PURPOSE: This study evaluated the benefits of adjuvant chemotherapy on elderly patients with advanced gastric cancer (AGC) using meta-analysis of well-designed randomized controlled clinical studies. MATERIALS AND METHODS: PubMed, Embase, and Cochrane were searched to retrieve clinical studies evaluating the benefits of adjuvant chemotherapy in the elderly with AGC. Hazards ratios (HRs) with 95% confidence intervals (CIs) were pooled across studies using a fixed-effects model. RESULTS: Two studies were included in this meta-analysis to estimate HR for the overall survival (OS), and relapse-free survival (RFS) between adjuvant chemotherapy and surgery in elderly and non-elderly patients. HR for OS in the elderly and non-elderly was 0.745 (95% CI, 0.552 to 1.006, p=0.055) and 0.636 (95% CI, 0.522 to 0.776; p < 0.001), respectively, which showed no heterogeneity regarding HR between the two groups (p(interaction)=0.389). HR for RFS in the elderly and non-elderly was 0.613 (95% CI, 0.466 to 0.806; p < 0.001) and 0.633 (95% CI, 0.533 to 0.753; p < 0.001), respectively (p(interaction)=0.846). CONCLUSION: Meta-analysis suggests that the benefit of adjuvant chemotherapy to the elderly is not big enough to reach statistical significance while the HR for OS is less than 1 (0.745) and no heterogeneity are observed regarding the HR between the elderly and non-elderly patients.
Aged* ; Chemotherapy, Adjuvant* ; Humans ; Population Characteristics ; Stomach Neoplasms*

OBJECTIVE: The rates of participation in the Korean nationwide cervical cancer screening program and the rates of abnormal test results were determined. METHODS: The database of the National Health Insurance Service (NHIS) was used during the study period (2009–2014). RESULTS: The participation rate increased from 41.10% in 2009 to 51.52% in 2014 (annual percentage change, 4.126%; 95% confidence interval [CI]=2.253–6.034). During the study period, women ≥70 years of age had the lowest rate of participation (range, 21.7%–31.9%) and those 30–39 years of age the second-lowest (27.7%–44.9%). The participation rates of National Health Insurance beneficiaries (range, 48.6%–52.5%) were higher than those of Medical Aid Program (MAP) recipients (29.6%–33.2%). The rates of abnormal results were 0.65% in 2009 and 0.52% in 2014, with a decreasing tendency in all age groups except the youngest (30–39 years). Every year the abnormal result rates tended to decrease with age, from the age groups of 30–39 years to 60–69 years but increased in women ≥70 years of age. The ratio of patients with atypical squamous cells of undetermined significance compared with those with squamous intraepithelial lesions increased from 2.71 in 2009 to 4.91 in 2014. CONCLUSION: Differences related to age and occurring over time were found in the rates of participation and abnormal results. Further efforts are needed to encourage participation in cervical cancer screening, especially for MAP recipients, elderly women and women 30–39 years of age. Quality control measures for cervical cancer screening programs should be enforced consistently.
Aged ; Atypical Squamous Cells of the Cervix ; Early Detection of Cancer* ; Female ; Humans ; Korea* ; Mass Screening* ; National Health Programs* ; Papanicolaou Test ; Quality Control ; Squamous Intraepithelial Lesions of the Cervix ; Uterine Cervical Neoplasms*

