• Title/Summary/Keyword: Cancer patients

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인공와우 이식의 비용효용 분석 (Cost-Utility Analysis of the Cochlear Implant)

  • 이후연;김희남;김한중;최재영;박은철
    • Journal of Preventive Medicine and Public Health
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    • 제37권4호
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    • pp.353-358
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    • 2004
  • Objective : To determine the quality of life and cost consequences for deaf adults who received a cochlear implant. Methods : The data from 11 patients, post-lingual deaf adults who received cochlear implants from 1990 to 2002, underwent cost-utility analysis. The average age of the participants was 49.6 years. The main outcomes were direct cost per quality-adjusted life-year (QALY) using the visual analog scale (VAS), health utility index (HUI), EuroQol (EQ-5D), and quality well-being (QWB), with costs and utilities being discounted 3% annually. Results : Recipients had an average of 5.6 years of implant use. Mean VAS scores increased by 0.33, from 0.27 before implantation to 0.60 at survey. HUI scores increased by 0.36, from 0.29 to 0.65, EQ-5D scores increased by 0.26, from 0.52 to 0.78, and QWB scores increased by 0.16, from 0.45 to 0.61. Discounted direct costs were $22,320, yielding $19,223/QALY using VAS, $17,387/QALY using HUI, $24,604/QALY using EQ-5D, and $40,474/QALY using QWB. Cost-utility ratios using VAS, HUI, and EQ-5D were all below $25,000 per QALY, except using QWB. Conclusion : Cochlear implants in post-lingual deaf adult have a positive effect on quality of life at reasonable direct costs and appear to produce a net saving to society.

The Surgical Impact of E-Cigarettes: A Case Report and Review of the Current Literature

  • Fracol, Megan;Dorfman, Robert;Janes, Lindsay;Kulkarni, Swati;Bethke, Kevin;Hansen, Nora;Kim, John
    • Archives of Plastic Surgery
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    • 제44권6호
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    • pp.477-481
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    • 2017
  • We report a case of a 51 years old female with a 25 pack year smoking history who underwent bilateral mastectomy and immediate tissue expander reconstruction for newly diagnosed right breast cancer. The patient reported herself as a non-smoker despite significant e-cigarette use, with resulting significant mastectomy skin flap necrosis and breast reconstruction failure. Little is known about the physiologic effect of e-cigarettes on wound healing and tissue perfusion. To this end, we provide an updated review of the impact of e-cigarettes on surgical outcomes. PubMed, Ovid MEDLINE, and PRS GO were searched for the terms "e-cigarette", "electronic cigarette", "e-cig", "electronic nicotine delivery system", "vaping", "surgery", "surgical", "peri-operative", "operate", "operative", and "wound healing". Abstract review of all articles was performed. 123 articles returned that contained both variants of e-cigarettes and surgery as keywords. Of those, manual assessment returned three articles which were found to be relevant to e-cigarette use in the surgical patient. No articles were found that compared perioperative complications in e-cigarette versus traditional cigarette users in humans. In conclusion, our case report depicts the potential dangers associated with e-cigarette use in the surgical patient. There is a public misconception that e-cigarettes are healthier than traditional cigarettes and as such their use may go unreported by patients. Early evidence suggests e-cigarettes may induce some of the same physiologic changes as traditional cigarettes, and may have a significant deleterious effect on wound healing.

비소세포폐암 환자의 국소 림프절 전이 발견을 위한 FDG PET의 이용 (The Use of FDG PET for Nodal Staging of Non-Small-Cell Lung Cancer)

