• Journal of Korean Academy of Nursing
• /
• v.39 no.5
• /
• pp.683-692
• /
• 2009

Purpose: The purpose of this study was to identify cancer-related symptom clusters and to validate the conceptual meanings of the revealed symptom clusters in patients with hepatocellular carcinoma. Methods: This study was a cross-sectional survey and methodological study. Patients with hepatocellular carcinoma (N=194) were recruited from a medical center in Seoul. The 20-item Symptom Checklist was used to assess patients' symptom severity. Selected symptoms were factored using principal-axis factoring with varimax rotation. To validate the revealed symptom clusters, the statistical differences were analyzed by status of patients' performance status, Child-Pugh classification, and mood state among symptom clusters. Results: Fatigue was the most prevalent symptom (97.4%), followed by lack of energy and stomach discomfort. Patients' symptom severity ratings fit a four-factor solution that explained 61.04% of the variance. These four factors were named pain-appetite cluster, fatigue cluster, itching-constipation cluster, and gastrointestinal cluster. The revealed symptom clusters were significantly different for patient performance status (ECOG-PSR), Child-Pugh class, anxiety, and depression. Conclusion: Knowing these symptom clusters may help nurses to understand reasonable mechanisms for the aggregation of symptoms. Efficient symptom management of disease-related and treatment-related symptoms is critical in promoting physical and emotional status in patients with hepatocellular carcinoma.

• Korean Journal of Community Nutrition
• /
• v.3 no.3
• /
• pp.358-367
• /
• 1998

The study purpose was to investigate psychosocial factors related to smoking among adolescent boys. The Theory of Planned Behavior provide the basis for the study. Twenty-five attitudinal beliefs, 9 normative beliefs and 20control beliefs were identified through questionnaire development. The data were analyzed using t-test and χ2-test. Thirty-three percent of 300 students were smokers. Most of the beliefs examined were significantly different between smokers(n=92) and nonsmokers(n=92). With respect to attitudinal beliefs, smokers responded less negatively on the items of bad health effects of smoking such as sore throat, headache, chest pain, risk of cancer and bad blood circulation(p<0.001), and decreased physical strength(p<0.05). Smokers believed less negatively on the items that smoking leads to bothering others, bad breath, yellow teeth and making them spend money(p<0.001). In contrast, smokers felt more positively on smoking as a means of stress management, relaxing, helping digestion(P<0.001). Smokers felt less pressure for not smoking from significant others. Especially mother, siblings, friends, girl friends, seniors of school were important sources of influence regarding subject's smoking. Smokers felt less confident in controlling the urge to smoke in several situations including; when they were with friends or asked to smoke by friends; after the meal, or drinking; when they were bored or stressed, upset, and when they felt unstable(p<0.001). Smokers also scored lower on specific skills to quit or control the urge to smoke as well as overall perceived control, compared to nonsmokers(p<0.001). These results suggest that interventions for adolescents incorporate diverse strategies to increase the perceived control over smoking in specific situations as well as overall perceived control, to help them realize and modify attitudinal beliefs, and to elicit support from significant others for not smoking. (Korean J Community Nutrition 3(3) : 358∼367,1998)

• Journal of Sasang Constitutional Medicine
• /
• v.33 no.3
• /
• pp.138-145
• /
• 2021

Objectives Edema occurs in various disorders, such as heart failure, nephrotic syndrome, renal failure, liver cirrhosis, and cancer. The excessive accumulation of interstitial fluid in limb tissue will often manifest with ankle and knee swelling and lowers patient's quality of life. But the conventional treatment includes restricting dietary sodium and using diuretics. The purpose of this study is about significant improvement of a patient with edema who had suffered from dependent gait accompanied by mild pain, after treatment by herbal medicine based on SCM(Sasang constitutional medicine). Methods The pattern identification of the patient was diagnosed with a superficial disease of Taeeumin. So after the admission, Gunyuljejo-tang was used, almost two times per day during 2 weeks. Also, we applied acupuncture routinely every day and western medicine as needed. We measured the circumferences of Lt. thigh and followed up the bioelectrical impedance analysis and checked the appearance of lower limb. Results and Conclusions The therapy was effective, and the circumferences, which was 59.69cm at onset time, decreased to 52.07cm almost same to the healthy side of her thigh. There was no more edematous sign on the body, either. This case showed that management of Taeeumin's healthy energy(呼散之氣, the energy of exhalation) could be effective in treating edema.

