In the past few years, the number of clinical trials has increased rapidly in East Asia, especially for gastric and hepatobiliary cancer that are prevalent in Asian populations. However, the actual ...degree of understanding or perceptions of clinical trials by cancer patients in East Asian countries have seldom been studied.
Between July 1st and November 30th of 2011, we conducted a prospective study to survey cancer patients regarding their awareness of, and willingness to participate in, a clinical trial. Patients with gastrointestinal/hepatobiliary cancer who visited the Hematology-Oncology outpatient clinic at Samsung Medical Center (SMC) were enrolled. A total of 21 questions were asked including four questions which used the Visual analogue scale (VAS) score.
In this survey study, 1,000 patients were asked to participate and 675 patients consented to participate (67.5%). The awareness of clinical trials was substantially higher in patients who had a higher level of education (p<0.001), were married (p=0.004), and had a higher economic status (p=0.001). However, the willingness to participate in a clinical trial was not affected by the level of education or economic status of patients. The most influential factors for patient willingness to participate were a physician recommendation (n=181, 26.8%), limited treatment options (n=178, 26.4%), and expectations of effectiveness of new anti-cancer drugs (n=142, 21.0%). Patients with previous experience in clinical trials had a greater willingness to participate in clinical trials compared to patients without previous experience (p<0.001).
This large patient cohort survey study showed that Korean cancer patients are more aware of clinical trials, but awareness did not translate into willingness to participate.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background
Obesity is associated with arterial stiffening, left ventricular (LV) hypertrophy, and diastolic dysfunction. However, there is no data regarding dynamic changes in arterial hemodynamics ...with exercise in overweight subjects. We hypothesized that overweight women would show a different exercise response in wave reflection compared with lean women.
Methods
A total of 59 overweight and 68 lean nondiabetic women (mean age 63 ± 7 years) underwent symptom-limited supine bicycle exercise testing with simultaneous two-dimensional and Doppler echocardiography. Central hemodynamics including central aortic pressure and augmentation index (AIx) were obtained at rest and immediately after peak exercise using radial artery tonometry.
Results
Overweight women showed a higher LV mass index (lean vs. overweight; 40.2 ± 10.2 vs. 45.3 ± 11.0g/m2.7, P = 0.007) and a lower early diastolic mitral annular velocity (6.3 ± 1.8 vs. 5.5 ± 1.6 cm/s, P = 0.013) than lean women. Although the two groups did not differ in peripheral and central hemodynamics including AIx (36.3 ± 11.7 vs. 36.8 ± 10.2%, P = 0.830) and AIx normalized for heart rate 75/min (AIx@75, 30.4 ± 11.5 vs. 30.1 ± 9.9%, P = 0.885) at rest, AIx (20.9 ± 11.5 vs. 27.6 ± 10.4%, P = 0.004) and AIx@75 (25.8 ± 10.2 vs. 31.6 ± 7.7%, P = 0.002) at peak exercise were significantly higher in overweight women. In simple correlation analysis, body mass index (BMI) showed significant correlations with AIx, and AIx@75 at peak exercise, whereas no relationships were found with those parameters at rest. Multiple regression analysis showed that BMI was an independent determinant of AIx@75 at peak exercise (β = 0.28, P = 0.004).
Conclusions
Despite similar resting peripheral and central hemodynamics, the wave reflection in overweight women after exercise differed from that in lean women. These findings suggest that being overweight is related to higher wave reflection after exercise.
American Journal of Hypertension advance online publication 11 August 2011; doi:10.1038/ajh.2011.121
Recently, positron emission tomography (PET) has been incorporated into a series of prospective studies as a predictor of outcomes in multiple myeloma (MM), and the number of (18)F-fluorodeoxuglucose ...(FDG)-avid focal lesions (FLs) and the intensity of tumor metabolism have been designated as important surrogate markers for predicting prognosis. Here, we compared initial clinical characteristics of MM patients with baseline PET parameters: the number of FLs and the maximum standardized uptake value (SUVmax). A total of 59 patients diagnosed with MM between August 2004 and February 2012 were reviewed. At diagnosis, 23 patients (40.0%) had ≤3 FLs, 11 patients (18.6%) 4-9 FLs, and 25 patients (42.4%) ≥10 FLs. The median SUVmax was 5.3 (range 0-24.3), and 40 patients (67.8%) showed a SUVmax >4. No clinical characteristics were significantly different between groups with a SUVmax ≤4 and a SUVmax >4. However, there were significant differences in several clinical indices between the FLs ≤3 and FLs >3 groups; elevated β2-microglobulin, elevated lactate dehydrogenase, anemia and more advanced disease by the Durie-Salmon stage corresponded to FLs >3 at baseline PET. Adverse baseline PET findings are positively correlated with prognostically relevant clinical parameters. Regarding PET parameters, FLs are more likely to be well correlated with disease aggressiveness and pathophysiology compared to SUVmax.
