• Perspectives in Nursing Science
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• v.10 no.2
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• pp.87-96
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• 2013

Purpose: The purpose of this study was to investigate the relationships of activity status, anxiety, depression, social support, symptom experience, and functional status in patients with lung cancer based on the theory of unpleasant symptoms. Methods: The participants for this study were 101 lung cancer patients who visited the out-patient department for treatment or follow-up at one hospital in Seoul. Data were collected from January 1 to February 8, 2013 using self-reported questionnaires and clinical records. To measure variables, the functional scale and symptom scale of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30, EORTC QLQ-Lung Cancer 13, Eastern Cooperative Oncology Group Performance Status, Hospital Anxiety and Depression Scale, and Multidimensional Scale of Perceived Social Support were used in this study. The data were analyzed using SPSS 19.0 software for Windows. Results: The symptom experience showed more severity in patients with lower activity status, higher anxiety and depression. With lower activity status and social support, functional status was lower. When anxiety, depression, and symptom experience were higher, functional status was also lower. The significant factors predicting symptom experience were depression, anxiety, activity status, and social support, which explained 57.8% of the variance. Conclusion: These results suggest that psychological factors such as anxiety and depression had a negative influence on the symptom experience of lung cancer patients. Therefore, providing emotional support based on the patients' needs prior to providing symptom management could be a useful strategy for improving symptom experience and functional status.

• Journal of Korean Neurosurgical Society
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• v.64 no.6
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• pp.983-994
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• 2021

Objective : The effectiveness of gamma knife radiosurgery (GKR) in the treatment of brain metastases is well established. The aim of this study was to evaluate the efficacy and safety of maximizing the radiation dose in GKR and the factors influencing tumor control in cases of small and medium-sized brain metastases from non-small cell lung cancer (NSCLC). Methods : We analyzed 230 metastatic brain tumors less than 5 mL in volume in 146 patients with NSCLC who underwent GKR. The patients had no previous radiation therapy for brain metastases. The pathologies of the tumors were adenocarcinoma (n=207), squamous cell carcinoma (n=18), and others (n=5). The radiation doses were classified as 18, 20, 22, and 24 Gy, and based on the tumor volume, the tumors were categorized as follows : small-sized (less than 1 mL) and medium-sized (1-3 and 3-5 mL). The progression-free survival (PFS) of the individual 230 tumors and 146 brain metastases was evaluated after GKR depending on the pathology, Eastern Cooperative Oncology Group (ECOG) performance score (PS), tumor volume, radiation dose, and anti-cancer regimens. The radiotoxicity after GKR was also evaluated. Results : After GKR, the restricted mean PFS of individual 230 tumors at 24 months was 15.6 months (14.0-17.1). In small-sized tumors, as the dose of radiation increased, the tumor control rates tended to increase (p=0.072). In medium-sized tumors, there was no statistically difference in PFS with an increase of radiation dose (p=0.783). On univariate analyses, a statistically significant increase in PFS was associated with adenocarcinomas (p=0.001), tumors with ECOG PS 0 (p=0.005), small-sized tumors (p=0.003), radiation dose of 24 Gy (p=0.014), synchronous lesions (p=0.002), and targeted therapy (p=0.004). On multivariate analyses, an improved PFS was seen with targeted therapy (hazard ratio, 0.356; 95% confidence interval, 0.150-0.842; p=0.019). After GKR, the restricted mean PFS of brain at 24 months was 9.8 months (8.5-11.1) in 146 patients, and the pattern of recurrence was mostly distant within the brain (66.4%). The small and medium-sized tumors treated with GKR showed radiotoxicitiy in five out of 230 tumors (2.2%), which were controlled with medical treatment. Conclusion : The small-sized tumors were effectively controlled without symptomatic radiation necrosis as the radiation dose was increased up to 24 Gy. The medium-sized tumors showed potential for symptomatic radiation necrosis without signifcant tumor control rate, when greater than 18 Gy. GKR combined targeted therapy improved the tumor control of GKR-treated tumors.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.12 no.1
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• pp.11-15
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• 2016

Angelman syndrome is characterized by a partial deficit of paired autosomal chromosome 15, which contains a subunit of the GABA (Gamma-Amino Butyric Acid) receptor. The main clinical characteristics of this syndrome are delayed neuropsychological development, intellectual disability, and speech impairment. The syndrome has oral manifestations such as diastemas, tongue thrusting, sucking swallowing disorder, and excessive chewing behavior. A 3-year-6-month old girl with Angelman syndrome was scheduled for dental treatment. She had multiple caries, but she was poorly cooperative for treatment due to developmental delay and movement disorder, so general anesthesia was considered. The patient with Angelman syndrome was successfully treated under general anesthesia. There were no postoperative complications related to anesthesia and dental treatment. When treating children with this syndrome, the dentist needs to manage their uncooperative behavior and medical problem.

