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Background/Aims: The incidence and prognosis of gastric cancer (GC) shows sex difference. This study aimed to evaluate the effect of body mass index (BMI) on GC survival depending on sex. Methods: The sex, age, location, histology, TNM stages, BMI, and survival were analyzed in GC patients from May 2003 to February 2020 at the Seoul National University Bundang Hospital. Results: Among 14,688 patients, there were twice as many males (66.6%) as females (33.4%). However, under age 40 years, females (8.6%) were more prevalent than males (3.1%). Cardia GC in males showed a U-shaped distribution for underweight (9.6%), normal (6.4%), overweight (6.1%), obesity (5.6%), and severe obesity (9.3%) but not in females (p=0.003). Females showed decreased proportion of diffuse-type GC regarding BMI (underweight [59.9%], normal [56.8%], overweight [49.5%], obesity [44.8%], and severe obesity [41.7%]), but males did not (p<0.001). Both sexes had the worst prognosis in the underweight group (p<0.001), and the higher BMI, the better prognosis in males, but not females. Sex differences in prognosis according to BMI tended to be more prominent in males than in females in subgroup analysis of TNM stages I, II, and III and the operative treatment group. Conclusions: GC-specific survival was affected by BMI in a sex-dependent manner. These differences may be related to genetic, and environmental, hormonal factors; body composition; and muscle mass (Trial registration number: NCT04973631). [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to record and evaluate interobserver agreement as quality control for the modified categorization of screening breast ultrasound developed by the Alliance for Breast Cancer Screening in Korea (ABCS-K) for the Mammography and Ultrasonography Study for Breast Cancer Screening Effectiveness (MUST-BE) trial. Methods: Eight breast radiologists with 4-16 years of experience participated in 2 rounds of quality control testing for the MUST-BE trial. Two investigators randomly selected 125 and 100 cases of breast lesions with different ratios of malignant and benign lesions. Two versions of the modified categorization were tested. The initially modified classification was developed after the first quality control workshop, and the re-modified classification was developed after the second workshop. The re-modified categorization established by ABCS-K added size criteria and the anterior-posterior ratio compared with the initially modified classification. After a brief lecture on the modified categorization system prior to each quality control test, the eight radiologists independently categorized the lesions using the modified categorization. Interobserver agreement was measured using kappa statistics. Results: The overall kappa values for the modified categorizations indicated moderate to substantial degrees of agreement (initially modified categorization and re-modified categorization: κ=0.52 and κ=0.63, respectively). The kappa values for the subcategories of category 4 were 0.37 (95% confidence interval [CI], 0.24 to 0.52) and 0.39 (95% CI, 0.31 to 0.49), respectively. The overall kappa values for both the initially modified categorization and the re-modified categorization indicated a substantial degree of agreement when dichotomizing the interpretation as benign or suspicious. Conclusion: The preliminary results demonstrated acceptable interobserver agreement for the modified categorization. [ABSTRACT FROM AUTHOR]

Background: Previous studies have reported that the quality of cardiopulmonary resuscitation (CPR) is closely associated with patient outcomes. The aim of this study was to compare patient CPR outcomes across resident, emergency medicine, and rapid response teams. Methods: The records of patients who underwent CPR at the Seoul National University Bundang Hospital from January 1, 2013 to December 31, 2016 were analyzed retrospectively. Return of spontaneous circulation, 10- and 30-day survival, and live discharge after return of spontaneous circulation were compared across patients treated by the three CPR teams. Results: Of the 1145 CPR cases, 444 (39%) were conducted by the resident team, 431 (38%) by the rapid response team, and 270 (23%) by the emergency medicine team. The adjusted odds ratios for the return of spontaneous circulation and subsequent 10-day survival among patients who received CPR from the resident team compared to the rapid response team were 0.59 (P = 0.001) and 0.71 (P = 0.037), respectively. There were no significant differences in the 30-day survival and rate of live discharge between patients who received CPR from the rapid response and resident teams; likewise, no significant differences were observed between patients who received CPR from the emergency medicine and rapid response teams. Conclusions: Patients receiving CPR from the rapid response team may have higher 10-day survival and return of spontaneous circulation rates than those who receive CPR from the resident team. However, our results are limited by the differences in approach, time of CPR, and room settings between teams. [ABSTRACT FROM AUTHOR]

Background: Cancer diagnosis is associated with an increased suicide risk, particularly within the first 1 year after diagnosis of cancer. Abnormal function of the hypothalamic–pituitary–adrenal axis has been implicated in the pathophysiology of depression and suicide. We examined genetic associations of the functional Bcl-1 polymorphism of (rs41423247) neuron-specific glucocorticoid receptor (NR3C1) gene, with death by suicide in cancer patients. Suicides occurring within a year of cancer diagnosis ('early suicide') were considered separately from those suicides during the second or subsequent year ('late suicide') after cancer diagnosis. Methods: The subjects consisted of 343 cancer patients admitted to a general hospital in Seoul, South Korea from 1996 to 2009, of which 182 had died by suicide and 161 were alive on December 31, 2009. Genomic DNA was extracted from formalin-fixed paraffin-embedded tissue sample of patients with cancer. We conducted a case-control association analysis of Bcl-1 polymorphism of NR3C1 gene. Results: Subjects carrying the GG genotype of Bcl-1 polymorphism were at increased risk of early suicide when compared to those carrying the CC genotype (OR 3.80, 95 % CI 1.02-14.16, p = .047). Similarly, those individuals carrying the GG genotype (recessive mode) had an increased risk of early suicide relative to the CC or CG genotype (OR 3.71, 95 % CI 1.03-13.43, p = .045). However, there were no differences in the genotype distributions of the NR3C1 Bcl-1 polymorphism between late suicide cases and controls. Conclusions: Our findings suggest that the NR3C1 Bcl-1 polymorphisms may be involved in the susceptibility to suicide within the first year after cancer diagnosis among cancer patients in Korean population. [ABSTRACT FROM AUTHOR]

Aim: This study was conducted to explore first experiences of high-fidelity simulation training in Korean nursing students, in order to develop and establish more effective guidelines for future simulation training in Korea. Methods: Thirty-three junior nursing students participated in high-fidelity simulation training for the first time. Using both qualitative and quantitative methods, data were collected from reflective journals and questionnaires of simulation effectiveness after simulation training. Descriptive statistics were used to analyze simulation effectiveness and content analysis was performed with the reflective journal data. Results: Five dimensions and 31 domains, both positive and negative experiences, emerged from qualitative analysis: (i) machine–human interaction in a safe environment; (ii) perceived learning capability; (iii) observational learning; (iv) reconciling practice with theory; and (v) follow-up debriefing effect. More than 70% of students scored high on increased ability to identify changes in the patient's condition, critical thinking, decision-making, effectiveness of peer observation, and debriefing in effectiveness of simulation. Conclusion: This study reported both positive and negative experiences of simulation. The results of this study could be used to set the level of task difficulty in simulation. Future simulation programs can be designed by reinforcing the positive experiences and modifying the negative results. [ABSTRACT FROM AUTHOR]