in patients with H. pylori IgG seropositivity were 4% (3/70), 37% (26/70), respectively. However, no parameter was useful in the selection of patients with stomach cancer or peptic ulcer. In patients with alarm signs, the positive rates of peptic ulcer in patients with and without H. pylori IgG seropositivity were 46% (22/48) and 26% (12/46), respectively (p=0.04). In patients under 35 years of age, the positive rates of peptic ulcer in patients with and without H. pylori IgG seropositivity were 58% (7/12) and 18% (2/11), respectively (p=0.048). CONCLUSIONS: The overall positive rates of stomach cancer or peptic ulcer were significantly higher in patient group with both H. pylori IgG seropositivity and alarm signs, and that under 35 years of age with H. pylori IgG seropositivity. However, there were also considerable number of peptic ulcer in patients who were excluded from those groups. We recommend that those parameters should be used only as a decision aid in selecting the candidates for endoscopy.
Anemia ; Anorexia ; Decision Support Techniques ; Deglutition Disorders ; Dyspepsia* ; Endoscopy* ; Endoscopy, Gastrointestinal ; Helicobacter pylori ; Hematemesis ; Humans ; Immunoglobulin G ; Melena ; Peptic Ulcer ; Stomach Neoplasms ; Vomiting ; Weight Loss

BACKGROUND/AIMS: Gastric cancer is one of the most common malignant disease worldwide, particularly in Korean populations, but its etiology is not well-established. The infection with Helicobacter pylori (H. pylori) has been implicated in the pathogenesis of gastroduodenal diseases and recent studies have focused on whether specific H. pylori strains are associated with gastric carcinogenesis. The aim of this study was to investigate whether VacA seropositivity is associated with increased risk of gastric cancer in Korean populations. METHODS: Gastroduodenoscopy was done in patients with upper gastrointestinal complaints. During the examination, rapid urease test for the presence of H. pylori infection was done using gastric biopsy specimens taken from normal gastric antrum. Sera were collected from 20 chronic gastritis and 23 gastric cancer patients with H. pylori infection. Western blotting was carried out using a commercially prepared kit-Helicoblot 2.0. RESULTS: VacA seropositivity was 35% (8/23) in patients with gastric cancer and 55% (11/20) in patients with chronic gastritis (p=0.15). According to Lauren classification of gastric cancer, the numbers of patients with the intestinal and diffuse type were 12 and 11, respectively. VacA seropositivity was 25% (3/12) in patients with the intestinal type and 45.4% (5/11) in patients with the diffuse type (p=0.30). CONCLUSIONS: The infection with VacA positive H. pylori strain is not associated with increasing risk of gastric cancer in Korean populations.
Biopsy ; Blotting, Western ; Carcinogenesis ; Classification ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Pyloric Antrum ; Stomach Neoplasms* ; Urease

Radiotherapy induced colorectal adenocarcinoma with radiation colitis after radiotherapy has been reported as a rare case. A patient with rectal adenocarcinoma as a late complication of pelvic irradiation for gynecological malignancy is reported. A 55-year-old woman with bloody diarrhea for 6 months was admitted. She received radiation therapy for carcinoma of cervix 21 years ago. Colonoscopic findings revealed a polypoid mass on rectosigmoid colon. Histopathologic examination of the polypectomy specimen disclosed adenocarcinoma. We reported herein a case of rectal adenocarcinoma with radiation colitis. The patient who had received pelvic irradiation should have close follow-up with colonoscopic study for the early detection of colorectal cancer.
Adenocarcinoma* ; Cervix Uteri ; Colitis* ; Colon ; Colorectal Neoplasms ; Diarrhea ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Radiotherapy

