PURPOSE: The 8th edition of the American Joint Committee on Cancer (AJCC) staging system for pancreatic neuroendocrine tumor (PNET) included several significant changes. We aim to evaluate this staging system compared to the 7th edition AJCC staging system and European Neuroendocrine Tumors Society (ENETS) system. MATERIALS AND METHODS: We used Korean nationwide surgery database (2000-2014). Of 972 patients who had undergone surgery for PNET, excluding patients diagnosed with ENETS/World Health Organization 2010 grade 3 (G3), only 472 patients with accurate stage were included. RESULTS: Poor discrimination in overall survival rate (OSR) was noted between AJCC 8th stage III and IV (p=0.180). The disease-free survival (DFS) curves of 8th AJCC classification were well separated between all stages. Compared with stage I, the hazard ratio of II, III, and IV was 3.808, 13.928, and 30.618, respectively (p=0.007, p < 0.001, and p < 0.001). The curves of OSR and DFS of certain prognostic group in AJCC 7th and ENETS overlapped. In ENETS staging system, no significant difference in DFS between stage IIB versus IIIA (p=0.909) and IIIA versus IIIB (p=0.291). In multivariable analysis, lymphovascular invasion (p=0.002), perineural invasion (p=0.003), and grade (p < 0.001) were identified as independent prognostic factors for DFS. CONCLUSION: This is the first large-scale validation of the AJCC 8th edition staging system for PNET. The revised 8th system provides better discrimination compared to that of the 7th edition and ENETS TNM system. This supports the clinical use of the system.
Classification ; Discrimination (Psychology) ; Disease-Free Survival ; Humans ; Joints ; Neoplasm Staging ; Neuroectodermal Tumors, Primitive ; Neuroendocrine Tumors ; Pancreas ; Survival Rate

The Asian Society of Gynecologic Oncology International Workshop 2014 on gynecologic oncology was held in Asan Medical Center, Seoul, Korea on the 23rd to 24th August 2014. A total of 179 participants from 17 countries participated in the workshop, and the up-to-date findings on the management of gynecologic cancers were presented and discussed. This meeting focused on the new trends in the management of cervical cancer, fertility-sparing management of gynecologic cancers, surgical management of gynecologic cancers, and recent advances in translational research on gynecologic cancers.
Female ; Fertility Preservation/methods ; Genital Neoplasms, Female/*therapy ; Humans ; Ovarian Neoplasms/therapy ; Translational Medical Research/methods ; Uterine Cervical Neoplasms/therapy

The pneumonia severity index (PSI) and CURB-65 are widely used tools for the prediction of community-acquired pneumonia (CAP). This study was conducted to evaluate validation of severity scoring system including the PSI and CURB-65 scores of Korean CAP patients. In the prospective CAP cohort (participated in by 14 hospitals in Korea from January 2009 to September 2011), 883 patients aged over 18 yr were studied. The 30-day mortalities of all patients were calculated with their PSI index classes and CURB scores. The overall mortality rate was 4.5% (40/883). The mortality rates per CURB-65 score were as follows: score 0, 2.3% (6/260); score 1, 4.0% (12/300); score 2, 6.0% (13/216); score 3, 5.7% (5/88); score 4, 23.5% (4/17); and score 5, 0% (0/2). Mortality rate with PSI risk class were as follows: I, 2.3% (4/174); II, 2.7% (5/182); III, 2.3% (5/213); IV, 4.5% (11/245); and V, 21.7% (15/69). The subgroup mortality rate of Korean CAP patients varies based on the severity scores and CURB-65 is more valid for the lower scores, and PSI, for the higher scores. Thus, these variations must be considered when using PSI and CURB-65 for CAP in Korean patients.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Cohort Studies ; Community-Acquired Infections/*mortality ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Pneumonia/*mortality ; Prospective Studies ; Republic of Korea ; *Severity of Illness Index ; Young Adult

OBJECTIVE: Autophagy plays a vital role in homeostasis by combining organelles and cellular proteins with lysosome under starvation conditions. In addition, autophagy provides tumor cells with a source of energy. Continued autophagy will induce cells death. Here we aim to see if autophagic induction has an effect on conventional chemotherapeutic agents. METHODS: Rapamycin, or mammalian target of rapamycin and paclitaxel, apoptosis-inducing agents were used autophagy in HeLa cervical cancer cells. RESULTS: Growth inhibition of cells was not observed after the application of 0, 10, 20 nM of paclitaxel with or without rapamycin. Using a 5 nM concentration of paclitaxel, rapamycin administration inhibited cell growth significantly compared to no treatment. This implies the synergic antitumor effect of paclitaxel and rapamycin. Paclitaxel itself did not show any autophagic effect on cells but did show cell apoptosis by flow cytometry. Light chain 3, a microtubule-associated protein, which reflect autophagy, was increased with 5 nM of paclitaxel after pretreatment with 10 nM of rapamycin. CONCLUSION: These findings suggest that the autophagic inducer, rapamycin, can potentiate autophagic cell death when added as an apoptosis-inducing chemotherapeutic agent. In conclusion, the control of autophagy may be a future target for chemotherapy.
Apoptosis ; Autophagy ; Cell Death ; Flow Cytometry ; Homeostasis ; Light ; Lysosomes ; Organelles ; Paclitaxel ; Proteins ; Sirolimus ; Starvation ; TOR Serine-Threonine Kinases ; Uterine Cervical Neoplasms

