Purpose
Although a considerable number of cancer patients suffer from emotional distress which may have an impact on their quality of life, it still remains poorly understood which psychosocial ...factors contribute to individual vulnerabilities to emotional distress of cancer patients. Recently, resilience has been suggested as the capacity to cope with adversities like cancer. In this study, we investigated the relationships between resilience and emotional distress in cancer patients.
Methods
One hundred fifty-two cancer patients who were consecutively hospitalized for their scheduled treatments at the Seoul St. Mary’s Hospital were enrolled and completed the Connor–Davidson Resilience Scale and Hospital Anxiety Depression Scale to measure resilience and emotional distress. The relationships between the levels of psychological resilience and emotional distress were evaluated using univariate and multivariate logistic regression analyses.
Results
Psychological resilience levels were negatively associated with emotional distress after controlling for relevant covariates. The highest quartile of resilience level was associated with a 90 % (adjusted odds ratio OR = 0.10, 95 % confidence interval CI = 0.03–0.34,
P
< 0.001) reduction in the risk for emotional distress compared to the lowest quartile. Among metastatic cancer patients, resilience was also found to be a significant protective factor for emotional distress (adjusted OR = 0.14, 95 % CI = 0.02–0.79,
P
= 0.02).
Conclusion
The present study suggests that psychological resilience may independently contribute to low emotional distress in cancer patients. The relationship between resilience and emotional distress was also significant in the subgroup of metastatic cancer patients. Psychosocial interventions to enhance resilience might provide useful approaches to overcome cancer-related emotional distress.
Background
As indicators of the systemic inflammatory response, the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been proposed to predict the clinical outcome in ...some cancers. The purpose of this study was to investigate the impact of NLR and PLR on the prognosis of gastric cancer.
Methods
From 2000 to 2009, 1986 consecutive patients who underwent curative surgery for gastric cancer were enrolled. The optimal cutoff value of PLR and NLR was determined according to receiver operating characteristic analysis. We categorized the patients into the high or low PLR and NLR group based on the cutoff value, and the clinical features of these two groups were comparatively analyzed.
Results
The high NLR and PLR groups were significantly associated with poor prognosis. The NLR was an independent prognostic factor for overall survival hazard ratio (HR) = 1.403;
p
= 0.023; however, the PLR was not (
p
= 0.788).
Conclusions
Although both the PLR and NLR can reflect the prognosis, the NLR is more predictive of overall survival than the PLR.
A new ankylosaurid dinosaur, Tarchia tumanovae sp. nov., has been recovered from the Upper Cretaceous Nemegt Formation of Mongolia. It includes a well-preserved skull, dorsal, sacral, caudal ...vertebrae, sixteen dorsal ribs, ilia, a partial ischium, free osteoderms, and a tail club. The squamosal horns of T. tumanovae are divided into two layers, the external dermal layer and the underlying squamosal horn proper. The irregular ventral margin of the base of the upper dermal layer may represent a resorption surface, suggesting that the squamosal horns of some ankylosaurids underwent extreme ontogenetic remodeling. Localized pathologies on the dorsosacral ribs and the tail provide evidence of agonistic behaviour. The tail club knob asymmetry of T. tumanovae resulted from restricted bone growth due to tail club strikes. Furthermore, T. tumanovae had an anteriorly protruded shovel-shaped beak, which is a morphological character of selective feeders. Ankylosaurid diets shifted from low-level bulk feeding to selective feeding during the Baruungoyot and the Nemegt "age" (middle Campanian-lower Maastrichtian). This ankylosaurid niche shifting might have been a response to habitat change and competition with other bulk-feeding herbivores.
An artificial neural network model (ANN) and a geographic information system (GIS) are applied to the mapping of regional groundwater productivity potential (GPP) for the area around Pohang City, ...Republic of Korea. The model is based on the relationship between groundwater productivity data, including specific capacity (SPC) and its related hydrogeological factors. The related factors, including topography, lineaments, geology, and forest and soil data, are collected and input into a spatial database. In addition, SPC data are collected from 44 well locations. The SPC data are randomly divided into a training set, to analyse the GPP using the ANN, and a test set, to validate the predicted potential map. Each factor’s relative importance and weight are determined by the back-propagation training algorithms and applied to the input factor. The GPP value is then calculated using the weights, and GPP maps are created. The map is validated using area under the curve analysis with the SPC data that have not been used for training the model. The validation shows prediction accuracies between 73.54 and 80.09 %. Such information and the maps generated from it could serve as a scientific basis for groundwater management and exploration.
