Background: The goal of this study is to determine the efficacy and toxicity of weekly irinotecan as second-line chemotherapy in advanced gastric cancer after failure of cisplatin-based regimen. Methods: Gastric cancer patients failing cisplatin-based chemotherapy received 125 mg/m² of irinotecan weekly for 4 weeks followed by 2-week rest, until disease progression. Results: Thirty-seven patients were enrolled into this study. The objective response was documented in seven of 35 patients with measurable lesion (response rate 20%, 95% CI: 6.1–33.9). Eight patients (22.9%) had stable disease and overall tumor control rate was 42.9%. The disease remained stable in both of two patients without measurable disease. At a median follow-up duration of 15.8 months, median time to progression and overall survival were 2.6 months (95% CI: 2.4–2.8) and 5.2 months (95% CI: 3.6–6.7), respectively. Neutropenia and diarrhea were the main toxicities. Among 37 patients treated, grade 3/4 (G3/4) neutropenia occurred in 43.2/24.3% of patients, respectively, and was accompanied with fever in three patients. Non-hematologic toxicities consisted mainly of delayed diarrhea (G3/4, 18.9/0%) and nausea/vomiting (G3/4, 18.9/0%). These toxicities were manageable and there was no treatment-related death. Conclusions: This weekly schedule of irinotecan was modestly active against cisplatin-refractory gastric cancer and relatively well-tolerated with appropriate dose modification.

Docetaxel (T) and capecitabine (X) are active agents against gastric cancer with synergistic antitumor effects. We conducted the current phase II study to assess the response rate and toxicity of combination TX regimen in patients with metastatic gastric cancer. Eligible patients were treated with docetaxel (36 mg/m2 intravenously) on days 1 and 8 and capecitabine (1000 mg/m2 orally twice a day) on days 1–14 of a 3-week schedule until progression occurred. From December 2001 to May 2003, 55 patients with median age of 54 years (range, 22–73 years) were enrolled; 47 patients had measurable lesions. A total of 358 courses of treatment were given, with a median of 5 (range, 1–22+) per patient. Objective responses were documented in 19 of 47 patients with measurable lesions (response rate, 40.4%; 95% confidence interval [CI], 25.9–54.9), with the median response duration of 5.6 months (range, 2.1–13.6+). At a median follow up of 15.9 months for all of 55 study patients, the median time to progression and survival were 4.5 months (95% CI, 3.4–5.6) and 12.0 months (95% CI, 7.5–16.6), respectively. Hematologic toxicities were mild to moderate, and the observed grade 3 nonhematologic toxicities, the most frequent of which was stomatitis, were generally manageable. Four patients experienced pneumonitis, but all of them responded to steroid treatment. The TX regimen was relatively well tolerated and effective against metastatic gastric cancer, with the added advantage of being an outpatient regimen.

Purpose: To compare and contrast demographic characteristics and health care service utilization between overusers and underusers of health care services and to identify factors associated with the overuse or underuse of health care services among the medical aid beneficiaries in Korea. Methods: Secondary data analysis was performed using health care costs and medical aid case management progress data. Data on demographic characteristics, health-related quality of life (HRQoL), and inappropriate health care service user category (overuse or underuse) were provided by the Medical-Aid Case Management Center of Korea, and heath care service reimbursement data were provided by the Korea National Health Insurance Corporation (NHIC). Data on 22,697 beneficiaries were used for analysis, and logistic regression analysis was conducted to examine factors that are associated with overuse and underuse of health care services. Results: The study results revealed that older individuals, women, unemployed individuals, type 1 medical aid beneficiaries, and those with higher education and disabilities were more likely to belong to the overuse group, but urban residents, compared to metropolitan residents, and those with higher HRQoL were more likely to belong to the underuse group (p < .05). Conclusions: Understanding factors associated with the overuse or underuse of health care services may help to provide tailored case management services to improve the HRQoL of the beneficiaries and optimize their use of health care services. Clinical Relevance: Promoting appropriate use of health care services may enhance clients' quality of life and preserve resources for other essential services for medical aid beneficiaries.

[Purpose] This study examined sex differences in physical activity and social cognitive theory factors in Korean college students. [Subjects and Methods] A cross-sectional survey of 688 college students (285 men and 403 women) in Korea was conducted using a self-reported questionnaire. [Results] There was a significant difference in the level of physical activity between male and female students. The significant predictors of physical activity for male students were physical activity goals, physical activity self-efficacy, and sitting time. Meanwhile, those for female students were perceived weight, physical activity goal, physical activity outcome expectations, and sitting time. [Conclusion] Sex differences should be considered when developing interventions to increase physical activity.

This study was performed to identify the factors influencing gender differences in sleep quality between men and women. A cross-sectional survey was conducted using a convenience sample of 300 young adults from three Korean universities. Participants were 20–40 years of age, used smartphones, and took no sleep medication. Participants completed questionnaires on sleep quality, exercise, stress, depression, and smart phone addiction. The predictors of sleep quality in men were coffee consumption, napping, depression, failure to engage in light exercise at least three times per week, being overweight, being in the potential smart phone addiction group, and being employed, which explained 30.2% of the variance. The predictors of sleep quality in women were education to college level or higher, smoking, and stress, which explained 30.5% of the variance. To improve sleep quality in this population, future intervention should contain life style modification strategies containing smartphone addiction prevention.

Background: Hypertension and ischemic heart disease are major causes of adult mortality. Related interventions to manage these conditions are important to implement during long, symptom-free periods. The recent proliferation of smartphones has spawned numerous health interventions that rely on mobile applications. Purpose: This systematic review was designed to summarize and analyze research on interventions using mobile applications for patients with hypertension and ischemic heart disease. Methods: We searched for related studies published from January 2006 to August 2017 on MEDLINE, EMBASE, CINAHL, and three Korean databases. Seventeen studies were identified and evaluated against eligibility criteria that included a focus on patients with hypertension or ischemic heart disease and a discussion of the detailed effects of a mobile-app-based intervention. All of the identified studies were evaluated qualitatively using a methodology checklist. Results: Twelve of the 17 studies were deemed as of acceptable quality according to the Scottish Intercollegiate Guideline Network quality assessment. According to the National Institutes of Health quality assessment tool, one article was of fair quality and four articles were of poor quality. Monitoring, education, and reminders were identified as application interventions. The effects of the app interventions were analyzed according to physiological factors, cognitive and behavioral factors, and psychological factors. Of the seven studies that measured blood pressure in patients with hypertension, five studies reported that the app-based interventions reduced blood pressure. Two of three studies showed a significant decrease of body mass index in patients with ischemic heart disease after the app-based interventions compared to the control group. Five of seven studies reported a significant change in medication adherence. Several studies showed different outcomes according to the disease, but the limited number of eligible studies was insufficient to demonstrate a conclusive effect. Conclusions: To ensure the long-term effects of mobile-application-based interventions, healthcare professionals should consider the functions of mobile applications. Moreover, because the focus of these interventions may differ based on the nature of the disease, it is recommended that the composition of interventions be tailored to the specific disease.