The HRs for low income status are larger for colon cancer (2.37, 95% CI 1.17 to 4.80), followed by stomach (1.67, 95% CI 1.01 to 2.78), liver (1.57, 95% CI 1.03 to 2.39) and lung cancers (1.46, 95% CI 0.99 to 2.14). In the model including the variable of healthcare utilisation, colon and stomach cancers exhibited a lower HR in the moderate healthcare utilisation groups (0.40, 95% CI 0.21 to 0.76 in colon; 0.59, 95% CI 0.37 to 0.96 in stomach), whereas for liver cancer, the high utilisation group exhibited a higher hazard (1.72, 95% CI 1.07 to 2.75). A lower income status is independently related to a shorter survival time in cancer patients, especially in less fatal cancers. Healthcare utilisation independently affects the likelihood of survival from colon and stomach cancers, implying that a moderate degree of healthcare utilisation contributes to a longer survival time.
BackgroundThe aim of this study was to determine the cytologic features of anaplastic lymphoma kinase (ALK) expressing pulmonary adenocarcinoma.MethodsWe analyzed the cytopathological findings of 15 cases of endobronchial ultrasound guided aspiration and a case of bronchial washing. These cases were selected based on the histomorphology of ALK-rearranged lung adenocarcinoma.ResultsCytology showed mucinous (81.3%) and hemorrhagic (50%) backgrounds. The cells were arranged in tubulopapillary or tubulocribriform patterns (93.8%), and clusters (56.3%) admixed with signet ring cell features (87.5%). The tumor cells were monotonous and uniform with vesicular nuclei and a small nucleolus.ConclusionsThe characteristic findings were sheets showing a tubulopapillary or tubulocribriform appearance, with vesicular nuclei and a bland chromatin pattern (p<0.001). Scattered signet ring cells were helpful in suggesting ALK-positive adenocarcinoma (p<0.001).
Purpose: This study was to examine whether medical students' academic motivation, general academic stress influence their perceived academic performance.Methods: Of the 606 medical students surveyed from two universities in Seoul and Incheon, 308 completed and returned the questionnaires yielding a total response rate of 50.8%. The final sample consisted of 129 premedical students (41.9%) and 179 medical students (58.1%). Of these, 189 were male (61.4%), 94 were female (30.5%), and 25 did not identify their gender (8.1%). Their average age was 22.43 years. Measures of students' academic motivation, general academic stress, medical stress, and their perceptions of academic performance were obtained.Results: Pearson's correlations indicated that students' perceptions of academic performance were associated with academic motivation, general academic stress, and medical stress. It was observed that there were gender differences in 'perceptions of academic performance,' 'intrinsic academic motivation,' and 'extrinsic academic motivation.' Females scored themselves higher in 'perceptions of academic performance,' and 'intrinsic academic motivation,' but lower in 'extrinsic academic motivation' than did the males. Moreover, premedical students had higher 'perceptions of academic performance' and 'extrinsic academic motivation' scores, but lower 'general academic stress' and 'medical stress' scores than medical students. Hierarchical multiple regression analyses showed that the 'amotivation' subscale from the academic motivation measure and 'social-psychological' subscale from the general academic stress measure predicted the perceptions of academic performances of the medical students after controlling for gender and education level.Conclusion: Medical educators need to be aware that medical students' perceived stress and their academic motivation affects their academic performance which can have a tremendous impact on their quality of life and psychological well-being. Perhaps an academic adjustment program needs to be developed to reduce students' perceived stress in medical training.
Creating stronger student support programs to prevent social detachment and implementing strategies to reduce fatigue can improve QoL in medical students.
Resorbable plating systems are used extensively for craniofacial reconstruction, particularly in children. The systems provide rigid fixation while potentially minimizing the long-term drawbacks of permanent plating systems such as plate "migration," bone growth restriction, and imaging artifact. However, the need for active plate resorption represents both the strength and weakness of these fixation systems. We present four patients who underwent cranial vault remodeling using a resorbable plating system, following which the plates were palpable and observable for at least 2 years postoperatively. All required surgical removal. On gross inspection, the plates had been replaced by an encapsulated spongy material containing yellow, grainy, cloudy liquid. The bone underlying the plates was depressed and irregular in contour when compared with the adjacent bone. Microscopic studies showed a giant cell foreign-body reaction with crystalline material present in the cell vacuoles.
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