• Korean Journal of Clinical Pharmacy
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• v.24 no.1
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• pp.15-25
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• 2014

Background: Elderly patients with gastrointestinal (GI) and cardiovascular (CV) risk factors may be more easily exposed to NSAID-related side effects (SEs). Based on the ACG guideline of year 2009, the aim of the study is to evaluate proper use of NSAIDs and gastroprotective drugs according to the degree of GI and CV risk strengths in the patients. Methods: Retrospectively surveyed 410 elderly patients with NSAIDs for more than 30 days at a general hospital in Korea. GI risk factor includes age, ulcer history, high-dose NSIADs, concurrent aspirin use, steroids or anticoagulants. CV risk factor includes angina, myocardial infarction, cerebral infarction, atrial fibrillation or coronary intervention requiring low-dose aspirin. These factors were classified as high/low cardiovascular groups and high/moderate/low GI groups. Results: There were 14 patients in high CV risk group and high GI risk group. The group was recommended not to use NSAIDs as it is not adequate. There were 101 patients in high CV risk group and moderate GI risk group. This group was recommended to use naproxen and PPI/misoprostol. But all patients except one were not adequate. There were 9 patients in low CV risk group and high GI risk group. This group was recommended to use selective COX-2 inhibitor and PPI/misoprostol. 5 cases were proper while 4 cases did not. There were 285 patients in low CV risk and moderate GI risk group who were recommended to use non selective NSAIDs and PPI/misoprostol or selective COX-2 inhibitor only. 103 patients were proper while 182 patients not adequate. Overall, the SEs were higher in those cases for inadequate use of drugs comparing to the adequate. CV SEs were statistically significant. However, SEs for each risk groups were different. For the case of low CV risk group and high/moderate GI risk group, the inadequate use of drugs makes the SE high and the other groups are not. Also, it was not statistically significant. Conclusions: In elderly patients, the inappropriate use of NSAIDs can increase the risk of the disease. Therefore, GI and CV risk must be considered simultaneously, and the proper use of NSAIDs and gastroprotective drugs for each risk groups should be reconsidered.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5715-5719
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• 2015

Background: Breast cancer is the most common malignancy of women in the world. The disease is caused by infectious and non-infectious, environmental and lifestyle factors. Tobacco smoke has been one of the most widely studied environmental factors wiith possible relevance to breast cancer. The purpose of this study was to assess the impact of tobacco smoking in breast cancer patients in a hospital based cohort and to establish prognostic implications if any. Materials and Methods: A retrospective audit of 100 women with pathological diagnosis of invasive breast cancer was included in this study. The verbal questionnaire elicited information on current and previous history of exposure to smoking in addition to active smoking. All analyses were adjusted for potential confounders, including stage at presentation, alcohol intake, hormonal replacement therapy, oral contraceptive intake, obesity and menopausal status. Results: The mean age at presentation of breast cancer was $51.4{\pm}10.86$ years. Mean age of presentation was $53.1{\pm}11.5$ and $45.7{\pm}11.9$ years in never smokers and passive smokers, respectively. Age at presentation varied widely in patients exposed to tobacco smoke for >10 years in childhood from $40.3{\pm}12.0$ years to $47.7{\pm}13.9$ in patients exposed for > 20years as adults. Among passive smokers, 60.9% were premenopausal and 39.1% of patients were postmenopausal. In never smokers, 71.4% were post menopausal. Expression of receptors in non-smokers vs passive smokers was comparable with no significant differences. Metastatic potential in lung parenchyma was slightlyelevated in passive smokers as compared to never smokers although statistically non-significant. Conclusions: An inverse relationship exists between the intensity and duration of smoking and the age at presentation and poor prognostic factors. The results strongly suggest efforts should be taken to prevent smoking, encourage quitting and restrict exposure to second hand smoke in India.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.1
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• pp.275-282
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• 2015

Background: Breast cancer (BC) is the most-common malignancy of women worldwide. Though there are differences among developed and developing countries, BC remains the most common cancer type of women in Turkey. Objective: This study aimed to identify the level of knowledge, awareness, and their potential predictors towards BC in Ankara, Turkey. Materials and Methods: The present descriptive study was conducted on 376 females attending a breast health outpatient clinic. A self-administered questionnaire was designed to evaluate knowledge level about BC and predictors effecting its level. Data analysis was performed using the chi-square test. A value of p<0.05 was considered statistically significant. Results: Mean age of the participants was $46.2{\pm}9.93$ (22-75). The majority (92.6 %) were married; 41.5% were educated less than nine years. Most of the women were housewives (82.7%) and, were living in an urban region (86.4%). Predictors of effecting responses to seven knowledge and awareness questions about BC varied from demographic features including older age groups, higher educational levels, being married, living in an urban area, being employee, smoking, having greater BMI to additional attributes associated breast health such as the increased number of births, applying for the purpose of control, positive family history of breast diseases, any diagnoses of breast diseases and performing BSE practice. Conclusions: It was determined that females in Turkey have better knowledge of BC than other developing countries even though it is not at the desired level. These findings revealed that females should be more informed about BC risk factors, prognosis and treatments by primary health-care providers to counteract the ascending burden of this disease.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.3
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• pp.861-866
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• 2012

