11860293
Changing patterns in the association between regional socio-economic context and dental caries experience according to gender and age: A multilevel study in Korean adults
BackgroundLittle is known about the effects of socio-environmental factors on dental caries in different demographic situations in Asian populations. We investigated whether the nature of the association between regional socio-economic context and dental caries experience differed according to gender and age groups in Korean adults.MethodsWe obtained a linked data set containing individual information from the 2000 Korean National Oral Health Survey and regional information from the “Major statistical indices of Si-Gun-Gu” (city-county-ward), published by the Korean Statistical Office. We stratified participants into women and men and into four 10-year-interval age groups (19–34, 35–44, 45–54, and 55–64 years) and analysed the linked data using a multilevel analysis. In total, 5,259 individuals were included in the final study population.ResultsRegional socio-economic context was significantly associated with dental caries experience in men, but not in women. The patterns of the association between regional contextual variables and dental caries experience differed among age groups. People 35–44 years of age living in areas less dependent on the manufacturing industry and those 45–54 years of age living in areas where local government was relatively poor were more prone to have caries experience.ConclusionsThe results of this study indicated that socio-economic factors affecting residents’ dental health status may operate through different mechanisms or degrees according to geographic location, suggesting that some gender- and age-defined subgroups may be likely to benefit from different types of intervention, including the development of specific health policies.
44613407
Job satisfaction and trust in Health Insurance Review Agency among Korean physicians.
OBJECTIVES
To measure Korean physicians' job satisfaction and to examine the relationship between trust in Health Insurance Review Agency (HIRA) and job satisfaction.


METHODS
Stratified sampling was used. The sample was representative of Korean office-based physicians; 1593 office-based physicians in Korea were surveyed by mail over a 4-week period using a self-administered questionnaire. Multivariate analysis using logistic regression was performed to investigate predictors of physicians' job satisfaction and to examine whether trust in HIRA was related to job satisfaction.


RESULTS
Overall, the job satisfaction of physicians was very low. The payment denial rate was not related to job satisfaction. Physicians who trusted HIRA were more likely to be satisfied with their job.


CONCLUSIONS
Physicians who trusted in the HIRA were more likely to report satisfaction. These results emphasize that trust in the HIRA is key to physicians' job satisfaction.
43129468
Trends in Socioeconomic Disparities in Organized and Opportunistic Gastric Cancer Screening in Korea (2005-2009)
Background: A growth of consensus and increasing activities related to organized cancer screening programs has occurred in Korea since 1999. It is important to assess disparities in the fight against cancer, and it is crucial to identify particular groups that may be experiencing a high burden of cancer-related illness. Methods: Data from 8,160 men and women ages >40 years from the 2005 to 2009 Korean National Cancer Screening Survey were used to analyze the relationship between socioeconomic position and receiving upper gastrointestinal series or upper endoscopy within the past 2 years. We used absolute and relative concentration indexes, that is, summary measures of disparity based on both rate differences and rate ratios. Results: For organized screening, the education disparity declined, but the income disparity index increased, indicating that participation in organized screening was relatively more concentrated among the lower-income groups. For opportunistic screening, income and education disparities increased due to the widening of socioeconomic differences. Conclusions: The results of this study suggested progress toward socioeconomic disparity-related goals in organized screening for gastric cancer. However, the income disparity trends in organized screening may change in a manner similar to those in opportunistic screening in the future because of the much faster rate of organized screening uptake by those higher on the socioeconomic scale. Impact: This study addresses the routine monitoring of coverage of screening among different socioeconomic groups and could be used to inform polices to reduce disparity in coverage. Cancer Epidemiol Biomarkers Prev; 19(8); 1919–26. ©2010 AACR.
28196227
Assessment of participant satisfaction with upper gastrointestinal endoscopy in South Korea.
AIM
To measure the perceived satisfaction with gastric cancer screening as part of the National Cancer Screening Program (NCSP) in South Korea.


METHODS
Data were derived from the participants in a satisfaction survey of the Quality Evaluation of National Cancer Screening in 2009. This is a population-based nationwide telephone survey of participants who were screened by the NCSP between May and October 2009. This study included 4412 participants who provided full sets of data and who had upper endoscopies for the purpose of gastric cancer screening.


RESULTS
The negative appraisal percentages for each of the seven questions were as follows: explanation in preparation for the upper endoscopy, 12.3%; explanation about the process and procedure of the upper endoscopy, 13.8%; explanation about any pain or discomfort related to the upper endoscopy, 27.5%; level of pain during the procedure, 30.3%; physical environment, 16.2%; manner of the staff, 11.2%, and privacy protection, 8.8%.