PURPOSE: The purpose of this study was to identify the influence of the ego-resilience and social support on the depression among hospital nurses. METHODS: The subjects of this study were 369 nurses in a hospital. We used the self-reported questionnaire to assess the level of ego-resilience, social support and depression of hospital nurses. The data were analyzed using descriptive statistics, frequency, t-test, ANOVA and logistic regression. RESULTS: The mean scores of ego-resilience, social support and depression were 42.6, 28.3 and 14.1, respectively. When scores of ego-resilience and social support were high, the level of mild and major depression of subjects decreased. The influencing factors of depression level were the department of work, ego-resilience and social support. CONCLUSION: The findings suggest that developing programs to improve ego-resilience and social support might be useful. Further study is required to justify the scale on ego-resilience and social support.
Depression ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to identify the effects of the social support and ego-resilience on the nursing performance among hospital nurses. METHODS: The subjects of this study were 369 nurses in a senior general hospital. We used the self-reported questionnaire to assess the level of ego-resilience, social support and nursing performance of hospital nurses. The data were analyzed using descriptive statistics, frequency, t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression. RESULTS: This study showed the positive relationship between the social support and ego-resilience on tne the nursing performance of hospital nurses. The higher group of the social support and ego-resilience showed the more performance of hospital nurses. And, the influencing factors on the performance are age, ego-resilience, social support, night working days a month in the order. CONCLUSION: Further studies will be needed to promote the performance of nurse in hospital and policies to be develop to elevate the social support and ego-resilience of nurses.
Hospitals, General ; Surveys and Questionnaires ; Task Performance and Analysis

Organophosphate insecticides are used globally and are household items in rural areas of Korea. Their ingestion for a suicidal purpose is common in Korea. Respiratory failure is the most serious manifestation and the usual cause of death in acute organophosphate poisoning, and is usually common during acute cholinergic crisis. But, respiratory failure may appear suddenly in a patient who is recovering from a cholinergic crisis, even while receiving conventional therapy. Most of these respiratory failures are associated with intermediate syndrome or pneumonia. In several recent studies, acute pancreatitis as a complication of organophosphate poisoning has been shown to be not a rare condition and respiratory failure may also occur in acute pancreatitis. However, acute lung injury developing as a complication of organophosphate intoxication-induced pancreatitis has not been hitherto reported in Korea. We described a case of a 50-year-old woman who had acute organophosphate intoxication-induced acute pancreatitis. The patient developed acute lung injury on the eighth day hospital day, after cholinergic crisis, without intermediate syndrome and pneumonia. Exclusion of other causes indicated that the acute lung injury may have developed due to acute pancreatitis.
Acute Lung Injury ; Cause of Death ; Eating ; Family Characteristics ; Female ; Humans ; Insecticides ; Korea ; Middle Aged ; Organophosphate Poisoning ; Pancreatitis ; Pneumonia ; Respiratory Insufficiency

PURPOSE: This study was to investigate the relationship between IBS and nurses' occupational stress. METHOD: We used the modified Rome III criteria to measure the relationship between IBS and nurses' occupational stress. This questionnaire is composed of 9 areas and 43 items related to the stress. We collected the data of 395 respondents from W hospital. The survey was done from July 10th to July 31th, 2009. RESULTS: The morbidity of IBS showed 24.3%. It was significantly influenced by night shift, and hospital visits and medication because of abdominal discomfort for the past 6 months. The causes of the nurses' occupational stress, which influenced the difference between IBS and non-IBS group, were "conflict with doctors" "difficulties in human relationships" "dealing with guardians and patients." The IBS group's stress was higher that of the non-IBS group. Also 96.9% of the IBS group and 79.3% of the non-IBS group responded there was relationship between IBS and nurses occupational stress. CONCLUSION: We found the relationship between IBS and nurses' occupational stress. And such stress could be reduced through the education about IBS.
Surveys and Questionnaires ; Humans ; Irritable Bowel Syndrome ; Rome

INTRODUCTION: Renal cell carcinoma (RCC) is a relative rare tumor, accounting for approximately 3% of adult malignancies. Renal cell carcinoma has a high metastatic potential and is renowned for its ability to spread to almost any organ of the body. Pancreas is a rare site for metastasis from other primary cancers. Moreover, pancreatic metastasis is difficult to differentiate and may be misdiagnosed as a primary pancreatic cancer. The aim of this study was to review our cases of renal cell carcinoma that had metastasized to the pancreas after radical nephrectomy. METHODS: We did a retrospective review of the records of 4 patients with pathologically confirmed RCC that had metastasized to the pancreas after radical nephrectomy. RESULTS: Our group of 4 patients consisted of 2 men and 2 women. Their average age was 58.7 years (+/- 10.51 years). The locations within the pancreas were the head, in 2 (50.0%) and the body/tail in 2 (50.0%) patients. The pancreatic metastases were treated by pancreaticoduodenectomy in 2 patients, and by distal pancreatectomy in 2 patients. Median survival duration was 109.0 (+/- 67.3 months) "Median" is associated with an interquartile range (25% to 75%). The number 67.3 appears to be a standard deviation which is associated with the "mean". CONCLUSIONS: RCC is an unpredictable tumor that may result in a late metastasis even from an early stage. Aggressive surgical management of pancreatic lesions offers a chance of long-term survival.
Accounting ; Adult ; Carcinoma, Renal Cell ; Female ; Head ; Humans ; Male ; Neoplasm Metastasis ; Nephrectomy ; Pancreas ; Pancreatectomy ; Pancreatic Neoplasms ; Pancreaticoduodenectomy ; Retrospective Studies