This study assessed the effectiveness of three intervention strategies to improve the participation rate of gastric cancer screening among people who had never undergone such screening, and those who had been screened for the disease, but not recently. It was conducted in the Ilsandong-gu District of Goyang City, Korea. The population for the current study was restricted to male residents, aged 40-65 years, who received an invitation letter to undergo gastric cancer screening from the National Health Insurance (NHI) Corporation at the beginning of 2010. The subjects were divided into two categories according to their screening history: never-screened, and ever-screened. A total of 2,065 men were eligible: 803 never-screened and 1,262 ever-screened. In each screening category they were randomly assigned to one of three intervention groups: 1) tailored telephone counseling; 2) tailored postcard reminder after tailored telephone counseling;and 3) tailored telephone counseling after tailored postcard reminder. At 3 months post-intervention, never-screened men with any intervention were more likely to undergo gastric cancer screening (OR=2.75, 95% CI: 1.22-6.18) compared to those in the reference group (no intervention). However, there was no statistically significant intervention effect in ever-screened men (OR=1.21, 95% CI: 0.65-2.27). Examination of the intervention effects by intervention group among never-screened men showed that those in the postcard reminder after telephone counseling group to be statistically significantly more likely to undergo gastric cancer screening (OR=4.49, 95% CI: 1.79-11.29) than the reference group (no intervention). Our results highlight that use of tailored postcard reminders after tailored telephone counseling is an effective method to increase participation in gastric cancer screening among men who had never been screened.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.671-676
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• 2014

Objective: The objective of this study was to establish a program model for use in wide-spread cervical cancer screening. :Methods: Cervical cancer screening was conducted in Zhongshan city in Guangdong province, China through a coordinated network of multiple institutes and hospitals. A total of 43,567 women, 35 to 59 years of age, were screened during regular gynecological examinations using the liquid-based ThinPrep cytology test (TCT). Patients who tested positive were recalled for further treatment. Results: The TCT-positive rate was 3.17%, and 63.4% of these patients returned for follow-up. Pathology results were positive for 30.5% of the recalled women. Women who were younger than 50 years of age, urban dwelling, low-income, had a history of cervical disease, began having sex before 20 years of age, or had sex during menstruation, were at elevated risk for a positive TCT test. The recall rate was lower in women older than 50 years of age, urban dwelling, poorly educated, and who began having sex early. Ahigher recall rate was found in women 35 years of age and younger, urban dwelling, women who first had sex after 24 years of age, and women who had sex during menstruation. The positive pathology rate was higher in urban women 50 years of age and younger and women who tested positive for human papillomavirus. Conclusion: An effective model for large-scale cervical cancer screening was successfully established. These results suggest that improvements are needed in basic education regarding cervical cancer screening for young and poorly educated women. Improved outreach for follow-up is also necessary to effectively control cervical cancer.

• The Journal of Art Theory & Practice
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• no.14
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• pp.7-32
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• 2012

The exhibition was started in 2010 in the New Acropolis Museum of Athens and embarked a journey since 2011 as a travelling exhibition inside Greece and abroad. The main purpose of the exhibition was to draw attention of the general public to the value of the 'rescue excavation' and of cultural heritage of Greece, by presenting the reconstruction bust of a girl whose skull was found in Kerameikos cemetery of ancient Athens. The new Kerameikos excavation was initiated by the construction of Metropolitan Railway lines in the center of Athens between 1992 to 1998. It revealed a pit of a mass burial where about 150 people were inhumed in a very hasty way without proper funeral rites or offerings. These bodies are identified as the victims of the infamous plague of Athens in the first years of the Peloponnesian War(430-426 BC). The epidemic disease killed almost one third of the city population including Pericles, and brought extreme fear and panic to the Athens society. The traditional funerary rites were totally disrupted, and the social decorum and the morality among the citizens became enfeebled. The plague and the civil war were the decisive factors to end the Golden Age of Democratic Athens. However, the exhibition organizers did not focus on the tragic aspect of this disaster and its casualties. Their main concern was to simplify the scholarly works of archaeological excavation and microchemistry analysis so that the exhibition viewers will easily understand and empathize the living value of the scholarly works of ancient Greek civilization. The centripetal element of the exhibition was the vivid face of an 11 years old ancient girl 'Myrtis', which was carefully reconstructed based on both the scientific data and artistic imagination. Also the set up of the exhibition was structured in order to stimuli cognitive and emotional experience of the visitors who witnessed the rebirth of a vibrant human being from an ancient debris. The museologists' continuous efforts to promote projects of contemporary artists, publications, and school programs related to the exhibition indicate that the ulterior motive of this exhibition is the cultural education of the present and future generation through the intimate experiences of ancient Greek life. Also this is the reason why the various museums that held the travelling exhibition try to make the presentation as a gesture of memorial service for an anonymous Athenian girl who deceased circa 2400 years ago. The pragmatic efforts of Greek scholars and museologists through exhibition show us a way to find a solution to the continuous threat of cultural resources by massive construction projects and land development, and to overcome public indifference to the history and cultural heritage.