CONCLUSION
The critical issues identified by the Pareto analysis include the adequacy of the explanation about any pain or discomfort associated with the upper endoscopy and the level of pain experienced during the procedure.
1467835
Time to follow up after an abnormal finding in organized gastric cancer screening in Korea
BackgroundThe prognosis for an abnormal medical finding is affected by both early detection and adherence to the presecribed schedule for follow-up examinations. In this study, we examined the time to follow up after an abnormal finding and determined the risk factors related to delays in follow up in a population-based screening program.MethodsThe study population consisted of patients who were newly diagnosed with gastric cancer through a gastric cancer screening program sponsored by the National Cancer Screening Program (NCSP) in 2005. Due to the skewed nature of the distribution of time to follow up, medians and interquartile ranges (IQR) are presented, and we analyzed the number of days preceding the follow-up time as a binary variable (≤90 days or >90 days). We used logistic regression analyses to evaluate the risk factors for a long delay.ResultsThe median number of days to follow-up initiation after an abnormal finding was 11 (IQR 7–27); 13.9% of the patients with gastric cancer obtained their follow-up evaluation more than 90 days. Age, type of health insurance, screening method, and screening results were risk factors for delays in follow up.ConclusionsThis study examined delays from the time of the discovery of an abnormal finding to time of the follow-up evaluation. Because inadequate follow up of abnormal exam results undermines the potential benefits of cancer screening, it is important to organize services that minimize delays between cancer screening and treatment.
13185622
Comparing upper gastrointestinal X-ray and endoscopy for gastric cancer diagnosis in Korea.
AIM
To compare the cost and accuracy of upper gastrointestinal (GI) X-ray and upper endoscopy for diagnosis of gastric cancer using data from the 2002-2004 Korean National Cancer Screening Program (NCSP).


METHODS
The study population included 1,503,646 participants in the 2002-2004 stomach cancer screening program who underwent upper GI X-ray or endoscopy. The accuracy of screening was defined as the probability of detecting gastric cancer. We calculated the probability by merging data from the NCSP and the Korea Central Cancer Registry. We estimated the direct costs of the medical examination and the tests for upper GI X-ray, upper endoscopy, and biopsy.


RESULTS
The probability of detecting gastric cancer via upper endoscopy was 2.9-fold higher than via upper GI X-ray. The unit costs of screening using upper GI X-ray and upper endoscopy were $32.67 and $34.89, respectively. In 2008, the estimated cost of identifying one case of gastric cancer was $53,094.64 using upper GI X-ray and $16,900.43 using upper endoscopy. The cost to detect one case of gastric cancer was the same for upper GI X-ray and upper endoscopy at a cost ratio of 1:3.7.


CONCLUSION
Upper endoscopy is slightly more costly to perform, but the cost to detect one case of gastric cancer is lower.
15313024
Aging and arterial stiffness.
Arterial walls stiffen with age. The most consistent and well-reported changes are luminal enlargement with wall thickening and a reduction of elastic properties at the level of large elastic arteries. Longstanding arterial pulsation in the central artery causes elastin fiber fatigue and fracture. Increased vascular calcification and endothelial dysfunction are also characteristic of arterial aging. These changes lead to increased pulse wave velocity, especially along central elastic arteries, and increases in systolic blood pressure and pulse pressure. Vascular aging is accelerated by coexisting cardiovascular risk factors, such as hypertension, metabolic syndrome and diabetes. Vascular aging is an independent risk factor for cardiovascular disease, from atherosclerosis to target organ damage, including coronary artery disease, stroke and heart failure. Various strategies, especially controlling hypertension, show benefit in preventing, delaying or attenuating vascular aging.
24434225
Melanoma: differences between Asian and Caucasian patients.
INTRODUCTION
Cutaneous melanoma is rare in Asia and the clinical presentation and outcome of melanoma is not well described in Southeast Asia. In addition, it is unclear if ethnic variations exist between the various racial groups. The objective of our study is to present the clinical characteristics of melanoma in Singapore and to highlight ethnical differences between Asians and Caucasians living in Singapore.


MATERIALS AND METHODS
Data were retrospectively collected from 48 patients with histological confirmation of melanoma who were seen in both the National Skin Centre and National Cancer Centre of Singapore.


