Eun Kyo Kang has her expertise in palliative care and improving public health. Through this study, she tried to find out the factors affecting the perception of medical professionals about pediatric palliative care.
Aim: We aimed to investigate the perceptions of health care professionals about appropriate age disclosing terminal illness, awareness of ACP and the relationship between ACP knowledge, disclosing age and the preference for palliative care for children. Methods: We administered nationwide questionnaires to 928 physicians from the 12 hospitals and the Korean Medical Association. We asked about the age at which the pediatric patients could be notified of their terminal illness by 4 groups: 4 years old or older, 12 years old or older, 15 years old or older, or not. In addition, we surveyed the questionnaires about the knowledge of ACP of the medical staff, the preference of the pediatric hospice palliative care, aggressive treatment and life-sustaining treatment preference. Results: In the appropriate age disclosing terminal illness, more than 50% of the physicians responded that patients under the age of 15 should be informed about their terminal status. Health care professionals who had knowledge of the ACP responded that disclosing terminal illness is possible at a younger age. Palliative care preference in pediatric patients who were expected to expire within months was higher when health care professionals had knowledge of ACPs compared to those without knowledge. The age of the terminal status notification, the health care professionals who thought to be available at a lower age have a higher preference for palliative care and has less preference for aggressive treatment and life-sustaining treatment. The same results were obtained when deaths were expected within weeks or days. Conclusion: Our study confirmed that there is a difference in the preference of the health care professionals for pediatric palliative care according to the ACP knowledge of the medical staff or the appropriate age disclosing terminal illness. Future research should focus on strategies for inducing changes in perceptions of health care professionals and identifying other obstacles for the pediatric palliative care.
Madiniyeti Niyazi completed the Clinical Medicine Research Institute which is First Affiliated Hospital of Xinjiang Medical University in China; His research interests include pathophysiology of cancer and tumor biology.
The aim of this study is to investigate if there is vasculogenic mimicry (VM), which is the formation of microvascular channels by aggressive, metastatic and genetically deregulated tumor cells in Kazakh esophageal cancer patients and to illustrate its clinical significance. 76 Kazakh esophageal cancer tissues and 20 paraneoplastic normal esophageal mucous membranes were collected, VM was studies by using immune-histochemical CD34 and PAS double staining combining HE and the associated clinical pathological features such as tumor differentiation and pathological classification were analyzed. VM was detected in 42.1% (32/76) of esophageal cancer tissues, which was significantly higher than normal esophageal mucous membranes (P<0.05). VM was not related to gender, age, tumor location, tumor size, however, it was significantly related to tumor differentiation (P<0.05), lymphatic metastasis (P<0.05) and the TNM classification (P<0.05). Furthermore, VM was detected in 28.8% (17/59) of high-moderately differentiated cases, 88.2% (12/15) low-moderately differentiated cases, 26.8% (11/41) of early staged (T1-T2) cases and 60.0% (21/35) of advanced staged (T3-T4) cases. Kaplan-Meier survival curve indicated that survival was shorter in cases of VM positives than VM negatives (Log Rank: 2=7.803, P<0.05). Cox analysis showed that VM, lymphatic metastasis and TNM classification were the independent risk factors in the prognosis of esophageal cancer. There is vasculogenic mimicry (VM) in Kazakh esophageal cancer patients. VM is related to tumor differentiation, lymphatic metastasis and TNM classification, it may affect the survival of esophageal cancer patients by increasing regional lymphatic metastasis, and this is clinically significant for prognoses of the metastasis and survival of esophageal cancer patients.