  • 백희종;박종호;최창운;임상무;최두환;조경자;원경준;조재일
    • Journal of Chest Surgery
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    • 제32권10호
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    • pp.910-915
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    • 1999
  • Background: Positron emission tomography(PEFT) using fluorine-18 deoxyglucose(FDG), showing increased FDG uptake and retention in malignant cells, has been proven to be useful in differentiating malignant from benign tissues. We indertook the prospective study to compare the accuracy of the whole-body FDG PET with that of the conventional chest computed tomography(CT) for nodal staging of non-small-cell lung cancers(NSCLC). Material and Method: FDG PET and contrast enhanced CT were performed in 36 patients with potentially resectable NSCLC. Each Imaging study was evaluated independently, and nodal stations were localized according to the AJCC regional lymph nodes mapping system. Extensive lymph node dissection(1101 nodes) of ipsi- and contralateral mediastinal nodal stations was performed at thoracotomy and/or mediastinoscopy. Image findings were compared with the histopathologic staging results and were analyzed with the McNema test(p) and Kappa value(k). Result: The sensitivity, specificity, positive predictive value, and negative predictive value of CT for ipsilateral mediastinal nodal staging were 38%, 68%, 25%, 79%, and 61%, and those of PET were 88%, 71%, 47%, 95%, and 75%(p>0.05, K=0.29). When analyzed by individual nodal group(superior, aortopulmonary window, and inferior), the sensitivity, specificity, positive predictive value, and negative predictive value of CT were 27%, 82%, 22%, 85%, and 73%, and those of PET were 60%, 87%, 92%, and 82%(p<0.05, k=0.27). Conclusion: FDG PET in addition to CT appears to be superior to CT alone for mediastinal staging of non-small cell lung cancers.

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멕켈 세포 암종 환자의 치험례: 전방 외측 대퇴부 천공지 유리 피판술을 이용한 재건 (Reconstruction with Anterolateral Thigh Perforator Free Flap in Patients with Merkel Cell Carcinoma: Report of Two Cases)

  • 김규남;김태곤;김훈;강병수;홍준표
    • Archives of Reconstructive Microsurgery
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    • 제18권1호
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    • pp.31-34
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    • 2009
  • Purpose: Merkel cell carcinoma, also called neuroendocrine carcinoma, is a very rare type of skin cancer that develops as Merkel cells grow out of control. Merkel cell carcinoma is reported below 1% of whole skin neoplasms in the United States and is known that the 2-year survival rate is about 50~70%. The principles of treatment are wide excision of primary lesion with radiotherapy and/or chemotherapy that decrease the local recurrent rate. There has been no report of reconstruction with free flap after resection of Merkel cell carcinoma in Korea. Methods: We reconstructed the skin and soft tissue defect after wide excision of Merkel cell carcinoma with anterolateral thigh perforator free flap in two cases. No distant metastasis was found at the preoperative imaging work-up. In one case, preoperative chemotherapy was performed and the size of lesion was decreased. Results: There were no recurrence and significant complications. Functionally and aesthetically satisfactory results were obtained with reconstruction. Conclusion: Wide excision and reconstruction with anterolateral thigh perforator free flap for Merkel cell carcinoma patient is the first report in Korea. We regard this method as the treatment of choice in Merkel cell carcinoma.

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Verruciform xanthoma of the palatal gingiva: a report of two cases

  • Ryu, Da Jung;Lee, Sang Hoon;Yuk, Jong In;Kim, Hyung Jun;Huh, Joing-Ki;Park, Kwang-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제39권6호
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    • pp.292-296
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    • 2013
  • Verruciform xanthoma (VX) is a rare, benign lesion that presents in the oral cavity, skin, or genital organs as a verrucous, papillomatous, or flat papule with varying colors. VX has indistinct clinical features, making histopathological examination necessary for a definitive diagnosis. Histologically, VX is characterized by parakeratosis, rete ridges with uniform depth, and an accumulation of the foam cells, which are also known as the "xanthoma cells". These foam cells test positive for antibodies, such as CD-68 and vimentin; it is thought that VX foam cells are derived from the monocyte-macrophage lineage, and that VX's pathogenic mechanism is partly related to an immune mechanism. Nevertheless, the pathogenesis of VX remains unclear. VX can be treated by surgical excision; other medical, chemical, and radiological treatments are not required postoperatively. Recurrence and malignant transformation of VX are rare. Two patients, each with a mass of unknown origin on the palatal gingiva, were presented at our clinic. Excisional biopsies of the masses were performed for a histological diagnosis after clinical and radiological examinations. Histological examination confirmed a diagnosis of VX in both cases.