PURPOSE: Recurrent otitis media (ROM) is usually defined as > or =3 distinct and well-documented episodes within 6 months or > or =4 episodes within 12 months. ROM is sufficiently important to warrant consideration of chemoprophylaxis, tympanostomy tube placement. There also is evidence that children with ROM are at risk for both hearing loss and speech delay. However, studies of ROM have been notably insufficient. In addition, even though environmental, racial, and sociocultural differences can affect risk factors, few studies have been conducted with regard to recurrent otitis media in Korea. METHODS: This study was conducted from July 2009 to January 2010 with infants and children who were younger than 60 months old, who visited the out-patient clinics at Han-Il General Hospital and Kyunghee University Hospital. Data were collected by interview using a pre-formed sheet. Among a total of 892 infants and children, 457 were excluded, and the remaining 435 were allocated to 104 with ROM and 331 as a control group. RESULTS: Attendance at daycare centers (P<0.001, OR=2.85), allergic rhinitis (P=0.026, OR=2.32), past history of bronchiolitis (P=0.003, OR=2.33), and low socioeconomic status (P=0.005, OR=2.00) were found to have a close significant correlation with ROM. Risk factors such as sex, having a sibling, breast-feeding, use of pacifiers, atopy, pneumococcal vaccination, influenza vaccination, smoking of parents, and indoor smoking are not relevant. CONCLUSION: Attendance at daycare centers, allergic rhinitis, past history of bronchiolitis, and low socioeconomic status have been identified as risk factors for ROM.
Bronchiolitis ; Chemoprevention ; Child ; Hearing Loss ; Hospitals, General ; Humans ; Infant ; Influenza, Human ; Language Development Disorders ; Middle Ear Ventilation ; Otitis ; Otitis Media ; Outpatients ; Pacifiers ; Parents ; Rhinitis ; Rhinitis, Allergic, Perennial ; Risk Factors ; Siblings ; Smoke ; Smoking ; Social Class ; Vaccination

The objective of this study was to develop a pre-clinical large animal model for the in vivo hemodynamic testing of prosthetic valves in the aortic position without the need for cardiopulmonary bypass. Ten male pigs were used. A composite valved conduit was constructed in the operating room by implanting a prosthetic valve between two separate pieces of vascular conduits, which bypassed the ascending aorta to the descending aorta. Prior to applying a side-biting clamp to the ascending aorta for proximal grafting to the aortic anastomosis, an aorta to femoral artery shunt was placed just proximally to this clamp. The heart rate, cardiac output, Vmax, transvalvular pressure gradient, effective orifice area and incremental dobutamine stress response were assessed. A dose dependant increase with dobutamine was seen in terms of cardiac output, Vmax, and the peak transvalvular pressure gradient both in the native and in the prosthetic valve. However, the increment was much steeper in the prosthetic valve. No significant differences in cardiac output were noted between the native and the prosthetic valves. The described pre-clinical porcine model was found suitable for site-specific in-vivo hemodynamic assessment of aortic valvular prosthesis without cardiopulmonary bypass.
Adrenergic beta-Agonists/pharmacology ; Animals ; Aorta/pathology ; Aortic Valve/*pathology ; Disease Models, Animal ; Dobutamine/pharmacology ; Dose-Response Relationship, Drug ; Heart Rate ; *Heart Valve Prosthesis ; Male ; Pressure ; *Prosthesis Implantation ; Support, Non-U.S. Gov't ; Swine ; Thoracic Arteries/pathology

OBJECTIVE: To investigate the effect of exocelomic fluid in first trimester pregnancy on trophoblast cell proliferation in vitro. METHODS: The coelomic fluid was obtained from women with apparently normal pregnancies (n=9) and women presenting with missed abortion (n=22). The concentrations of cytokines in coelomic fluid were determined by two steps sandwich ELISA. The detection limits were the 4 pg/ml for IFN-gamma, 1 pg/ml for TNF-alpha, 2 pg/ml for IL-6 and 5 pg/ml for IL-10, respectively. The data are presented as mean+/-SEM. Statistical analysis was performed by Mann-Whitney U test. Trophoblast cell (Jeg-3 choriocarcinoma cell line) proliferation in vitro was determined using colorimetric immunoassay, based on the measurement of BrdU incorporation using DNA synthesis. The optical absorbance of the samples at 450 nm was measured using an ELISA reader. The data are presented as absorbance in the samples (mean+/-SEM). Statistical analysis was performed using regression analysis and t-test. RESULS: Th-2 type cytokines are present to some extent and IL-6, one of Th-1 type cytokines, also exists in the coelomic fluid from the missed abortion. Coelomic fluids from the majority of normal pregnancies inhibited trophoblast proliferation in vitro significantly higher than fluids from the missed abortion. CONCLUSION: These data showed that exocoelomic fluids may have a unique immune privilege surrounding developing embryo in the early pregnancy. Further studies are required to determine the goowth factors in coelomic fluids from normal pregnancies and missed abortion, and to evaluate the influence on the development of early pregnancy complications.
Abortion, Missed ; Bromodeoxyuridine ; Cell Proliferation* ; Choriocarcinoma ; Cytokines ; DNA ; Embryonic Structures ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunoassay ; Interleukin-10 ; Interleukin-6 ; Limit of Detection ; Pregnancy ; Pregnancy Complications ; Pregnancy Trimester, First* ; Trophoblasts* ; Tumor Necrosis Factor-alpha

