• Asian Pacific Journal of Cancer Prevention
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• v.15 no.19
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• pp.8135-8142
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• 2014

Background: Breast cancer is the most common cancer in Iranian women and usually features delayed presentation and late diagnosis. Interpretation of symptoms, as the most important step, has a significant impact on patient delay in seeking treatment. There is a dearth of studies on symptom appraisal and the process leading to seeking help in breast cancer patients. This study explored the perceptions and experiences of Iranian women with self-detected possible breast cancer symptoms. Materials and Methods: A qualitative method was conducted involving in-depth semi-structured interviews with 27 Iranian women with self-discovered breast cancer symptoms. Participants were purposefully selected from women who attended Cancer Institute of Tehran University of Medical Sciences during June 2012 to August 2013. The audiotaped interviews were transcribed and analyzed using conventional content analysis with MAXQDA soft ware version 10. The trustworthiness of the study was verified by prolonged engagement, member validation of codes, and thick description. Results: The main concepts emerging from data analysis were categorized in four categories: symptom recognition, labeling of symptoms, interactive understanding, and confronting the fear of cancer. Symptom recognition through breast self-examination, symptom monitoring and employing prior knowledge distinguished normal from abnormal symptoms and accompanied with perception of being at risk of breast cancer led to symptom labeling. Social interaction by selective disclosure and receiving reassurance from a consultant led to confirmation or redefinition of the situation. Perceived seriousness of the situation and social meanings of breast cancer as a stigmatized and incurable illness associated with loss of femininity were reasons for patient worries and fear. Conclusions: This study emphasized that entangled cognitive, emotional and socio-cultural responses affecting understanding of symptom seriousness require further investigation. It is suggested that programs aimed at shortening patient delay in breast cancer should be focused on improving women's knowledge and self-awareness of breast cancer, in addition to correcting their social beliefs.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.11
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• pp.4637-4642
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• 2014

Background: Hypoxia-inducible factor $1{\alpha}$ (HIF-$1{\alpha}$) plays an important role in regulating cell survival and angiogenesis, which are critical for tumor growth and metastasis. Genetic variations of HIF1A have been shown to influence the susceptibility to many kinds of human tumors. Increased expression of HIF-$1{\alpha}$ has also been demonstrated to be involved in tumor progression. However, the prognostic value of single nucleotide polymorphisms (SNPs) inthe HIF1A gene remains to be determined in most cancer types, including colorectal cancer (CRC). In this study, we sought to investigate the predictive role of HIF1A SNPs in prognosis of CRC patients and efficacy of chemotherapy. Materials and Methods: We genotyped two functional SNPs in HIF1A gene using the Sequenom iPLEX genotyping system and then assessed their associations with clinicopathological parameters and clinical outcomes of 697 CRC patients receiving radical surgery using Cox logistic regression model and Kaplan Meier curves. Results: Generally, no significant association was found between these 2 SNPs and clinical outcomes of CRC. In stratified analysis of subgroup without adjuvant chemotherapy, patients carrying CT/TT genotypes of rs2057482 exhibited a borderline significant association with better overall survival when compared with those carrying CC genotype [Hazard ratio (HR), 0.47; 95% confidence interval (95% CI): 0.29-0.76; P < 0.01]. Moreover, significant protective effects on CRC outcomes conferred by adjuvant chemotherapy were exclusively observed in patients carrying CC genotype of rs2057482 and in those carrying AC/CC genotype of rs2301113. Conclusions: Genetic variations in HIF1A gene may modulate the efficacy of adjuvant chemotherapy after surgery in CRC patients.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.6
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• pp.3903-3907
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• 2013