Radical gastrectomy is essential for gastric cancer treatment. While guidelines advise dissecting at least 16 lymph nodes, some research suggests over 30 nodes might be beneficial. This study ...assessed ICG-guided robotic gastrectomy’s effectiveness in thorough lymph node dissection. We analyzed data from 393 stage II or III gastric cancer patients treated at Seoul St. Mary’s Hospital from 2016–2022. Patients were categorized into conventional laparoscopy (G1, n = 288), ICG-guided laparoscopy (G2, n = 61), and ICG-guided robotic surgery (G3, n = 44). Among 391 patients, 308 (78.4%) achieved proper lymphadenectomy. The ICG-robotic group (G3) showed the highest success rate at 90.9%. ICG-guided robotic surgery was a significant predictor for achieving proper lymphadenectomy, with an odds ratio of 3.151. In conclusion, ICG-robotic gastrectomy improves lymphadenectomy outcomes in selected gastric cancer cases, indicating a promising surgical approach for the future.
The oncologic outcomes of laparoscopy-assisted gastrectomy for the treatment of gastric cancer have not been evaluated. The aim of this study is to validate the efficacy and safety of laparoscopic ...gastrectomy for gastric cancer in terms of long-term survival, morbidity, and mortality retrospectively.
The study group comprised 2,976 patients who were treated with curative intent either by laparoscopic gastrectomy (1,477 patients) or open gastrectomy (1,499 patients) between April 1998 and December 2005. The long-term 5-year actual survival analysis in case-control and case-matched population was conducted using the Kaplan-Meier method. The morbidity and mortality and learning curves were evaluated.
In the case-control study, the overall survival, disease-specific survival, and recurrence-free survival (median follow-up period, 70.8 months) were not statistically different at each cancer stage with the exception of an increased overall survival rate for patients with stage IA cancer treated via laparoscopy (laparoscopic group; 95.3%, open group: 90.3%; P < .001). After matching using a propensity scoring system, the overall survival, disease-specific survival, and recurrence-free survival rates were not statistically different at each stage. The morbidity of the case-matched group was 15.1% in the open group and 12.5% in the laparoscopic group, which also had no statistical significance (P = .184). The mortality rate was also not statistically significant (0.3% in the open group and 0.5% in the laparoscopic group; P = 1.000). The mean learning curve was 42.
The long-term oncologic outcomes of laparoscopic gastrectomy for patients with gastric cancer were comparable to those of open gastrectomy in a large-scale, multicenter, retrospective clinical study.
The aim of this study was to evaluate the safety of this trial with respect to morbidity and mortality.
Laparoscopic-assisted distal gastrectomy (LADG) is rapidly gaining popularity. However, there ...is limited evidence regarding its oncologic safety. We therefore conducted a phase III multicenter, prospective, randomized study comparing LADG with open gastrectomy (ODG).
Patient eligibility criteria were pathologically-proven adenocarcinoma, 20 to 80 years of age, preoperative stage I, no history of other cancer, chemotherapy, or radiotherapy. The primary end point was to determine whether there is a difference in overall survival between 2 groups. The morbidity and mortality were compared to evaluate the safety of this trial. The time was decided on the hypothesis that the morbidity of this trial was not significantly different from that of previous reports on open gastric cancer surgeries (17%-20%). This study is registered at ClinicalTrials.gov and carries the following ID number: NCT00452751.
A total of 342 patients were randomized (LADG, 179 patients; ODG, 161 patients) between January 1, 2006 and July 19, 2007. There were no significant differences between the 2 groups in age, gender, and comorbidities. The postoperative complication rates of the LADG and ODG groups were 10.5% (17/179) and 14.7% (24/163), respectively (P = 0.137). Reoperations were required in 3 cases each group. The postoperative mortality was 1.1% (2/179) and 0% (0/163) in the LADG and ODG groups (P = 0.497), respectively.
There was no significance difference in the morbidity and mortality between the 2 groups. Therefore, we conclude that this trial is safe and is thus ongoing.
To compare short-term surgical outcomes including financial cost of robotic and laparoscopic gastrectomy.
Despite a lack of supporting evidence, robotic surgery has been increasingly adopted as a ...minimally invasive modality for the treatment of gastric cancer because of its assumed technical superiority over conventional laparoscopy.
A prospective, multicenter comparative study was conducted. Patients were matched according to the surgeon, extent of gastric resection, and sex. The primary endpoint was morbidity and mortality. Outcomes were analyzed on an intention-to-treat and per-protocol basis.