핵의학 이용 방사핵종의 투여후 혈중 $PGE_2$의 변동 (Increased Plasma $PGE_2$ Levels after Administration of Radionuclides Used in Nuclear Medicine)

  • 유용운
    • Journal of Radiation Protection and Research
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    • 제14권1호
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    • pp.8-15
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    • 1989
  • $^{99m}TC,\;^{67}Ga,\;^{131}I,\;^{32}P$각각을 웅성백서에 투여하여 생체에 미치는 혈중 독성의 영향을 측정 비교하였다. 핵종의 투여량은 통상 인체에 주사되는 양을 기준으로하여 조절 하였으며 생화학적 반응 지표로 혈중 BUN, Creatinine, SGOT SGPT와 $PGE_2$의 활성도출 측정하였다. $^{99m}Tc$의 효과로 Creatinine의 변동은 없었으며 BUN, SGOT 및 $PGE_2$활성도가 투여 전에 비하여 증가된 경향을 보였으나 통계적 의의는 없었다. $^{67}Ga,\;^{131}I$$^{32}P$의 경우 BUN, SGPT 및 SGOT 에서의 증가는 임상적 의의는 없었으나 $PGE_2$는 정상치 보다 크게 상승 하였다. 한편 $^{238}U$이 가장 심한 독성을 나타내었다. 따라서 핵의학에서 이용되는 핵종의 방사성 독성의 효과를 평가할 경우 혈중 $PGE_2$의 측정법이 유용할 것으로 생각된다.

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미만성 거대 B형 세포 림프종 환자에서 CHOP 항암 치료와 Filgrastim 투여 후 발생한 폐쇄세기관지기질화폐렴 1례 (A Case of Bronchiolitis Obliterans Organizing Pneumonia Following CHOP Chemotherapy and Filgrastim Use in a Patient with Diffuse Large B-cell Lymphoma)

  • 정우영;변민광;이진형;한창훈;강신명;김진석;조상호;김영삼;김세규;장준;김성규;박무석
    • Tuberculosis and Respiratory Diseases
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    • 제59권5호
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    • pp.561-565
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    • 2005
  • Bronchiolitis obliterans organizing pneumonia (BOOP) is often diagnosed in patients with pneumonia who respond poorly to antibiotics. BOOP is often idiopathic, and the etiology of the remaining cases has been attributed to a wide range of agents or medical conditions. When a patient develops the clinical symptoms characteristic of BOOP, the medical team must endeavor to determine the etiology of this disease because it can be treated with glucocorticoid and avoidance of the causative agent. In particular, if BOOP is diagnosed during or after chemotherapy for a malignancy, the possible culprit agent can be the anti cancer drugs but other drugs used for supportive care must be also be considered. We report a case of BOOP that arose after CHOP chemotherapy and a filgrastim injection in a patient with a diffuse large B-cell lymphoma.

수치에 의한 권백의 항산화 효과와 MMP 발현 저해 효과 (Effect of the Processed Selaginella tamariscina on Antioxidation and Inhibition of Matrix Metalloproteinase)

  • 이범천;심관섭;김진희;김진화;표형배
    • 대한화장품학회지
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    • 제32권2호
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    • pp.69-74
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    • 2006
  • 권백은 동양에서 암환자 치료를 위한 전통 약용식물로 알려져 있다. 본 연구에서는 포제기술을 이용한 권백을 항노화 화장품 소재로 적용하고자 다양한 생물학적활성을 평가하였다. 열과 모래를 이용한 포제 권백은 기존 권백을 다른 목적으로 이용하고자 비교하였다. 포제 권백은 페놀함량이 증가하였고 DPPH 라디칼 소거활성도 증가하였다. 세포내 활성산소 소거평가를 위해 사람 섬유아세포를 배양하여 UVB($20 mJ/cm^2$)에 의해 증가된 세포내 활성산소가 포제 권백을 처리함으로써 활성 산소 소거효과가 증가하였다. 사람 섬유아세포에서 UVA에 의해 발현되는 MMP-1효소는 포제 권백에 의해 농도 의존적으로 감소하였다. 결론적으로 포제 권백은 페놀함량의 증가와 항산화 효과가 증가하였고, 자외선에 의한 세포손상을 보호하여 항노화 화장품의 새로운 소재로 이용될 것으로 사료된다.