The aim of this study was to evaluate the survival of 395 previously untreated cervical cancer patients with at least one high risk factor following concurrent chemoradiation and to assess the toxicities. Two different chemotherapy regimens were used for concurrent chemoradiation. In the patients with squamous cell carcinoma, 100 mg/m2 of cisplatin was infused intravenously, followed immediately by five consecutive daily administrations of 5-fluorouracil, 1,000 mg/m2/day, each infused intravenously over 24 hr. As for the patients with adenocarcinoma, 70 mg/m2 of cisplatin, 250 mg/m2 of cytoxan and 45 mg/m2 of adriamycin were administered intravenously on days 1, 2, and 3, respectively. The 5-year survival rate was 54.4+ACU- with stage III and IV, 62.6+ACU- with lymph node metastasis on computed tomogram or MRI, 77.9+ACU- with stage I-II disease with lesion size +AD4- or +AD0-4 cm, and 50.3+ACU- with small cell carcinoma or adenocarcinoma. Side effects from concurrent chemoradiation such as nausea, vomiting, and alopecia were present in all 395 cases. Anemia, leukopenia, thrombocytopenia, hepatotoxicity, and nephrotoxicity were observed to varying degrees, but there was no toxic death. This study suggests that cisplatin-based concurrent chemoradiation in treating cervical cancer patients with high risk factors is effective and relatively well tolerated, with acceptable toxicity.
Adenocarcinoma/radiotherapy ; Adenocarcinoma/mortality ; Adenocarcinoma/drug therapy ; Adult ; Aged ; Antineoplastic Agents, Combined/therapeutic use+ACo- ; Antineoplastic Agents, Combined/adverse effects ; Carboplatin/administration +ACY- dosage ; Carcinoma, Squamous Cell/radiotherapy ; Carcinoma, Squamous Cell/mortality ; Carcinoma, Squamous Cell/drug therapy ; Cervix Neoplasms/radiotherapy+ACo- ; Cervix Neoplasms/mortality ; Cervix Neoplasms/drug therapy ; Chemotherapy, Adjuvant/adverse effects ; Cisplatin/administration +ACY- dosage ; Combined Modality Therapy ; Comparative Study ; Cyclophosphamide/administration +ACY- dosage ; Doxorubicin/administration +ACY- dosage ; Female ; Fluorouracil/administration +ACY- dosage ; Gastrointestinal Diseases/etiology ; Gastrointestinal Diseases/epidemiology ; Hematologic Diseases/etiology ; Hematologic Diseases/epidemiology ; Hepatitis, Toxic/etiology ; Hepatitis, Toxic/epidemiology ; Human ; Kidney Diseases/epidemiology ; Kidney Diseases/chemically induced ; Korea/epidemiology ; Life Tables ; Lymphatic Metastasis ; Middle Age ; Particle Accelerators ; Radiotherapy, High-Energy+ACo-/adverse effects ; Retrospective Studies ; Risk ; Survival Analysis ; Treatment Outcome

