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Purpose@#This study investigated the correlation between non-mass-like enhancement (NME) observed on preoperative breast magnetic resonance imaging (MRI) and the actual pathological size of breast cancer. We further examined the effect of NME on the positive resection margins during partial mastectomy. @*Methods@#We retrospectively collected data from breast cancer patients who underwent surgery between January 2018 and September 2020. Patients were divided into two groups based on their MRI findings: NME and no-NME (mass-like lesion only) groups. The medical records, including MRI findings and clinicopathological information of patients, were collected retrospectively, and correlations with pathologic results were analyzed. Propensity score matching was applied to develop comparable cohorts of the NME group and no-NME group. @*Results@#This study included a total of 317 patients, with 66 and 251 patients in the NME and no-NME groups, respectively. The mean pathologic size of invasive lesion was significantly smaller than the mean lesion size in the NME group (1.55±1.39 cm vs. 3.45±1.81 cm, p<0.001). The mean pathologic size of ductal carcinoma in situ (DCIS) lesions was larger than that in the NME group but without statistical significance (3.91±2.67 cm vs. 3.50±1.79 cm, p=0.326). In the NME group, NME estimated DCIS size to within 1 cm in 20 patients (30.3%) and overestimated invasive lesion size by more than 1 cm in 31 patients (46.9%). NME (vs. no-NME; odds ratio [OR], 2.967; 95% confidence interval [CI], 0.878-10.025) showed a tendency to predict positive resection margins, but this was not statistically significant (p=0.080). @*Conclusion@#NME findings on MRI showed a similar extent of DCIS lesions. NME findings on preoperative MRI should be considered an important factor for measuring the extent of tumors, especially in DCIS patients.
ABSTRACT
Purpose@#This study examined the impact of a virtual reality intervention program based on psychological needs on behavioral and psychological symptoms, apathy, and quality of life (QOL) in patients with dementia or mild cognitive impairment living in nursing facilities. @*Methods@#This study is nonequivalent control group pretest-posttest design of quasi-experimental study. The study collected data from November 18, 2020 to July 24, 2021 from patients with dementia or mild cognitive impairment (30 in the experimental group and 30 in the control group) at three nursing facilities in G city using self-reporting and caregiver-informant reporting methods. The analysis employed the chi-square test, Fisher’s exact test, paired t-test, independent t-test, Wilcoxon signed rank test, Mann–Whitney U, repeated measures ANOVA, GEE, using SPSS/WIN 27.0. @*Results@#The severity of behavioral and psychological symptoms (Wald χ2 = 2.68, p = .102) and the care burden of caregivers (Wald χ2 = 1.72, p = .190) were not significant and was no significant time and group interaction effect (Wald χ2 = 0.63, p = .426, Wald χ2 = 0.52, p =. 471). The difference in apathy and QOL score were statistically significant for the group-time interaction (F = 43.65, p < .001; F = 4.35, p= .041). @*Conclusion@#The virtual reality intervention program of this study shows a positive effect on the apathy reduction and QOL of patients with dementia or mild cognitive impairment residing in nursing facilities.
ABSTRACT
BACKGROUND/AIMS: The standard triple therapy used as the first-line treatment for Helicobacter pylori that combines a proton pump inhibitor (PPI), amoxicillin, and clarithromycin had an initial eradication rate of 90%. However, many recent studies have not found this level of effectiveness. This study evaluated the trend in the eradication rates of H. pylori infection over the last 11 years. METHODS: This was a retrospective study of patients diagnosed with H. pylori infection between 1997 and 2007 and treated with triple therapy (PPI, amoxicillin, and clarithromycin). The patients answered questions about compliance and side effects within 2 weeks of completing their treatment. In addition, we assessed whether the H. pylori had been eradicated at least 4 weeks after the treatment using a 13C-urea breath test, rapid urease test, or histopathological examination. RESULTS: The eradication rate with first-line triple therapy decreased over the study period. There was no change in the eradication rate with second-line quadruple therapy (PPI, bismuth, metronidazole, and tetracycline). There were no differences in the eradication rate and recrudescence between 1- and 2-week regimens. CONCLUSIONS: The effectiveness of the recommended first-line triple therapy for H. pylori eradication has decreased significantly in the last decade. Therefore, the first-line therapy based on the combination of PPI, amoxicillin and clarithromycin may need to be changed in the near future.