We report on the influence of substrate temperature on SiOC(–H) thin films deposited on
p-type Si(100) substrates by plasma enhanced chemical vapor deposition (PECVD) with dimethoxydimethylsilane ...(DMDMS) and oxygen gas as precursors. The films were deposited at various substrate temperatures with a radio frequency (rf) power of 500 W and working pressure of 700 mTorr. Fourier transform infrared (FTIR) spectroscopy was used in the absorbance mode over the range of 400 to 4000 cm
−1 which showed the various bonding configurations such as Si–O–Si(C), Si–CH
3,–OH, and CH
n
bonds in the SiOC(–H) films. The X-ray photoelectron spectroscopy (XPS) was used to study the binding energies of Si–C, SiO–C
3, SiO
2–C
2, SiO
3–C, Si–O
2, C–C, C–H and C–O bonds in the SiOC(–H) films as a function of the substrate temperature. The dielectric constant of the SiOC(–H) films was measured using a metal insulator semiconductor (MIS, Al/SiOC(–H)/
p-Si) structure at 1 MHz frequency. The lowest dielectric constant of the films deposited at room temperature was 2.22 and was achieved with DMDMS/O
2 precursor.
Aims
Despite the prognostic importance of ventricular filling and ventricular-arterial interaction in patients with advanced systolic heart failure, the structural determinants of these parameters ...have not been fully studied. We aimed to investigate whether patterns of late gadolinium enhancement (LGE) on cardiac magnetic resonance affect ventricular elastic properties or performance in patients with non-ischaemic dilated cardiomyopathy (DCM).
Methods and results
Patients (n = 49) with markedly reduced systolic function (left ventricular (LV) ejection fraction <35%) due to longstanding non-ischaemic DCM underwent contrast-enhanced cardiac magnetic resonance after comprehensive echo-Doppler evaluations. The single beat-derived end-diastolic elastance, end-systolic elastance, arterial elastance, and dyssynchrony indices were measured by echo. On the basis of LGE patterns, patients could be divided into three groups: non-LGE (n = 18), non-midwall LGE (n = 13), and midwall LGE (n = 18). The midwall LGE group had lower LV systolic longitudinal velocity (4.6 ± 1.7 for non-LGE vs. 4.3 ± 1.2 for non-midwall LGE vs. 3.5 ± 1.0 cm/s for midwall LGE, P = 0.025), higher end-diastolic elastance index (0.41 ± 0.21 vs. 0.46 ± 0.31 vs. 0.85 ± 0.51 respectively, P = 0.008), and a more impaired ventriculoarterial coupling index (3.14 ± 1.53 vs. 2.88 ± 1.94 vs. 5.52 ± 3.18, P = 0.006) than other subgroups.
Conclusion
Patients with midwall LGE had a higher ventricular stiffness index and more impaired ventriculoarterial coupling when compared with other non-ischaemic DCM patients.
Botulinum neurotoxins (BoNTs), produced by
, are the most toxic substances known. However, the number of currently approved medical countermeasures for these toxins is very limited. Therefore, ...studies on therapeutic antitoxins are essential to prepare for toxin-related emergencies. Currently, more than 10,000 Halla horses, a crossbreed between the native Jeju and Thoroughbred horses, are being raised in Jeju Island of Korea. They can be used for equine antitoxin experiments and production of hyperimmune serum against BoNT/A1. Instead of the inactivated BoNT/A1 toxoid, Halla horse was immunized with the receptor-binding domain present in the C-terminus of heavy chain of BoNT/A1 (BoNT/A1-HCR) expressed in
. The anti-BoNT/A1-HCR antibody titer increased rapidly by week 4, and this level was maintained for several weeks after boosting immunization. Notably, 20 μL of the week 24 BoNT/A1-HCR(-immunized) equine serum showed an in vitro neutralizing activity of over 8 international unit (IU) of a reference equine antitoxin. Furthermore, 20 μL of equine serum and 100 μg of purified equine F(ab')
showed 100% neutralization of 10,000 LD
in vivo. The results of this study shall contribute towards optimizing antitoxin production for BoNT/A1, which is essential for emergency preparedness and response.