• Journal of Korean Medical classics
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• v.21 no.2
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• pp.1-20
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• 2008

The Song Dynasty(宋代) period gained the summit in the developmental phase of the history in pediatrics. In 1076, Taeuiguk(太醫局) was founded and Sobangmaek(小方脈) was the one of nine branch in Taeuiguk(太醫局). As a result, educational agency and system was arranged in the field of pediatrics. At the same time, pediatrics have furnished with foundation to develop independent field in medical science. Especially, Byeonjeungnonchi(辦證論治) system is established in pediatrics science according to the compilation of "Soayakjeungjikgyeol(小兒藥證直訣)" by Jeoneul(錢乙). Children's doctors, Jeoneul(錢乙), Jinmunjung(陳文中) and Donggeup(董汲) arranged clinically theories, so they made that age the peak of the pediatrics. Looking at the developmental part of theory in pediatrics of the Song Dynasty period, Jeoneul(錢乙), who was the representative children's doctor in Song Dynasty period, insisted that children had formed Ojang-yukbu(五臟六腑) in the physiological part but they were not perfect like adult's. Therefore they had to consider the poor part in children's body, and then they had to cure them. 'Byeonjeung(變蒸)' was considered to be normal physiological phenomenon. Also he insisted that Yukeum(六淫), 'Pung, Han, Seo, Seup, Jo, Hwa(風, 寒, 暑, 濕, 燥, 火)' and 'Gyeong, Pung, Gon, Cheon, Heo(驚, 風, 困, 喘, 虛)' are the main cause of the children's five vital organ's pathology Like this, his academic thought, which lay emphasized on children's spleen and stomach and Ojangbyeonjeung(五臟辦證) main principles, affected on doctors, Donggeup(董汲), Yeomhyochung(閣孝忠), Yubang(劉肪), Jang-wonso(張元素), Idong-won(李東垣), Manjeon(萬全). Bangje(方劑) fields of pediatrics had developed so fast and "Taepyeongsunghyebang(太平聖惠方)" contained about 2689 kinds of children's prescription. According to this, there are so many kinds of medicinal shape, for example 'Hwan, San, Go, Dan(丸, 散, 膏, 丹)', which cured children' s disease. Through this, we find that the shape of medicine about the children's diseases had developed to the more simple direction, taking account of the children's clinical trait.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.14
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• pp.5927-5936
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• 2014

Introduction: Breast cancer is the most common cancer among Jordanians. Breast cancer patients suffer from several negative consequences after treatment and these include pain, fatigue, sexual problems, appearance and body image concerns, with psychological dysfunction. This could affect the patient quality of life and psychological well-being. To the best of our knowledge, there is no published quantitative data on the quality of life and psychological well-being of breast cancer patients in Jordan. The objective of this study was to obtain such data and assess predictors with calculated scores. Methods: In this cross-sectional study conducted among breast cancer patients in Jordan diagnosed in 2009 and 2010, assessment was performed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Breast Module (QLQ-BR23) and the Hospital Anxiety and Depression Scale (HADS). Clinical, demographic and psychosocial indicators that could predict patient quality of life scores were collected. Results: The number of patients interviewed was 236 (mean age=$50.7{\pm}10.7$ years). The mean Global Health score for the QLQ-C30 was $63.7{\pm}20.2$ SD. Among functional scales, "social functioning" scored the highest ($mean=78.1{\pm}28.6$ SD), whereas "emotional functioning" scored the lowest ($mean=59.0{\pm}SD\;33.5$). For the QLQ-BR23, the worst scores within the functional scales were for "body image" ($mean=52.1{\pm}36.8$ SD) and "future perspective" ($mean=52.9{\pm}38.5$ SD). The worst symptom was "upset by hair loss" ($mean=69.8{\pm}43.0$). The mean HADS scores was $18.{\pm}9.0$ SD. Out of study participants, 53% scored abnormal on the anxiety scale and 45% on the depression scale. Severe depression and severe anxiety were detected among 8% and 14% of study participants, respectively. Statistically significant predictors for individual scores were similar to those reported in published studies, such as the presence of recurrence since baseline, family history of cancer, low educational status, current social problems, extent of the disease, presence of financial difficulties, and employment status. Conclusions and Recommendations: Breast cancer survivors in Jordan have overall good quality of life scores when compared with patients from Western countries. However, their psychological wellbeing is more impaired. There is an urgent need for psychosocial support programs and psychological screening and consultation for breast cancer patients at hospitals of the Ministry of Health in Jordan.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.9
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• pp.5095-5099
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• 2013