The aim of this study was to evaluate the survival of 395 previously untreated cervical cancer patients with at least one high risk factor following concurrent chemoradiation and to assess the toxicities. Two different chemotherapy regimens were used for concurrent chemoradiation. In the patients with squamous cell carcinoma, 100 mg/m2 of cisplatin was infused intravenously, followed immediately by five consecutive daily administrations of 5-fluorouracil, 1,000 mg/m2/day, each infused intravenously over 24 hr. As for the patients with adenocarcinoma, 70 mg/m2 of cisplatin, 250 mg/m2 of cytoxan and 45 mg/m2 of adriamycin were administered intravenously on days 1, 2, and 3, respectively. The 5-year survival rate was 54.4+ACU- with stage III and IV, 62.6+ACU- with lymph node metastasis on computed tomogram or MRI, 77.9+ACU- with stage I-II disease with lesion size +AD4- or +AD0-4 cm, and 50.3+ACU- with small cell carcinoma or adenocarcinoma. Side effects from concurrent chemoradiation such as nausea, vomiting, and alopecia were present in all 395 cases. Anemia, leukopenia, thrombocytopenia, hepatotoxicity, and nephrotoxicity were observed to varying degrees, but there was no toxic death. This study suggests that cisplatin-based concurrent chemoradiation in treating cervical cancer patients with high risk factors is effective and relatively well tolerated, with acceptable toxicity.
Adenocarcinoma/radiotherapy ; Adenocarcinoma/mortality ; Adenocarcinoma/drug therapy ; Adult ; Aged ; Antineoplastic Agents, Combined/therapeutic use+ACo- ; Antineoplastic Agents, Combined/adverse effects ; Carboplatin/administration +ACY- dosage ; Carcinoma, Squamous Cell/radiotherapy ; Carcinoma, Squamous Cell/mortality ; Carcinoma, Squamous Cell/drug therapy ; Cervix Neoplasms/radiotherapy+ACo- ; Cervix Neoplasms/mortality ; Cervix Neoplasms/drug therapy ; Chemotherapy, Adjuvant/adverse effects ; Cisplatin/administration +ACY- dosage ; Combined Modality Therapy ; Comparative Study ; Cyclophosphamide/administration +ACY- dosage ; Doxorubicin/administration +ACY- dosage ; Female ; Fluorouracil/administration +ACY- dosage ; Gastrointestinal Diseases/etiology ; Gastrointestinal Diseases/epidemiology ; Hematologic Diseases/etiology ; Hematologic Diseases/epidemiology ; Hepatitis, Toxic/etiology ; Hepatitis, Toxic/epidemiology ; Human ; Kidney Diseases/epidemiology ; Kidney Diseases/chemically induced ; Korea/epidemiology ; Life Tables ; Lymphatic Metastasis ; Middle Age ; Particle Accelerators ; Radiotherapy, High-Energy+ACo-/adverse effects ; Retrospective Studies ; Risk ; Survival Analysis ; Treatment Outcome

Proliferating cell nuclear ntigen (FCNA) iis a nuclear protein that is syntheaimd in late Gl and S phases of cell cycle and is correlated with the cell proliferative stale. The recent study demonstrated that FCNA functions in 13NA replication. The present study evaluated proliferetive iindices (PI) for the assessment of tumor proliferation and for investigating prognostic significancx, in cervical tumors. lmmunohiatoehemical PCNA staining was perfurmed in formalin-fixed paraffin-embedded cervical tissues via the avidin-biotin-complex immunoperoxidase methad. Mean PI was 36.03+/-5.14% in normaI controls, as compared to 66.19+/-11.36% in cerviml intraepithelial neoplasia. and 63.19+/-10.94% in invasive cervical cancer. Our results showed no significant correlation between Pll and histological type. Among invasive cervical cancer (24 cases), PI waa 64.43+/-10.94% in squamoua cell carcinoma and 59.00+/-4.10% in adenocarcinoma. There was no eipiifiant relationship between Fl and clinical etage, and between PI and lesion size. This study auggeste that Pl may not serve as a new prognostie factor in cervical tumors.
Adenocarcinoma ; Cell Cycle ; Nuclear Proteins ; Proliferating Cell Nuclear Antigen* ; S Phase ; Uterine Cervical Neoplasms

No abstract available.
Pyometra* ; Rupture, Spontaneous*

No abstract available.
Antibodies* ; Mass Screening* ; Postpartum Period* ; Thyroid Gland*