암 환자 임상영양요법 개발 및 성과도출 (Development & Outcome of Nutrition Care Process(NCP) for cancer patients)

  • 이봉미;윤수진;서혜연
    • 한국의료질향상학회지
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    • 제15권2호
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    • pp.87-92
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    • 2009
  • 문제: 순천향대학교병원에서 개발된 영양검색도구를 이용한 검색 결과 본원에 입원하는 암환자들의 약 30%가 중등도이상의 영양불량위험을 가지고 있는 것으로 조사되었으나 이들 암환자의 치료 효과를 높이기 위한 전문화된 영양관리과정(Nutrition Care Process NCP)이 순천향대학교병원 영양과에는 마련되어 있지 않다. 목적: 본원에 내원하는 암 환자를 위한 암 영양교육프로그램과 암으로 입원하는 환자에게 제공할 영양식을 개발 적용으로 병원식의 섭취율 향상과 환자의 영양불량 정도가 개선되어 치료효과를 증진시킬 수 있도록 하기 위함이다. 의료기관: 서울시 한남동 소재 순천향 대학교 병원 질 향상 활동: 암과 관련된 전문적인 영양정보제공을 위해 교육자료 개발과 암환자 교육 상담 프로그램, 교육수가 등을 정하여 비급여 수가 교육 항목을 신설하고 입원환자를 위한 암영양식 식단을 개발하여 이를 특이식으로 처방할 수 있도록 마련하였다. 개선효과: 본원 의료진의 암환자 영양상담 의뢰 건수는 개선활동을 시행하기 전 2008년 5~6월에 월평균 2건에서 활동시행 후 8~12월에 월평균 13건으로 증가하였고, 암영양식은 식사를 적용하기 시작한 2008년 8월부터 12월까지 처방건수가 꾸준히 늘어났으며, 8월~9월 암영양식을 섭취한 암환자 그룹과 일반식을 섭취한 암환자 그룹의 병원식 섭취율은 88%, 67%로 암영양식을 섭취하는 그룹에서 더 높게 나타났고 식사에 대한 만족도에서도 (5점척도 기준) 평균 4.2점, 3.1점으로 조사되었다.

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Lactobacillus plantarum HY7712 Ameliorates Cyclophosphamide-Induced Immunosuppression in Mice

  • Jang, Se-Eun;Joh, Eun-Ha;Lee, Ho-Yong;Ahn, Young-Tae;Lee, Jung-Hee;Huh, Chul-Sung;Han, Myung Joo;Kim, Dong-Hyun
    • Journal of Microbiology and Biotechnology
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    • 제23권3호
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    • pp.414-421
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    • 2013
  • Lactic acid bacteria (LAB) in fermented foods have attracted considerable attention recently as treatment options for immune diseases, the incidence of which has been increasing worldwide. The ability of 500 strains of LAB, isolated from kimchi, to induce TNF-${\alpha}$ production in peritoneal macrophages was investigated. Lactobacillus plantarum HY7712 most strongly induced TNF-${\alpha}$ production as well as NF-${\kappa}B$ activation. However, HY7712 inhibited NF-${\kappa}B$ activation in LPS-stimulated peritoneal macrophages. When HY7712 was orally treated in cyclophosphamide (CP)-immunosuppressed mice for 5 or 15 days, it reversed the body and spleen weights, blood RBC and WBC levels, and splenocyte and bone marrow cells that were reduced by CP. Orally administered HY7712 increased concanavalin A-induced T cell proliferation to 84.5% of the normal group on day 15, although treatment with CP alone markedly reduced it to 53.7% of the normal group. Furthermore, orally administered HY7712 significantly induced the expressions of IL-2 and IFN-${\gamma}$ in ConA-induced splenic cytotoxic T cells of CP-treated mice. Orally administered HY7712 restored the CP-impaired phagocytosis of macrophages in mice. Orally administered HY7712 also restored the cytotoxicity of NK and cytotoxic T cells derived from spleen and bone marrow against YAC-1 in CP-immunosuppressed mice. Based on these findings, orally administered HY7712 may accelerate the recovery of cyclophosphamide-caused immunosuppression, without evident side effects, by immunopotentiating NK and Tc cells, and may provide a mechanistic basis for using HY7712 as an alternative means in lessening chemotherapyinduced immunosuppression in cancer patients.