• Radiation Oncology Journal
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• 제37권4호
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• pp.286-292
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• 2019

Purpose: A mandibular metastasis is uncommon in patients with hepatocellular carcinoma (HCC). We report the clinical features of this rare lesion and evaluate the effectiveness of radiotherapy in affected patients. Materials and Methods: We retrospectively reviewed our institutional medical records for HCC patients who received radiotherapy for bone metastasis, and included cases of mandible metastasis. The clinical features of these cases, and the characteristics and outcomes of the treatments were assessed. Results: A total of 1,498 patients with a bone metastasis from HCC were treated with radiotherapy between July 1998 and April 2012 at our institution. We identified 9 patients (0.6%) in this cohort that received radiotherapy for a mandibular metastasis. The condyle was the most common location of mandibular metastasis. The median radiation dose was 40 Gy (range, 27.5 to 60 Gy), with a daily dose of 2-3 Gy. All of these 9 patients died during a median follow-up of 9 months (range, 1 to 19 months). Symptom relief was achieved in 7 of 8 patients who completed radiotherapy. Tumor size reduction was observed in 2 of 4 patients who underwent radiologic evaluation after radiotherapy. Conclusions: Metastasis to the mandible from HCC has a poor prognosis. Radiotherapy can be an effective local treatment option for symptomatic relief in these cases.

• Asian Pacific Journal of Cancer Prevention
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• 제17권11호
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• pp.4973-4976
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• 2016

Objective: This article concerns evaluation of the sensitivity, specificity and accuracy of FNAB for pre-surgical diagnosis of benign and malignant lesions of major and minor salivary glands of patients treated in the Department of Head and Neck Surgery of Erasto Gartner Hospital. Methods: This retrospective study analyzed medical records from January 2006 to December 2011 from patients with salivary gland lesions who underwent preoperative FNAB and, after surgical excision of the lesion, histopathological examination. Results: The study had a cohort of 130 cases, but 34 cases (26.2%) were considered unsatisfactory regarding cytology analyses. Based on the data, sensitivity was 66.7% (6/9), specificity was 81.6% (71/87), accuracy was 80.2% (77/96), the positive predictive value was 66,7% (6/9) and the negative predictive value was 81.6% (71/87). Conclusion: Despite the high rate of inadequate samples obtained in the FNAB in this study the technique offers high specificity, accuracy and acceptable sensitivity.

• Asian Pacific Journal of Cancer Prevention
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• 제15권21호
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• pp.9165-9170
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• 2014

Purpose: This study evaluated the effect of an Educational Program on Palliative Care for MPM for Nurses in Japan. Program: The 5-h program consisted of lectures and care planning group work. Materials and Methods: This study used a pretest-posttest design with a single cohort of nurses and included a Difficulties in Palliative Care for Patients with MPM (DPCMPM) Scale with 15 items. The pre- and posttest scores were compared using a t-test. Results: We included 27 female nurses with a mean of 14.4 years of nursing experience. In 12 of 15 DPCMPM items, the posttest difficulty scores were lower than the pretest scores. Participants highly evaluated the program for validity, clarity, clinical usefulness, and the facilitators. The Palliative Care for MPM Handbook for Nurses was developed as an educational tool for clinical settings. Conclusions: The Educational Program on Palliative Care for MPM for Nurses was effective in reducing nursing difficulties.

• 지역사회간호학회지
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• 제17권2호
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• pp.186-194
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• 2006

Purpose: This study was to evaluate the nutritional risk and health status of osteoarthritis elderly comparing with that of non-osteoarthritis elderly in urban areas. Methods: A cross-sectional analysis was conducted. The subjects were 132 osteoarthritis elderly, 154 non-osteoarthritis elderly. Data were collected by using a questionnaire including Nutritional Screening Initiatives, blood test and measurement of weight & height. Collected data were analyzed through descriptive statistics and $x^2-test$ by using SPSS 12.0. Results: The percentage of high nutritional risk among osteoarthritis elderly were higher than those among non-osteoarthritis elderly(p<0.01). When comparing the main nutritional risk factors such as 'I eat alone most of the time', 'I don't always have enough money to buy', 'I have tooth or mouth Problems that make it hard for me to eat' between osteoarthritis elderly and non-osteoarthritis elderly, significantly differences were found(p<0.05). There were no statistically significant difference in ADL, BMI, Lymphocyte, Hemoglobin, Hematocrit, Albumin and total-Cholesterol between osteoarthritis elderly and non-osteoarthritis elderly. Conclusion: On the basis of this study, it is necessary to figure out the main factors of nutritional risk in arthritis elderly through the cohort study for effective prevention & control in nutritional risk.