• Journal of Hospice and Palliative Care
• /
• v.22 no.1
• /
• pp.1-7
• /
• 2019

The first hospice care center in Korea dates back to the East West Infirmaries (Dongseodaebiwon in the Korean language) of the Goryeo period in the early 11th century. It has been 50 years since hospice care was introduced in Korea. Initially hospice care was provided in the private sector, including those with a religious background, and its development was slow. In the 1990s, related religious organizations and academic associations were established, and then, a full-swing growth phase was ushered in as the Korean government institutionalized hospice care in the early 2000s. As a result, enhanced quality of hospice care service could be provided, which meant better pain management and higher quality of life for late stage cancer patients and their families. Still, the nation lacked a realistic reimbursement system which was needed to for financial stability of the affected patients. However, the national health insurance scheme began to cover hospice palliative expenses in 2015. In 2016, the Act on Decisions on Life-Sustaining Treatment for Patients in Hospice and Palliative Care or at the End of Life was legislated, allowing terminally-ill patients to refuse meaningless life-sustaining treatments. As the range of diseases subject to hospice palliative care was expanded, more challenges and issues need to be addressed by the service providers.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.22 no.5
• /
• pp.349-356
• /
• 2022

Background: Awake fiberoptic intubation (AFOI) is the procedure of choice for securing the airway in patients with a difficult airway when undergoing surgeries under general anesthesia. An ideal drug would not only provide conscious sedation but also maintain spontaneous ventilation, smooth intubation conditions, and stable hemodynamics. We compared the effects of dexmedetomidine alone and dexmedetomidine in combination with fentanyl at a dose lower than the standard dose for achieving conscious sedation during AFOI in difficult airway patients undergoing oral cancer and dental surgeries. Methods: We included 68 adult patients undergoing AFOI. The patients were randomized in two groups, wherein Group D received intravenous dexmedetomidine 1 ㎍/kg and Group DF received dexmedetomidine 0.5 ㎍/kg and fentanyl 1 ㎍/kg. The outcomes measured were airway obstruction score, intubation scores, fiberoptic intubation comfort score, sedation score, and hemodynamic variables. Results: Low-dose dexmedetomidine with fentanyl showed similar results as those with the standard dose of dexmedetomidine in terms of airway obstruction, vocal cord movement, degree of cough, degree of limb movements, and intubation comfort. However, the sedation achieved and incidence of hypotension and bradycardia were higher in Group D than in Group DF. Conclusions: A low dose of dexmedetomidine-fentanyl provides satisfactory intubation conditions as those with a standard dose of dexmedetomidine in AFOI, thereby avoiding bradycardia, hypotension, and sedation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.49 no.1
• /
• pp.21-29
• /
• 2023

Objectives: Dental or maxillofacial emergencies are uncommon during pregnancy, but if they occur, they are challenging to treat due to potential risks. The mother should not be denied necessary medical or dental care because of pregnancy. The aim of the study is to observe outcomes of pregnancy in patients requiring emergency minor oral surgical procedures during gestation and to determine the safety of the pregnant woman undergoing the procedure and the fetus. Materials and Methods: The study was conducted on 52 pregnant women requiring emergency oral surgical procedures. A standard treatment protocol for treatment of specific entities was followed. Close monitoring and observation were the primary goal of treatment. All patients were followed postoperatively until complete recovery from the surgical procedures and then until birth of the baby. A control group of 52 healthy pregnant patients who did not require oral surgical procedures was considered for statistical analysis. The measurements to calculate observation were fetal loss (spontaneous abortion), preterm birth, low-birth weight, or incidence of any congenital anomalies in the baby and its association with surgical procedures. Results: No fetal loss occurred in any of the cases. However, four patients experienced preterm birth and seven neonates exhibited low birth weights. No congenital abnormalities were discovered. In one instance, a patient who underwent surgery for a mandibular symphysis fracture under general anesthesia in the 31st week of pregnancy experienced labor pain on the fourth postoperative day, requiring an emergency Caesarean section. Conclusion: The results of our study demonstrate that, compared to the control group, minor emergency surgeries performed during pregnancy have no discernible negative effects on the fetus. These procedures can safely be performed by adhering to our described protocols.

• Annals of Hepato-Biliary-Pancreatic Surgery
• /
• v.28 no.1
• /
• pp.80-91
• /
• 2024

Backgrounds/Aims: Optimal intravenous fluid management during the perioperative period for patients undergoing pancreaticoduodenectomy (PD) within the framework of enhanced recovery after surgery (ERAS) is unclear. Studies have indicated that excessive total body salt and water can contribute to the development of oedema, leading to increased morbidity and extended hospital stays. This study aimed to assess the effects of an intravenous therapy regimen during postoperative day (POD) 0 to 2 in PD patients within ERAS. Methods: A retrospective interventional cohort study was conducted, and it involved all PD patients before and after implementation of ERAS (2009-2017). In the ERAS group, a targeted maintenance fluid regimen of 20 mL/kg/day with a sodium requirement of 0.5 mmoL/kg/day was administered. Outcome measures included the mmol of sodium and chloride administered, length of stay, and morbidity (postoperative pancreatic fistula, POPF; acute kidney injury, AKI; ileus). Results: The study included 169 patients, with a mean age of 64 ± 11.3 years. Following implementation of the intravenous fluid therapy protocol, there was a significant reduction in chloride and sodium loading. However, in the multivariable analysis, chloride administered (mmoL/kg) did not independently influence the length of stay; or rates of POPF, ileus, or AKI (p > 0.05). Conclusions: The findings suggested that a postoperative intravenous fluid therapy regimen did not significantly impact morbidity. Notably, there was a trend towards reduced length of stay within an increasingly comorbid patient cohort. This targeted fluid regimen appears to be safe for PD patients within the ERAS program. Further prospective research is needed to explore this area.