Background: The overall incidence of breast cancer in South Asian countries, including Nepal, is low compared to Western countries. However, the incidence of breast cancer among young women is relatively high. Breast cancer in such cases is characterized by a relatively unfavorable prognosis and unusual pathological features. The aim of this study was to investigate clinico-pathological and biological characteristics in younger breast cancer patients (<40 years) and compare these with their older counterparts. Materials and Methods: Nine hundred and forty four consecutive female breast cancer patients, admitted to the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal between November 1997 and October 2012, were retrospectively analyzed. Results: Out of the 944 female breast cancer patients, 263 (27.9%) were <40 years. The mean age was $34.6{\pm}5.0$ years among younger patients compared to $54.1{\pm}9.9$ for those ${\geq}40$ years. The mean age at menarche was also significantly lower ($13.5{\pm}1.5$ vs $14.2{\pm}1.5$ years p=0.001) while the mean duration of symptoms was significantly longer (7.6 vs 6.5 months p=0.004). Family history of breast cancer was evident in 3.0% of the young women versus 0.3% in the older one. Mammography was performed less frequently in younger patients (59.7%), compared to older (74.4%), and was of diagnostic benefit in only 20% of younger patients compared to 85% of older ones. At diagnosis, the mean tumor diameter was significantly larger in young women ($5.0{\pm}2.5$ vs $4.5{\pm}2.4cm$, p=0.005). Axillary lymph nodes were positive in 73% of younger patients and 59% of older patients. In the younger group, the proportion of stage III or IV disease was higher (55.1% vs 47.1%, $p{\leq}0.05$). The proportion of breast conserving surgery was higher in young patients (25.1% vs 8.7%) and a higher proportion of younger patients receive neoadjuvant chemotherapy (9.9% vs 2.8%). The most common histological type was ductal carcinoma (93.1% vs 86%). The proportion of histological grade II or III was higher in younger patients (55.9% vs 24.5%). Similarly, in the younger group, lymphatic and vascular invasion was more common (63.2% vs 34.3% and 39.8% vs 25.4%, respectively). Patients in the younger age group exhibited lower estrogen and/or progesterone receptor positivity (34.7% vs 49.8%). Although statistically not significant, the proportion of triple negative tumors in younger age group was higher (22.4% vs 13.6%). Conclusions: Breast cancer in young Nepalese women represents over one quarter of all female breast cancers, many being diagnosed at an advanced stage. Tumors in young women exhibit more aggressive biological features. Hence, breast cancer in young women is worth special attention for earlier detection.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.8
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• pp.226-235
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• 2016

The purpose of this study was to determine the relationships among the functional status, hostility, and social support in patients with percutaneous coronary intervention (PCI). The subjects were comprised of 135 patients who had received PCI from two general hospitals in Seoul, Korea. The functional status differed significantly according to gender (t=5.880, p<0.001), age (F=23.620, p<0.001), education (F=17.718, p<0.001), occupation (t=-6.498, p<0.001), monthly income (F=7.237, p<0.001), and smoking (t=2.327, p=0.025). The hostility differed significantly according to age (F=6.150, p=0.001), period after PCI (F=6.141, p=0.001), and family history (t=2.514, p=0.013). Differences were observed in the scores for social support according to age (F=2.866, p=0.039) and education (F=5.136, p=0.002). Significant positive correlations were found among functional status and social support (r=.20, p=0.025), friends support (r=.22, p=0.010) and a significant negative correlation between functional status and hostility (r=-.24, p=0.005). A significant negative correlation was found between hostility and friends support (r=-.17, p=0.046). Nurses should consider the characteristics of patients who have undergone PCI and develop nursing intervention programs to improve their functional status, hostility, and social support.