Background: Patients with colorectal cancer are usually treated with chemotherapy, which reduces the number of blood cells, especially white blood cells, and consequently increases the risk of infections. Some research studies have reported that aromatherapy massage affects the immune system and improves immune function by, for example, increasing the numbers of natural killer cells and peripheral blood lymphocytes. However, there has been no report of any study which provided good evidence as to whether aromatherapy with Thai massage could improve the immune system in patients with colorectal cancer. The objectives of this study were to determine whether the use of aromatherapy with light Thai massage in patients with colorectal cancer, who have received chemotherapy, can result in improvement of the cellular immunity and reduce the severity of the common symptoms of side effects. Materials and Methods: Sixty-six patients with colorectal cancer in Phichit Hospital, Thailand, were enrolled in a single-blind, randomised-controlled trial. The intervention consisted of three massage sessions with ginger and coconut oil over a 1-week period. The control group received standard supportive care only. Assessments were conducted at pre-assessment and at the end of one week of massage or standard care. Changes from pre-assessment to the end of treatment were measured in terms of white blood cells, neutrophils, lymphocytes, CD4 and CD8 cells and the CD4/CD8 ratio and also the severity of self-rated symptom scores. Results: The main finding was that after adjusting for pre-assessment values the mean lymphocyte count at the post-assessment was significantly higher (P=0.04) in the treatment group than in the controls. The size of this difference suggested that aromatherapy with Thai massage could boost lymphocyte numbers by 11%. The secondary outcomes were that at the post assessment the symptom severity scores for fatigue, presenting symptom, pain and stress were significantly lower in the massage group than in the standard care controls. Conclusions: Aromatherapy with light Thai massage can be beneficial for the immune systems of cancer patients who are undergoing chemotherapy by increasing the number of lymphocytes and can help to reduce the severity of common symptoms.

• Journal of the Korean Society of Radiology
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• v.10 no.6
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• pp.457-468
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• 2016

The purpose of this study was to investigate factors of perception by inpatients of the Medical Examination institutions about exposure to radioactivity at the time of radioactive examination, providing basic information for making educational materials aimed to change their perception. Most of those patients, 72.0% responded that CT was a type of radioactive examination bringing highest exposure to radiosensitivity. Most of the subjects, 63.5% said that a body part most vulnerable to exposure to radiosensitivity was the genital gland at the time of radiosensitivity examination. And most of the participants, or 29.0% responded that they obtained information about radiation from TVs or newspapers. Among the surveyed patients, men were higher in scores for factors of the perception of radiation such as recognition of radiation, harmfulness of radiation, psychological state at the time of radioactive examination, prevention of exposure to radioactivity and necessity of radiation that women were, with statistically significant differences between the two groups. These findings suggest that it is urgently needed to develop an education program which helps patients better perceive exposure to radioactivity and that radiologists should be very careful to reduce the does of that exposure. If patients better perceive radiation, they would be less anxious and less exposed to radioactivity when receiving the radioactive examination.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.5
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• pp.1699-1705
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• 2015

Background: Medication errors in oncology may cause severe clinical problems due to low therapeutic indices and high toxicity of chemotherapeutic agents. We aimed to investigate unintentional medication errors and underlying factors during chemotherapy preparation and administration based on a systematic survey conducted to reflect oncology nurses experience. Materials and Methods: This study was conducted in 18 adult chemotherapy units with volunteer participation of 206 nurses. A survey developed by primary investigators and medication errors (MAEs) defined preventable errors during prescription of medication, ordering, preparation or administration. The survey consisted of 4 parts: demographic features of nurses; workload of chemotherapy units; errors and their estimated monthly number during chemotherapy preparation and administration; and evaluation of the possible factors responsible from ME. The survey was conducted by face to face interview and data analyses were performed with descriptive statistics. Chi-square or Fisher exact tests were used for a comparative analysis of categorical data. Results: Some 83.4% of the 210 nurses reported one or more than one error during chemotherapy preparation and administration. Prescribing or ordering wrong doses by physicians (65.7%) and noncompliance with administration sequences during chemotherapy administration (50.5%) were the most common errors. The most common estimated average monthly error was not following the administration sequence of the chemotherapeutic agents (4.1 times/month, range 1-20). The most important underlying reasons for medication errors were heavy workload (49.7%) and insufficient number of staff (36.5%). Conclusions: Our findings suggest that the probability of medication error is very high during chemotherapy preparation and administration, the most common involving prescribing and ordering errors. Further studies must address the strategies to minimize medication error in chemotherapy receiving patients, determine sufficient protective measures and establishing multistep control mechanisms.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.10
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• pp.4637-4642
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• 2016

