The Emotional Status, Attitudes in Decision-Making Process, and Their Impact on Surgical Choices in Korean Breast Cancer Patients.

PURPOSE: We examined the incidence of emotional distress in women with newly diagnosed breast cancer to determine whether the degree of emotional distress affected their choice of breast-conserving surgery (BCS) or mastectomy and evaluated how the patient's preferred role in decision-making influenced her choice of surgical method. METHODS: This prospective study included 85 patients newly diagnosed with in situ or invasive breast cancer eligible for BCS. Their degree of depression/anxiety and attitude toward the decision-making process were measured using the Hospital Anxiety and Depression Scale (HADS) and Control Preference Scale (CPS), respectively. After receiving information on both surgical methods, the patients indicated their preferred surgical method and completed the CPS at their initial and second visits before surgery. RESULTS: After the diagnosis of breast cancer, 75.3% of patients showed abnormal or borderline HADS scores for depression and 41.2% for anxiety. Patients with borderline or abnormal degrees of depression were more likely to have coexisting abnormal degrees of anxiety (p < 0.001). However, the presence of depression or anxiety was not associated with patients' surgical choices (p=0.394 and 0.530, respectively). Patients who preferred a more active role in the decision-making process were more likely to choose mastectomy over BCS, while those who were passive or collaborative chose BCS more frequently (p=0.001). CONCLUSION: Although many patients with newly diagnosed breast cancer experience depression and anxiety before surgery, these do not affect the choice of surgical method; however, their attitudes toward the decision-making process do.

Quantitative computed tomographic evaluation of bone mineral density in beagle dogs: comparison with dual-energy x-ray absorptiometry as a gold standard.

This study aimed to demonstrate the higher accuracy and reproducibility of quantitative computed tomography (QCT) compared with dual-energy X-ray absorptiometry (DXA) as a gold standard for measuring canine bone mineral density (BMD). Seven middle-aged beagle dogs underwent lumbar vertebral and bilateral femoral DXA and QCT scans. BMD (mg/cm2) was measured at the vertebral body from L2 to L6, femoral neck, and proximal and distal femoral diaphyses. The BMD values were measured 3 times and compared. The BMD value on QCT was higher than that on DXA for femoral BMD but not for vertebral BMD. The correlation was strong for the lumbar vertebrae (r=0.66) and was strongest for L3 (r=0.85). No correlation was found for the femoral neck (P=0.35), and only moderate correlations were found for the proximal and distal femoral diaphyses (r=0.43 and r=0.40, respectively). The limits of agreement were narrower for vertebral BMD than for femoral BMD, and L3 had the narrowest limits of agreement. The intraclass correlation (ICC) was higher for DXA than for QCT at all lumbar and femoral sites measured, but the ICC of QCT was higher than 0.7. In conclusion, L3 can be used to monitor changes in BMD, and relative values and sequential monitoring of femoral BMD can also be useful because of the high reproducibility of QCT measurements. QCT would be a useful technique for evaluation of BMD in veterinary practice.

Effects of shoot bending on lateral fate and hydraulics: invariant and changing traits across five apple genotypes.

The aim of this work was to study the variability of physiological responses to bending and the relationship with hydraulic conductance of the sap pathway to the laterals for five apple genotypes. The study focuses on the fate of the laterals. The genetic variability of bending can have two sources: a genetic variability of stem geometry which can lead to differences in mechanical state; and a genetic variability of sensitivity to bending. Since the aim was to check if some genetic variability of sensitivity to bending exists, the genetic variability of shoot geometry was taken into account. To do so, bending was controlled by imposing different bending intensities using guides of different curvature conferring a similar level of deformation to the five genotypes. Bending was done either in the proximal zone or in the distal zone of shoots, in June and in the following winter, respectively. A Principal Component Analysis comparing upright and bent shoots revealed that bending in the proximal zone stimulated vegetative growth of buds which would otherwise stay latent. A second Principal Component Analysis restricted to bent shoots revealed that bending increased the abortion of laterals in the lower face of the shoots. The abortion phenomenon was to the detriment of sylleptic laterals or of inflorescence, depending on the genotype. There was a strong effect of position around the shoot on within-shoot hydraulics. Hydraulic conductance was significantly decreased in the lower face of the shoot bent in winter. This result suggested a causal relationship between this phenomenon and lateral abortion.