Twenty six cases of borderline ovarian tumor(BOT) were treated between Jan. 1985 and Dec. 1997 at the Department of Obstetrics and Gynecology, Hanyang University. The clinical records were reviewed for all patients including histopathology, clinical features, and follow-up. The frequency of BOT was 12%(26/214) of epithelial ovarian malignancies, and patients with these tumors tend to present at a younger age(36 yrs) than those with invasive carcinomas. In terms of histologic type, mucinous type(21/26: 81%) were more prevalent than serous tumor(5/21: 19%) in this study. The positive rate of CA 125 was 20% in serous, and the positive rate of CA 19-9 was 24% in mucinous tumor. The size of mucinous was larger than that of serous tumors(17.1 cm vs 9,3 cm). Almost all of these tumor categorized as early stage(stage I: 96%), however, only one patient with serous tumor had advanced stage of disease(stage III: 4%), Therefore BOT tend to be diagnosed as earlier than invasive carcinoma. About 2/3 of patients were treated as conservative surgery(unilateral salpingooophorectomy or enuclation). Postoperative adjuvant chemotherapy was not given about half of cases(13/26). Median follow-up was 43 months and recurrent case was found only one in serous tumor, All patients in this study are still alive and free of disease except one, 5-year survival rate was 100%. But large number of study and long-term follow-up are needed to make a decision to treat and manage of BOT.
Chemotherapy, Adjuvant ; Female ; Follow-Up Studies ; Gynecology ; Humans ; Mucins ; Obstetrics ; Ovary* ; Survival Rate

OBJECTIVE: The purpose of this study was to analyze the clinical characteristics and prognosis of small cell uterine cervical carcinoma with neuroendocrine differentiation. METHODS: Patient's medical records were reviewed retrospectively who were diagnosed as small cell carcinoma of uterine cervix and were treated at Hanyang University Hospital between 1972 and 1997. RESULTS: Between 1972 and 1997, of 1164 patients who were diagnosed as invasive cervical cancer, there were 10 cases of small cell carcinoma of uterine cervix in the department of obstetrics and gynecology, Hanyang University Hospital. The incidence of small cell carcinoma in invasive cervical cancer was 0.9% (10/1164). Of 10 small cell carcinoma, seven(70%) were neuroendocrine types which were identified with several kinds of immunohistochemical stains (Chromogranin, Grimelius, and/or NSE). The age of these 7 patients ranged from 34 to 63 years (mean 49). Two were in stage Ib, 3 in stage lla, I in stage IIIb, and 1 in stage IVb. Patients with stage Ib-IIb (n 5) received 3-5 courses of neoadjuvant VBP chemotherapy (vinblastine, bleomycin and cis-platinum) followed by radical hysterectomy with pelvic and paraaortic node dissection. One IIIb patient was managed with concurrent chemo-radiation(3 cycles of cis-platinum & 5-FU) followed by 6 courses of chemotherapy. One IVb patient was treated by palliative chemotherapy with 8 cycles of VBP chemotherapy. Of 5 paticn(s who underwent surgery, none showed pelvic lymph node metastases. These 7 patients were folk>wed for 8 - 62 months (average: 20 months). During this period, 5 patients died of disease hetween 8 and 62 months later and 2 patients are still alive for 12 (stage Ib) and 26 months (stage Ib), respectively. In the contrary, of 3 patients without neuroendocrine differentiation, who underwent neoadjuvant VBP chemotherapy followed by radical hysterctomy with pelvic and paraaortic node dissetion or concurrent chemo-radiation, two stage IIb patients are still alive for 58 and 74 months, and one IIIb patient died of disease 12 months later. CONCLUSION: In summary, neuroendocrine differentiation seemed to adversely affect the prognosis and longterm survival of small cell carcinoma of uterine cervix. So, for this high risk group, more aggressive therapy would be need to improve outcome. However, as the number of patients were small in our study, further study with large number of patients are warranted.
Bleomycin ; Carcinoma, Neuroendocrine* ; Carcinoma, Small Cell ; Cervix Uteri* ; Cisplatin ; Coloring Agents ; Drug Therapy ; Female ; Gynecology ; Humans ; Hysterectomy ; Incidence ; Lymph Nodes ; Medical Records ; Neoplasm Metastasis ; Obstetrics ; Prognosis ; Retrospective Studies ; Uterine Cervical Neoplasms