Purpose: To evaluate palliative care for patients with gynecologic cancer in Japan. Materials and Method: A questionnaire asking facility characteristics, systems to coordinate palliative care, current status of end-of-life care, provision of symptom relief, palliative radiation therapy and chemotherapy, and cases of death from gynecological cancer, was mailed to facilities treating gynecologic cancer. Results: A total of 115 facilities (29.3% of the total) responded to the questionnaire. Of these, 33.0 (29.0%) had a palliative care ward. End-of-life care was managed by obstetricians and gynecologists in 72.0% of the facilities. The site where end-of-life care was provided was most often a ward in the department where the respondent worked. The waiting period for transfer to a hospice was 2 weeks or more in 52% of facilities. Before the start of primary treatment, pain control was managed by obstetrians and gynecologists in 98.0% of facilities. Palliative radiation therapy or chemotherapy was administered at 93.9% and 92.0% of facilities, respectively. Of the 115 facilities, 34.0 (29.6%) reported cases of death from gynecological cancer. There were 1,134 cases of death. The median time between the last cycle of chemotherapy and death was 85 days for all gynecological cancers. The proportion of patients receiving chemotherapy in the last 30 and 14 days of life were 17.4% and 7.1%, respectively. Conclusions: This large-scale survey showed characteristics of palliative care given to patients with gynecologic cancer in Japan. Assessment of death cases showed that the median time between the last cycle of chemotherapy and death was relatively short.

• Radiation Oncology Journal
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• v.33 no.4
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• pp.276-283
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• 2015

Purpose: We evaluated the efficacy and toxicity of repeated high dose 3-dimensional conformal radiation therapy (3D-CRT) for patients with unresectable hepatocellular carcinoma. Materials and Methods: Between 1998 and 2011, 45 patients received hepatic re-irradiation with high dose 3D-CRT in Samsung Medical Center. After excluding two ineligible patients, 43 patients were retrospectively reviewed. RT was delivered with palliative or salvage intent, and equivalent dose of 2 Gy fractions for ${\alpha}/{\beta}=10Gy$ ranged from $31.25Gy_{10}$ to $93.75Gy_{10}$ (median, $44Gy_{10}$). Tumor response and toxicity were evaluated based on the modified Response Evaluation Criteria in Solid Tumors criteria and the Common Terminology Criteria for Adverse Events (CTCAE) ver. 4.0. Results: The median follow-up duration was 11.2 months (range, 4.1 to 58.3 months). An objective tumor response rate was 62.8%. The tumor response rates were 81.0% and 45.5% in patients receiving ${\geq}45Gy_{10}$ and $<45Gy_{10}$, respectively (p = 0.016). The median overall survival (OS) of all patients was 11.2 months. The OS was significantly affected by the Child-Pugh class as 14.2 months vs. 6.1 months (Child-Pugh A vs. B, p < 0.001), and modified Union for International Cancer Control (UICC) T stage as 15.6 months vs. 8.3 months (T1-3 vs. T4, p = 0.004), respectively. Grade III toxicities were developed in two patients, both of whom received ${\geq}50Gy_{10}$. Conclusion: Hepatic re-irradiation may be an effective and tolerable treatment for patients who are not eligible for further local treatment modalities, especially in patients with Child-Pugh A and T1-3.

• Journal of the Korean Home Economics Association
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• v.41 no.10 s.188
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• pp.101-116
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• 2003