• Journal of radiological science and technology
• /
• v.32 no.3
• /
• pp.293-298
• /
• 2009

Background/aim : Gallbladder stone is the most common disease of biliary tract. It is lead to acute abdominal pain. The cholecystitis which is caused by in gallbladder stone occurs frequently and the possibility of the gallbladder cancer comes to be high. Our study was designed to determine the prevalence and risk factors gallbladder stone in a population who community. Materials and Methods : We enrolled a total of 826 (male : 297, female : 529) persons who 60 or older in Jeju-do 10 places from 2008 July one months. The height, weight, liver function tests, lipid profile, fasting blood sugar, were all measurement. They had their gallbladder examined with using ultrasonography. Statistical significance was defined as a p-value less than 0.05. Results : Among 826 persons, gallbladder stone was found in 49 persons (5.9%). The male is 6.1% and the female is 5.8%, the male 1.03 times appeared more highly the female. The body mass index above of 23.0 kg/$m^2$ with the gallbladder stone was 69.3% (p<0.047). Conclusion : The gallbladder stone appeared highly according to age increases. The obesity is the risk factor of gallbladder stone. The weight management and diet control is a possibility of reducing a gallbladder stone creation.

• Journal of Hospice and Palliative Care
• /
• v.9 no.1
• /
• pp.35-39
• /
• 2006

A 77-year-old female presented panperitonitis due to advanced gastric ranter during palliative care. In the case of panperitonitis following obstruction or perforation, surgical treatment is vital to avoid fatal sepsis and dehydration. However, the risk of surgery and the residual life of a patient must be carefully considered because of high mortality and complication rate in those patients with advanced disease due to the poor condition. The therapeutic value of aggressive hydration, nasogastric tube insertion, and the use of antibiotics is also questionable. Palliative surgery was not performed on this case, and she passed away peacefully in the presence of family after 4 days of palliative medical care. Here is the appropriate management for this kind of patients we would like to recommend through review of relevant references and long discussions. Firstly, we need to predict survival time using clinical variables. Secondly, considering patient status and risk of surgery, non surgical palliative care such as pain control, transient nasogastric tube insertion, and parenteral hydration is recommended. Minimal use of fluid is desirable to minimize complications such as edema and dyspnea if massive hydration in the beginning of treatment is not proved to be effective. Even though started earlier in the course of disease, discontinuation of antibiotics could be discussed with patients and their caregiver if patient status is not improved.

• Journal of Digestive Cancer Research
• /
• v.3 no.2
• /
• pp.82-88
• /
• 2015

Gastric lymphoma comprises 1-6% of all gastric malignant neoplasms and among them 50% is gastric MALT lymphoma. The 60-70% of MALT lymphomas is diagnosed at early, localized diseased state. Gastric MALT lymphoma is assumed that it progress slowly with indolent course. It presents nonspecific symptoms such as epigastric pain, dyspepsia, nausea and vomiting. It is rarely associated with serious complication such as gastrointestinal bleeding or perforation. The definite diagnosis of gastric MALT lymphoma should be made with histopathologically. Wotherspoon score is used to differential diagnosis with Helicobacter pylori associated gastric inflammatory change. Gastric MALT lymphoma is associated with Helicobacter pylori infection with supported by epidemiologic and histopathologic studies. Gastric MALT lymphoma is characterized with genetic aberrations such as trisomy 3, trisomy 18, chromosomal translocations t(11;18), t(1;14), t(14;18), t(3;14). Appropriate clinical staging is essential to determine the optimal treatment strategy for gastric MALT lymphoma. Lugano International Conference classification has been applied widely. Helicobacter pylori eradication is used as the first line treatment for gastric MALT lymphoma independent of the stage. The complete remission has been achieved in 60-90% of the stage I/II1 patients with Helicobacter pylori eradication only. The treatment options for the patients with refractory to eradication are radiotherapy, chemotherapy and/or immunotherapy with the complete remission rate of 75% to 100%. The incidence of gastric MALT lymphoma can be expected to down by virtue of the decrease of Helicobacter pylori infection rate. Further basic and clinical research is necessary to advance in determine the pathogenesis and management.