OBJECTIVES: To predict of the survival of patients with epithelial ovarian cancer, multivariable analysis was done to identify variables with independent prognostic factors. Based on materials from 191 clinical trials performed by Department of Obstetrics and Gynecology, Hanyang University Hospital, we constructed a prognostic index (Pp with considerable predictive power for long-term survival of patients with epithelial ovatian cancer treated with cis-platin based combination chemotherapy, METHODS: On identifying variables with independent prognostic value, statistical analysis were performed with clinicopathologic variables including age, FIGO stage, histologic subtype, histologic grade, residual tumor, presence of ascites, pretreatment levels of hemoglobin, platelet, and tumor markers(CA 125, CA 19-9). We also analyzed biological variables using immunohistochemical staining for GST-pie (glutathione-s-transferase-pie), p-glycoprotein, and MT (metallothinein) as a drug resistance and uPA (urokinase type plasminogen activator), PAI-1 (plasminogen activator inhibitor-l), nm23 (nonmetastatic gene 23) as a tumor invasion and metastasis. In addition, univariable analysis was performed followed by multivariable analysis using Coxs proportional hazards model to identify variables predictive of poor prognosis. Prognostic index (PI) was calculated based on sum of individual beta-coefficient of the most important independent prognostic value. RESULTS: With univariable analysis, age, FIGO stage, histologic grade, histologic subtype, presence of ascites, residual tumor, initial value of CA 125, MT, uPA, and PAI-1 were found to predict of patients survival. In the multivariable analysis and proportional hazard model, the pretreatment characteristics needed for the calculation of the PI are the age, the site of metastases expressed as stage, the histologic subtype, the size of residual tumor, the histological grade, and the presence of ascites. In the subgroup comprising the 10% of the patients with the best prognosis, 5-year survival rate was 78.9%, whereas in the subgmup comprising the 10% with the poorest prognosis, 5-year survival rate was 7.1%, which illustrates the large variability of the prognosis among patients. CONCLUSIONS: The PI was found to retain its value after response was achieved. The information provided by the PI can be expected to be useful in treatment planning and the proper stratification of patients in clinical trials.
Ascites ; Blood Platelets ; Drug Resistance ; Drug Therapy, Combination ; Gynecology ; Humans ; Neoplasm Metastasis ; Neoplasm, Residual ; Obstetrics ; Ovarian Neoplasms* ; P-Glycoprotein ; Plasminogen ; Plasminogen Activator Inhibitor 1 ; Prognosis ; Proportional Hazards Models ; Survival Rate

OBJECTIVES: This retrospective study was conducted to analyze the hypothesis that with neoadjuvant chemotherapy of vinblastine, bleomycin, and cisplatin followed by radical hysterectomy or radiation therapy and concurrent chemoradiation with cisplatin based regimen would improve survival in patients with barrel-shaped or bulky-endophytic (Diameter > 4cm) cervical carcinomas than those of radiation alone or combined radiation and surgery. STUDY DESIGN: Eighty-eight patients with barrel-shaped or bulky-endophytic cervical carcinomas, treated at the Hanyang University Hospital from 1983 to 1997, were the subjects of this investigation. Fifty-six of these patients were treated by neoadjuvant chemotherapy followed by radical hysterectomy with bilateral pelvic lymphadenectomy ( Stage I b2, 8; IIa, 15; IIb, 20; III- IV, 13), twelve patients were treated by neoadjuvant chemotherapy followed by radiation therapy ( Stage Ilb, 4; IIJ-IV, 8), and twenty patients were treated by concurrent chemo-radiotherapy ( Stage IIb, 2; III-IV, 18). RESULTS: The incidence of parametrial extension and pelvic lymphnode metastases was higher in patients with barrel-shaped or bulky-endophytic cervical carcinomas than non-barrel-shaped cervix (p .025: .001). 5-years disease free survival rate was determined for patients treated by neoadjuvant chemotherapy followed by radical hysterectomy with bilateral pelvic lymphadenectomy was 73.3 %. For patients treated by neoadjuvant chemotherapy followed by radiation therapy it was 45.7%. For patients treated by concurrent chemo-radiotherapy it was 46.1%. CONCLUSION: These data support an improvement in survival of patients with barrel-shaped or bulky-endophytic cervical carcinomas treated by neoadjuvant chemotherapy followed by radical hysterectomy or radiation therapy and concurrent chemo-radiotherapy.
Bleomycin ; Cervix Uteri* ; Cisplatin ; Disease-Free Survival ; Drug Therapy* ; Female ; Humans ; Hysterectomy ; Incidence ; Lymph Node Excision ; Neoplasm Metastasis ; Retrospective Studies ; Vinblastine