The study was conducted to establish hygienic standards of salad items for pizza restaurant located in Seoul by applying HACCP system during the summer of 2000. The study measured temperature, time, pH, Aw and microbial assessments. The hygienic conditions of the kitchen and workers were on the average(1.21, 1.0 out of 3 pts.), but some improvement should be made: separate use of trash can and leftover disposal, separate use of knives and cutting boards, habits for hand washing and wearing hygienic gloves. For salad production, all procedures were peformed under food safety danger zone ($5{\~}60^{\circ}C$). The ingredients were mostly above pH 5.0 and high in Aw($0.94{\~}0.99$). Microbial assessments for salad production revealed that TPC($1.8{\times}10^3{\~}1.0{\times}10^{10}CFU/g$) and coliforms($1.5{\times}10{\~}5.2{\times}10^5 CFU/g$) exceeded the standards by Solberg et al.(TPC: $10^6CFU/g$, coliforms: $10^3CFU/g$). S. aureus was not detected but Salmonella was found in three food items(egg, macaroni and macaroni salad). Moreover, the workers' hands contained 3.1 104 CFU/g of TPC and 4.2 102 CFU/g of S. aureus requiring further remedy since it exceeded the safety standards suggested by Harrigan and McCance (500 CFU/g of TPC per $100cm^2$ and 10 CFU/g of coliforms per $100cm^2$). According to the critical control point(CCP) decision tree analysis, vegetable receiving, vegetable holding, mixing, display on coleslaw, macaroni draining, display on macaroni salad, egg peeling & cutting, apple cutting, and display on salad bar were determined as CCPs. From the findings it would be suggested that purchase of Quality materials, short holding and display time, storing food at right temperature, using sanitary cooking utensils, and improvement of workers' food handing practices are needed to ensure the safe salad production in this specific pizza restaurant.

• Journal of Korean Society of Forest Science
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• v.54 no.1
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• pp.60-67
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• 1981

The run-off experiment plots had been established for eight sets of plot comprising four treatments with two replications on $20^{\circ}$ slope land having the Wait-A-Bit Clay soil(locally known), at the Olive River Soil Conservation Centre, Trelawny in Jamaica. The location of plots was about 820 metres m.s.l. and sloped north-west. Each plot size was determined as $40m^2$ having 2.7 m wide and 15.8 m long along slope. All of the run-off soil and water were collected by using the receiving tanks through the collection troughs and conveyance pipes. These run-off materials were measured and sampled, dried and computed for determination of the soil loss from each treatment of plots. During the first period of experiment for about 10 month which was one crop-year cycle of yam crop, total amount of 1,295 mm rainfall received. The heaviest daily rainfall was recorded as 116.2 mm on August 5 followed by 100.4 mm on August 6, 1980. The soil sediment had been collected and analysed for eleven times during this experiment. Total amounts of soil sediment as over-dried weight by the treatment plot were estimated as 182 ton/ha from treatment I, 105 tons/ha from treatment II, 50 tons/ha from treatment III, 43 tons/ha from treatment IV respectively. It is recommendable at present that the treatment III and IV measure which treated with contour mounds with the hillside ditch and grass buffer strip should be adopt4ed for hillside farming particularly with yam cultivation in Jamaica.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2003.09a
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• pp.63-63
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• 2003

Purpose: Planning target volume (PTV) for tumors in abdomen or thorax includes enough margin for breathing-related movement of tumor volumes during treatment. We developed a simple and handy method, which can reduce PTV margins in patients with moving tumors, respiratory motion reduction device system (RMRDs). Materials and Methods: The patients clinical database was structured for moving tumor patients and patient setup error measurement and immobilization device effects were investigated. The system is composed of the respiratory motion reduction device utilized in prone position and abdominal presser (strip device) utilized in the supine position, moving phantom and the analysis program, which enables the analysis on patients setup reproducibility. It was tested for analyzing the diaphragm movement and CT volume differences from patients with RMRDs, the magnitude of PTV margin was determined and dose volume histogram (DVH) was computed using a treatment planning software. Dose to normal tissue between patients with RMRDs and without RMRDs was analyzed by comparing the fraction of the normal liver receiving to 50% of the isocenter dose(TD50). Results: In case of utilizing RMRDs, which was personally developed in our hospital, the value was reduced to $5pm1.4 mm$, and in case of which the belt immobilization device was utilized, the value was reduced to 3$pm$0.9 mm. Also in case of which the strip device was utilized, the value was proven to reduce to $4pm.3 mm$0. As a result of analyzing the TD50 is irradiated in DVH according to the radiation treatment planning, the usage of the respiratory motion reduction device can create the reduce of 30% to the maximum. Also by obtaining the digital image, the function of comparison between the standard image, automated external contour subtraction, and etc were utilized to develop patients setup reproducibility analysis program that can evaluate the change in the patients setup. Conclusion: Internal organ motion due to breathing can be reduced using RMRDs, which is simple and easy to use in clinical setting. It can reduce the organ motion-related PTV margin, thereby decrease volume of the irradiated normal tissue.