BACKGROUND: The function of left atrium (LA) is difficult to assess because of its ventricle-dependent, dynamic movement. The aim of this study was to assess LA function using velocity vector imaging ...(VVI) and compare LA function in patients with hypertrophic cardiomyopathy (HCMP) and left ventricular hypertrophy (LVH) with normal controls. METHODS: Fourteen patients with HCMP (72% male, mean age of 52.6 ± 9.8), 15 hypertensive patients with LVH (88% male, mean age of 54.0 ± 15.3), and 10 age-matched controls (83% male, mean age of 50.0 ± 4.6) were prospectively studied. Echocardiographic images of the LA were analyzed with VVI, and strain rate (SR) was compared among the 3 groups. RESULTS: The e' velocity (7.7 ± 1.1; 5.1 ± 0.8; 4.5 ± 1.3 cm/sec, p = 0.013), E/e' (6.8 ± 1.6; 12.4 ± 3.3; 14.7 ± 4.2, p = 0.035), and late diastolic SR at mid LA (-1.65 ± 0.51; -0.97 ± 0.55; -0.82 ± 0.32, p = 0.002) were significantly different among the groups (normal; LVH; HCMP, respectively). The e' velocity, E/e', and late diastolic SR at mid LA were significantly different between normal and LVH (p = 0.001; 0.022; 0.018), whereas LA size was similar between normal and LVH (p = 0.592). The mean late diastolic peak SR of mid LA was significantly correlated with indices of diastolic function (E/e', e', and LA size). CONCLUSIONS: The SR is a useful tool for detailed evaluation of LA function, especially early dysfunction of LA in groups with normal LA size.
Background
Total gastrectomy is performed for early gastric cancer in the upper body of the stomach because of the high complication rate of endoscopic submucosal dissection (ESD). The aims of the ...present animal study in pigs were to verify: (1) the feasibility of the trans-umbilical route compared with the trans-oral route in gastric upper body ESD; (2) the non-inferiority of single port laparoscopic lymph node dissection (LLND) compared with multiport LLND; and (3) the safety of 2-basin LLND (upper greater and lesser curvature).
Methods
We separated the pigs (~40 kg each) into two groups: conventional and experimental (
n
= 5 per group). We performed ESD in the fundus and upper body anterior wall (UBAW) via the trans-oral route and multiport LLND in the conventional group, and via the trans-umbilical route and single port LLND in the experimental group.
Results
The completion rates, tissue weights, and specimen diameters of both routes showed no statistical differences in either the fundus or the UBAW. The operative time was shorter with the trans-umbilical route than with the trans-oral route in both areas (
p
< 0.05). In LLND, there were no differences in surgical outcomes between the multiport and single port groups. Intraoperative perforation was seen in the trans-oral route group (
n
= 1). Delayed perforation was observed in 30 % of the ESD sites.
Conclusions
The trans-umbilical route is feasible and has lower complication rates than the trans-oral route in gastric upper body ESD. Additionally, single port LLND is not inferior to multiport LLND, and one-side-basin dissection is safer than two-side.
A 52-year-old woman presented with severe dyspnea of 2 weeks' duration. Echocardiography showed an enlarged left atrium but normal global left ventricular systolic function. However, a huge, ...irregularly shaped mass at the dilated coronary sinus that extended into the right atrium was noted. Mitral inflow showed restrictive physiology and the E/E' ratio was significantly elevated, suggesting elevated left ventricular filling pressures. Echocardiography-guided biopsy was performed, and a diagnosis of primary cardiac lymphoma (diffuse large B-cell type) was made. After the first cycle of chemotherapy, the patient's symptom was markedly improved. A follow-up echocardiogram showed complete removal of the mass and a change in left ventricular filling pattern from restrictive to relaxation abnormality with decreased E/E'. The present case demonstrates a rare cause of diastolic dysfunction due to coronary sinus obstruction by tumor infiltration. Diastolic dysfunction caused by coronary sinus obstruction was improved after the tumor was resolved by chemotherapy.
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