RESULTS
Acral lentiginous melanoma (ALM) was the most common subtype of melanoma in Singapore (50%). A higher proportion of non-ALM subtypes of melanoma compared to ALM were diagnosed at stage 1 (48% vs. 25%). The delay in diagnosis of ALM was 27 months compared to 12 months in other subtypes. Compared to Caucasians, there was a trend towards Asian patients being older, having a higher proportion of ALM and a longer delay to diagnosis.


CONCLUSION
Geographical and ethnic variations in the clinical presentation of melanoma exist. Specially adapted programmes are necessary to increase awareness of the different clinical presentation of melanoma in Asia and to encourage examination of the palms and soles in order to reduce the delay in diagnosis.
6224768
Molecularly Targeted Therapy Using Bevacizumab for Non-Small Cell Lung Cancer: a Pilot Study for the New CT Response Criteria
Objective We wanted to compare the efficacy of the new CT response evaluation criteria for predicting the tumor progression-free survival (PFS) with that of RECIST 1.1 in non-small cell lung cancer (NSCLC) patients who were treated with bevacizumab. Materials and Methods Sixteen patients (M:F = 11:5; median age, 57 years) treated with bevacizumab and combined cytotoxic chemotherapeutic agents were selected for a retrospective analysis. The tumor response was assessed by four different methods, namely, by using RECIST 1.1 (RECIST), RECIST but measuring only the solid component of tumor (RECISTsolid), the alternative method reflecting tumor cavitation (the alternative method) and the combined criteria (the combined criteria) that evaluated both the changes of tumor size and attenuation. To evaluate the capabilities of the different measurement methods to predict the patient prognosis, the PFS were compared, using the log rank test, among the responder groups (complete response [CR], partial response [PR], stable disease [SD] and progressive disease [PD]) in terms of the four different methods. Results The overall (CR, PR or SD) response rates according to RECIST, RECISTsolid, the alternative method and the combined criteria were 81%, 88%, 81% and 85%, respectively. The confirmed response rates (CR or PR) were 19%, 19%, 50% and 54%, respectively. Although statistically not significant, the alternative method showed the biggest difference for predicting PFS among the three response groups (PR, SD and PD) (p = 0.07). RECIST and the alternative method showed a significant difference for predicting the prognosis between the good (PR or SD) and poor overall responders (p = 0.02). Conclusion The response outcome evaluations using the three different CT response criteria that reflect tumor cavitation, the ground-glass opacity component and the attenuation changes in NSCLC patients treated with bevacizumab showed different results from that with using the traditional RECIST method.
24029169
Genetic Characterization and Assessment of Authenticity of Ancient Korean Skeletal Remains
Abstract To study the maternal lineage history of Korea, we extracted DNA from the skeletal remains of 35 museum samples (some dating back to the Paleolithic Age) excavated from 11 local burial sites scattered throughout southern Korea. Mitochondrial DNA (mtDNA) control region sequences (HV1, HV2, and HV3) were successfully determined for 11 samples with no sharing of the control region polymorphisms with individuals involved in the laboratory analyses. Each of the 11 mtDNAs was assigned to the appropriate East Asian mtDNA haplogroup according to the haplogroup-specific control region mutation motif and diagnostic coding region single nucleotide polymorphism. The successful mtDNA haplogroup determination for each ancient Korean mtDNA and the confirmation of the absence of abnormal mutations based on the haplogroup-directed database comparisons indicates that there is no mosaic structure from cross-contamination or sample mix-up or other errors in our mtDNA sequences. The presence of haplogroups B, D, and G in the prehistoric age is consistent with the hypothesis that the early Korean population has a common origin in the northern regions of the Altai Mountains and Lake Baikal of southeastern Siberia. In addition, the modern Korean population, which possesses lineages from both southern and northern haplogroups, suggests additional gene flow from southern Asian haplogroups in recent times, but many more ancient samples need to be analyzed to directly tell whether there was regional continuity or replacement of early lineages by other lineages in ancient Korea.
26762430
Angularly fused triquinanes from linear substrates through trimethylenemethane diyl [2 + 3] cycloaddition reaction.
Angularly fused triquinanes were synthesized from linear dienes and phenyl(propynyl)iodonium salt through trimethylenemethane (TMM) diyl mediated [2 + 3] cycloaddition reaction. TMM diyl intermediates were obtained from alkylidene carbenes generated from reactions of alkynyliodonium salts with nucleophiles.