Expression of Alpha-catenin/E-cadherin and Clinical Significance of Metastatic Factors in Stage III Advanced Colon Cancer

PURPOSE: Among the cell adhesion molecules, alpha-catenin and E-cadherin play an important part in maintaining normal cell structure. The change in expression of cell adhesion molecules affects the invasion and metastasis of a tumor and the prognosis for patients. In this study, we evaluated the relationship between the expression of cell adhesion molecules and the histopathologic characteristics of stage III colon cancer. METHODS: The relationship between the immunohistochemical expression of cell adhesion molecules and tumor progression were statistically analyzed in 40 patients with stage III colon cancer. RESULTS: There were no statistically significant correlations between loss of membranous alpha-catenin and E-cadherin expressions and such variables as histologic differentiation and lymph node disease based on the criteria of the American Joint Committee on Cancer (AJCC). A significant correlation, however, existed between depth of mural invasion and loss of expressions of both alpha-catenin and E-cadherin (P=0.001 and P=0.002, respectively). Expressions of both alpha-catenin and E-cadherin were also significantly decreased in patients showing liver metastases during follow-up (P=0.019 and P=0.015, respectively). CONCLUSION: Immunohistochemical analyses of alpha-catenin and E-cadherin expressions may be available as predictors for distant metastasis, especially in stage III colon cancer. Such analyses may also help to identify appropriate therapeutic strategies and the need for intensive follow-up in patients with stage III colon cancer.

Knowledge and Attitude of Family Medicine Residents Towards Evidence-based Medicine

BACKGROUND: As medical informations are expanded, searching for useful information has become ever more important. Presently, teaching EBM (evidence-based medicine) is emphasiged. The purpose of this study was to survey family medicine residents' knowledge and utilization of EBM. Also, we investigated whether teaching EBM increased the knowledge and use of EBM in family medicine residents. METHODS: In July 2005, we sent a questionnaire to family medicine residents in Korea and received 260 answers. The questionnaire concerned education, attitude, utilization and knowledge of EBM. We analyzed the relationship of the level of knowledge and utilization of EBM in practice by using chi-square test. RESULTS: The family medicine residents who hed experienced learning EBM was 61%. Almost half of them were educated during their family medicine training programs (42.2%). Among the total, 33.6% of the respondents had an experience to attend EBM journal club. As for the knowledge of EBM, 59.8% of respondents knew the concept of what is EBM, 36.5% understood PICO question structure, and 28.5% knew how to calculate the NNT value. In the residents who had experienced EBM learning, the level of knowledge (P<0.001), the frequency of utilization (P<0.001), and the intention to use EBM in their practice were higher than in those who had not yet experienced EBM learning. CONCLUSION: Although family medicine residents usually learn EBM in medical school and resident training program, education and utilization of EBM were not organized enough. As can be seen in this study, it is necessary to make an effective education program in medical schools and resident training programs to increase the knowledge and utilization of EBM education.

The Effectiveness and Satisfaction of Personal Computer Based Smoking Cessation Program for Adolescents

BACKGROUND: Although smoking hazards are acknowledged worldwide, recent study of Korean teenage smokers shows that students' first smoking experiences are occurring at younger ages. Therefore, we have developed an internet-based smoking prevention program, and assessed the effectiveness of the self-administered internet program by comparing with traditional lecture. METHODS: Between April and June of 2004, 463 female eighth-grade students at a middle school were divided into two groups. One group (n=252) received the lecture- based smoking prevention education by an expert, while the other group (n=212) learned themselves via the internet program. Prior to both smoking prevention programs, the students filled out questionnaires about their basic information. One month after their education, the students were tested on the information included in the programs without prior notice and filled out another questionnaire on the level of comprehension, satisfaction and other factors. RESULTS: According to the pre-education questionnaire, the percentage of current smoking rate was 2.8%, and the first smoking experience was largely between the sixth and seventh grades. When comparing the scores of self-administered internet education with that of the lecture, the mean scores were 56.7 and 57.8, respectively, which was not significantly different (P=.267). The survey on comprehension, satisfaction, and other factors did not show any significant difference between the two groups. CONCLUSION: There was no significant difference between the internet-based program and the lecture- based one, in terms of effectiveness as well as comprehension, satisfaction, and other factors. Considering that the internet-based program is not restricted by time or location, it will no doubt be an effective tool in teenage smoking prevention programs.