A total of 434 patients were enrolled for treatment with either robotic (n = 223) or laparoscopic (n = 211) gastrectomy for intention-to-treat analysis, and a total of 370 patients (n = 185 per treatment) were compared in per-protocol analysis. Results were similar between both analyses. In per-protocol analysis, both groups showed similar overall complication rates (robotic = 11.9% vs laparoscopic = 10.3%) and major complication rates (robotic = 1.1% vs laparoscopic = 1.1%) with no operative mortality in either group. Patients treated with robotic surgery showed significantly longer operative time (robotic = 221 minutes vs laparoscopic = 178 minutes; P < 0.001) and significantly higher total costs (robotic = US$13,432 vs laparoscopic = US$8090; P < 0.001), compared with those who underwent laparoscopic gastrectomy. No significant differences between groups were noted in estimated blood loss, rates of open conversion, diet build-up, or length of hospital stay.
The use of robotic systems is assumed to provide a technically superior operative environment for minimally invasive surgery. However, our analysis of perioperative surgical outcomes indicated that robotic gastrectomy is not superior to laparoscopic gastrectomy. Clinical trials identification: NCT01309256.
High PM2.5 episodes frequently occur in Northeast Asia, and the source−receptor relationship for PM2.5 in megacities is a critical issue. As the largest industrial city in South Korea, Ulsan suffers ...from frequent high PM2.5 episodes. However, studies on the long-range atmospheric transport (LRAT), local emissions, and secondary formation of PM2.5 in Ulsan have been limited. In this study, the characteristics of high PM2.5 episodes in Ulsan were interpreted using hourly data for PM2.5 components. The periods with the highest PM2.5 concentrations in winter 2014 (February 24–26; 99.3 ± 18.6 μg/m3) and summer 2014 (June 24–27; 49.9 ± 12.3 μg/m3) were designated as Pollution Periods 1 and 2, respectively. In general, secondary inorganic ions (SO42−, NO3−, and NH4+; SNA) were generated by the liquid phase reaction of water-soluble materials during winter, and sulfate and secondary organic aerosols were mainly formed via photochemical reactions during summer. During Pollution Period 1, the concentrations of sulfate, organic carbon, and elemental carbon sharply increased, and three major sources were identified: (1) LRAT from fossil fuel and biomass burning in eastern China and North Korea, (2) the influence of petrochemical and non-ferrous industrial facilities in Ulsan, and (3) enhanced secondary formation of ammonium sulfate and organic aerosols due to air stagnation. During Pollution Period 2, the concentration of SNA and heavy metals sharply increased, and three pollution sources were identified: (1) the influence of local industrial facilities and ship emissions, (2) external inflow from thermal power stations and national industrial facilities in southern coastal cities, and (3) secondary organic and inorganic formation. In this study, the reasons for the high winter and summertime PM2.5 events in Ulsan were more clearly understood, which can be the basis for the establishment of PM2.5 management policies that consider LRAT, local primary emissions, and secondary formation.
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•PM2.5 components were measured semi-continuously in the industrial city of Ulsan.•The reason for high PM2.5 events was investigated using monitoring and modeling data.•In winter, LRAT and air stagnation were major reasons for the high PM event.•The high PM event in summer was due to local industry and secondary formation.
Abstract Background The relationship between preoperative body mass index (BMI) and the survival of postoperative gastric cancer patients is not clear. Furthermore, the survival impact with ...postoperative BMI is not known, even though weight loss is inevitable after gastrectomy. Methods Patients who underwent gastrectomy for gastric cancer between 2000 and 2008 were included in the study (n = 1909). Patients were divided into three groups based on their BMIs: low (<18.5 kg/m2 ), normal (18.5–24.9 kg/m2 ), and high BMI (≥25.0 kg/m2 ). Patient survival was compared according to BMI at two time points: baseline and 1 year after surgery. Results Regarding BMI 1 year after surgery, overall survival, disease-specific survival, and recurrence-free survival were longer in the high BMI group than the low and normal BMI groups. In a Cox proportional hazards model, adjusting for the patient's age, sex, type of surgery, tumour stage, histology, curative resection, and BMI at baseline, a high BMI 1 year after surgery was associated with lower overall mortality compared to normal BMI (hazard ratio 0.51; 95% confidence interval, 0.26–0.98). However, BMI at baseline was not an independent prognostic factor. Conclusion BMI 1 year after surgery significantly predicted the long-term survival of patients with gastric cancer compared with the preoperative BMI.
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