Combination Assessment of Clinical Complete Response of Patients With Rectal Cancer Following Chemoradiotherapy With Endoscopy and Magnetic Resonance Imaging.

PURPOSE: The response to neoadjuvant chemoradiotherapy (CRT) for rectal cancer can be assessed using digital rectal examination, endoscopy and magnetic resonance imaging (MRI). Precise assessment of clinical complete response (CR) after CRT is essential when deciding between optimizing surgery or organ-preserving treatment. The objectives of this study were to correlate the CR finding in endoscopy and MRI with pathologic CR and to determine the appropriate approach for combining endoscopy and MRI to predict the pathologic CR in patients with rectal cancer after neoadjuvant CRT. METHODS: This retrospective cohort study included 102 patients with rectal cancer who underwent endoscopy and MRI at 2-4 weeks after CRT. We assigned a confidence level (1-4) for the endoscopic and MRI assessments. Accuracy, sensitivity, and specificity were analyzed based on the endoscopy, MRI, and combination method findings. Diagnostic modalities were compared using the likelihood ratios. RESULTS: Of 102 patients, 17 (16.7%) had a CR. The accuracy, sensitivity, and specificity for the prediction CR of endoscopy with biopsy were 85.3%, 52.9%, and 91.8%, while those of MRI were 91.2%, 70.6%, and 95.3%, and those of combined endoscopy and MRI were 89.2%, 52.9%, and 96.5%, respectively. No significant differences were noted in the sensitivity and specificity of any each modality. The prediction rate for CR of the combination method was 92.6% after the posttest probability test. CONCLUSION: Our study demonstrated that combining the interpretation of endoscopy with biopsy and MRI could provide a good prediction rate for CR in patients with rectal cancer after CRT.

Breast Cancer Epidemiology of the Working-Age Female Population Reveals Significant Implications for the South Korean Economy.

In this study, we aimed to evaluate the economic loss due to the diagnosis of breast cancer within the female South Korean working-age population. A population-based cost analysis was performed for cancer-related diagnoses between 1999 and 2014, using respective public government funded databases. Among the five most common cancers, breast cancer mortality was strongly associated with the growth in gross domestic product between 1999 and 2014 (R=0.98). In the female population, breast cancer represented the greatest productivity loss among all cancers, which was a consequence of the peak in the incidence of breast cancer during mid-working age in the working-age population, in addition to being the most common and fastest growing cancer among South Korean women. Our study shows that breast cancer not only represents a significant disease burden for individual patients, but also contributes a real, nonnegligible loss in productivity in the South Korean economy.

Utilization management in a large urban academic medical center: a 10-year experience.

Management of laboratory test utilization presents an ongoing challenge. Most studies reported in the literature have described efforts to control one or a few tests, but the results cannot be generalized to a broader utilization management strategy. Herein we report our experiences with an organizational utilization management program during a 10-year period. Cumulatively, our program has achieved significant success, saving millions of dollars in blood components and reducing inpatient tests per discharge by 26%. Highlights from our experiences include the importance of implementing an institutional organizational structure to support utilization management, the central role fulfilled by clinical pathologists as leaders of the program, the ability to obtain timely utilization data, and careful selection of the most appropriate implementation tools tailored to the unique circumstances of each utilization management initiative.

Cultural orientations, daily activities, and adjustment in Mexican American youth.

The links between youth's daily activities and adjustment and the role of cultural practices and values in these links were studied in 469 youth from 237 Mexican American families. In home interviews, data on mothers', fathers', and two adolescent-age siblings' cultural practices (language use, social contacts) and values (for familism, for education achievement) were collected, along with data on youth risky behavior and depressive symptoms. In 7 nightly phone calls, youth reported on their day's free time activities (i.e., sports, academics, religious activities, television viewing, and hanging out). Analyses revealed that youth who spent more time in unsupervised hanging out reported more depressive symptoms and risky behavior, and those who spent more time in academic activities reported less risky behavior. Results also indicated that more Anglo-oriented youth spent more time in sports, that more Mexican-oriented youth spent more time watching television, that fathers' familism values were related to youth's time in religious activities, and that parents' educational values were linked to youth's time in academic activities. Some evidence indicated that parents' cultural practices and values, particularly fathers', moderated the links between daily activities and youth adjustment.

Development of a database for government-funded health/functional food research.

The Korean Health/Functional Food Act of 2002 has led to the promotion of research on health/functional foods (HFFs). In order to track government-funded studies on HFFs, a free accessible database (National Research & Development on Functional Food, NaReaD(ff)) has been established by the Korea Food and Drug Administration. About 200 project reports funded by government agencies from 1993 through 2007 were retrieved, using existing government-wide online databases created by the Korea Institute Science and Technology, Evaluation and Planning and the Korea Institute of Science and Technology Information. In 2008, the database was released with information regarding individual projects and technological achievements for individual ingredients with a vision for HFF development. Overall, government-funded HFF research has primarily involved botanicals including herbs and food plants. The immune system, oxidant stress alleviation, and the cardiovascular system are the three leading health systems being investigated. With regard to the types of studies performed, the majority were in vitro studies and animal studies with limited numbers of human intervention studies. Government funds have been fragmented for many different ingredients, and this represents a major gap in HFF development. This database is most valuable for evaluating trends in government-funded HFF research. It is also useful to identify research overlaps and gaps and to help research scientists within academia and industry identify potential sources of government funding.

Characteristics and correlates of sibling relationships in two-parent African American families.

The authors studied sibling relationships of African American youths and family and youth characteristics linked to sibling dynamics. Participants were fathers, mothers, and 2 siblings (M = 14.04 and M = 10.34 years of age) from 172 working-middle class 2-parent families. Cluster analyses of data collected in home interviews revealed 3 sibling relationship types: positive, negative, and distant. Parent education was lower, parent religiosity higher, and parent-child relationships more positive in the positive group; maternal discrimination experiences were higher in the negative group; youth ethnic identity was stronger in the positive group; and youth depression and risky behavior were higher in the negative group. The findings target sociocultural factors to consider in interventions for African American families.