• 보건의료산업학회지
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• 제14권1호
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• pp.93-102
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• 2020

Objectives: This study analyzed the prescription characteristics of medication for acute respiratory diseases before and after pay-for-performance to provide basic data on effective medical quality management policies. Methods: The research data were collected from the 2013-2014 sample cohort of the National Health Insurance Corporation, from Internal Medicine, Pediatrics, Otorhinolaryngology, Family Medicine and General practitioner clinics (classification of disease codes: J00-J06, J20-J22, J40 outpatients). Results: The antibiotics prescription rates decreased from 43.9% in 2013 to 43.5% in 2014 when the major diagnosis was for upper respiratory infections and increased from 62.0% in 2013 to 62.5% in 2014 when the major diagnosis was for lower respiratory infections. Conclusions: There is a need to identify the correct antibiotic prescription method by expanding the current assessment standards. Such standards must include acute lower respiratory infections and minor diagnoses as the current evaluation techniques focus only on the major diagnosis of acute upper respiratory infections.

• 지역사회간호학회지
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• 제28권2호
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• pp.206-215
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• 2017

Purpose: This study aimed to verify the predictive validity of Comprehensive Korean Frailty Instrument (CKFI) among older adults. Methods: A secondary analysis of data from a prospective cohort study was conducted. Frailty was determined in older adults (N=9,188) according to the data in 2008 and the effects of frailty on adverse outcomes (such as institutionalization and death) were evaluated according to the data in 2011. The Cardiovascular Health Study (CHS) index was used to compare with the predictive validity of CKFI. Results: The prevalence of frailty was 26.3%. With the CKFI, the frail group had a higher risk of negative health outcomes compared to the robust and pre-frail groups after three years. The two of the highest risks identified using the CKFI and CHS index were institutionalization (5.522 times higher) and mortality (3.210 times higher). For both instruments, the survival analysis revealed that the risk of death increased as the degree of frailty increased. Conclusion: The CKFI consisting of self-report items and multidimensional aspects of frailty can be used as a simple instrument for assessing the frailty of older adults residing in a local community in Korea.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권4호
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• pp.300-311
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• 2022

Purpose: Dysphagia, vomiting and feeding difficulties are common symptoms, with which children present. Esophageal function testing with high resolution manometry can help in diagnosing and treating these patients. We aim to access the clinical utility of high-resolution manometry of esophagus in symptomatic pediatric patients. Methods: A retrospective chart review was done on all symptomatic patients who underwent esophageal high-resolution manometry between 2010 and 2019 at Sydney Children's Hospital, Australia. Manometry results were categorized based on Chicago classification. Demographic data, indication of procedure, manometric findings, and details of treatment changes were obtained and analyzed. Results: There were 62 patients with median age of 10 years (9 months-18 years). The main indication for the procedure was dysphagia (56%). Thirty-two percent of patients had a co-morbid condition, with esophageal atresia accounting for 16%. The majority (77%) of patients had abnormal manometry which included, ineffective esophageal motility in 45.2%. In esophageal atresia cohort, esophageal pressurization was seen in 50%, aperistalsis in 40% and 10% with prior fundoplication had esophago-gastric junction obstruction. Patients with esophago-gastric junction obstruction or achalasia were treated by either pneumatic dilation or Heller's myotomy. Patients with ineffective esophageal motility and rumination were treated with a trial of prokinetics/dietary texture modification and diaphragmatic breathing. Conclusion: Esophageal high-resolution manometry has a role in the evaluation of symptomatic pediatric patients. The majority of our patients had abnormal results which led to change in treatments, with either medication, surgery and/or feeding modification with resultant improvement in symptoms.

• Journal of Gastric Cancer
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• 제23권3호
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• pp.428-450
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• 2023

This meta-analysis examined the surgical management of older patients (>80 years) with gastric cancer, who were often excluded from randomized controlled trials. We analyzed 23 retrospective cohort studies involving 18,372 patients and found that older patients had a higher in-hospital mortality rate (relative risk [RR], 3.23; 95% confidence interval [CI], 1.46-7.17; P<0.01) and more post-operative complications (RR, 1.36; 95% CI, 1.19-1.56; P<0.01) than did younger patients. However, the surgical complications were similar between the two groups. Older patients were more likely to undergo less extensive lymph node dissection and longer hospital stays. Although older patients had statistically significant post-operative medical complications, they were not deprived of surgery for gastric cancer. The comorbidities and potential risks of post-operative complications should be carefully evaluated in older patients, highlighting the importance of careful patient selection. Overall, this meta-analysis provides recommendations for the surgical management of older patients with gastric cancer. Careful patient selection and evaluation of comorbidities should be performed to minimize the risk of post-operative complications in older patients, while recognizing that they should not be deprived of surgery for gastric cancer.

• 한국조사연구학회지:조사연구
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• 제13권1호
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• pp.1-31
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• 2012

인구통계학적 분석(Demographic Analysis: DA)은 센서스 및 동태자료의 포함오류에 대한 질적 평가를 위해 센서스 후 조사(Post Enumeration Survey: PES)와 함께 널리 이용되는 방법이다. 그러나 우리나라에서는 인구통계학적 분석이 시행된 적이 없으며, 해외 인구통계학 논문에서는 인구통계학적 분석을 통해 우리나라 사망자 등록의 후진성을 지적하고 있다. 본 논문에서는 다양한 인구통계학적 분석방법을 소개하고, 한국의 현실에 맞도록 변형시킨 방법을 제시한다. 또한 이를 이용하여 1985년부터 2010년까지의 센서스 및 사망자 자료를 분석한 결과, 우리나라의 사망자 자료는 해외 논문의 결과와 달리 완성도(completeness)가 높은 것으로 나타났다. 센서스의 연도별 연령별 누락률을 추정하여, 센서스의 비정상적인 코호트의 증가 현상, 성비, 그리고 연령비의 이상 현상에 대해 분석하였다.

• 대한후두음성언어의학회지
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• 제15권2호
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• pp.81-86
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• 2004

Background and Objectives : In general, ambulatory 24-hour pH monitoring is considered the current gold standard for larynogopharyngeal reflux(LPR). There is no validated instrument whose purpose is to document the physical finding and severity of laryngopharyngeal reflux. The purposes of this study are to revaluate the validity and reliability of the reflux finding score(RFS) and to quantify laryngoscopic findings using reflux finding score. Material and Methods : Thirty-three LPR patients confirmed by dual-probe pH monitoring and thirty patients of control were selected. The RFS was documented for each patient with telescopic laryngoscopy before treatment. For test-retest intraobserver reliability assessment, a blinded laryngologists determined the RFS on two separate occasions. To evaluate interobserver reliability assessment, the RFS was determined by t재 different blinded laryngologists. Results : The mean age of the cohort with pH-documented LPR was 45.8 years and the mean RFS was 11.4. The mean age of cotrol subjects was 52 years and the mean RFS was 5.4. The mean RFS for laryngologist no. 1 was 10.8 at the initial screening and 10.9 at the repeat evaluation. The mean FRS for laryngologist no.2 was 11.1 at the intial test and 10.9 at the repeat evaluation. The correlation coefficient for interobserver variability was 0.93 and intraobserver variability was 0.94. Conclusion : The RFS demonstrates excellent inter-and introaobserver reproducibility and is helpful for quantifying laryngeal finding in LPR. We can be 95% certain that an individual with a RFS greater than 7 has LPR.