• Radiation Oncology Journal
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• v.33 no.3
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• pp.207-216
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• 2015

Purpose: Stereotactic radiosurgery (SRS) has been introduced for small-sized single and oligo-metastases in the brain. The aim of this study is to assess treatment outcome, efficacy, and prognostic variables associated with survival and intracranial recurrence. Materials and Methods: This study retrospectively reviewed 123 targets in 64 patients with non-small cell lung cancer (NSCLC) treated with SRS between January 2006 and December 2012. Treatment responses were evaluated using magnetic resonance imaging. Overall survival (OS) and intracranial progression-free survival (IPFS) were determined. Results: The median follow-up was 13.9 months. The median OS and IPFS were 14.1 and 8.9 months, respectively. Fifty-seven patients died during the follow-up period. The 5-year local control rate was achieved in 85% of 108 evaluated targets. The 1- and 2-year OS rates were 55% and 28%, respectively. On univariate analysis, primary disease control (p < 0.001), the Eastern Cooperative Oncology Group (ECOG) performance status (0-1 vs. 2; p = 0.002), recursive partitioning analysis class (1 vs. 2; p = 0.001), and age (<65 vs. ${\geq}65$ years; p = 0.036) were significant predictive factors for OS. Primary disease control (p = 0.041) and ECOG status (p = 0.017) were the significant prognostic factors for IPFS. Four patients experienced radiation necrosis. Conclusion: SRS is a safe and effective local treatment for brain metastases in patients with NSCLC. Uncontrolled primary lung disease and ECOG status were significant predictors of OS and intracranial failure. SRS might be a tailored treatment option along with careful follow-up of the intracranial and primary lung disease status.

• Journal of agricultural medicine and community health
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• v.9 no.1
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• pp.18-26
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• 1984

With the increase of using pesticides, pesticide poisonings become more frequent. In the previous epidemiological study on pesticide poisoning and the reports of the authorities concerned, it is carefully affirmed that pesticide poisonings are caused by farmers' ignorance and negligence in using the pesticides. But the pesticide poisoning should be taken into account in terms of the person who sprays the pesticides, its spraying process, farming style and farmers' socio-economic conditions. And based on the understanding mentioned above, preventive measures for pesticide poisoning should be established. In this socio-medical point of view, this study examined the public health problems caused by using pesticides and the treatment of pesticide poisoning, based on the interviews with farmers in a area of Kyunggi-Do about the spraying process of pesticides, poisoning experiences and its treatments. The results are as follows ; 1) The style of spraying pesticides in the target area is mostly an individual one, not cooperative one. And the subjects of spraying are householders, whose educational backgrounds are beneath notice. More than 2~5 of the subjects are women or old men of 60 years old or so. These are seen to derive from the socio-economic status of Korean agricultural families; their younger generation's moving to greater cities and their petty farming styles. 2) As for the safety measures for the spraying of pesticides, those which have nothing to do with the economic, problems such as efficient spraying and productivity, are well obeyed. On the other hand, some safety measures as the use of safety devices, and spraying time, the degree of dilution of pesticides and the spraying method In windy days, are not obeyed very well, for to keep those makes spraying difficult to do and productivity worse. These facts indicate that the safety measures for using pesticides must be directly concerned with the spraying process, farming style and farmers' socio economic status, rather than the subject's knowledge or carefulness. 3) Even In cases of poisoning they do rarely consult the doctors. This is caused by the problem of their locality and transportation since one should pass away a day even in the busiest season to consult doctors, and by their low socio-economic status. 4) The epidemiological studies on pesticide poisonings should be necessarily led to a socio-medical one which are concerned together with the spraying process of pesticides, farming style, farmer's socio-economic status and discrepancies in public health policies between agricultural communities and urban ones.

• Journal of Korean Neurosurgical Society
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• v.50 no.3
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• pp.216-223
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• 2011

Objective : The purposes of this study are to estimate postoperative survival and ambulatory outcome and to identify prognostic factors thereafter of metastatic spinal tumors in a single institute. Methods : We reviewed the medical records of 182 patients who underwent surgery for a metastatic spinal tumor from January 1987 to January 2009 retrospectively. Twelve potential prognostic factors (age, gender, primary tumor, extent and location of spinal metastases, interval between primary tumor diagnosis and metastatic spinal cord compression, preoperative treatment, surgical approach and extent, preoperative Eastern Cooperative Oncology Group (ECOG) performance status, Nurick score, Tokuhashi and Tomita score) were investigated. Results : The median survival of the entire patients was 8 months. Of the 182 patients, 80 (44%) died within 6 months after surgery, 113 (62%) died within 1 year after surgery, 138 (76%) died within 2 years after surgery. Postoperatively 47 (26%) patients had improvement in ambulatory function, 126 (69%) had no change, and 9 (5%) had deterioration. On multivariate analysis, better ambulatory outcome was associated with being ambulatory before surgery (p=0.026) and lower preoperative ECOG score (p=0.016). Survival rate was affected by preoperative ECOG performance status (p<0.001) and Tomita score (p<0.001). Conclusion : Survival after metastatic spinal tumor surgery was dependent on preoperative ECOG performance status and Tomita score. The ambulatory functional outcomes after surgery were dependent on preoperative ambulatory status and preoperative ECOG performance status. Thus, prompt decompressive surgery may be warranted to improve patient's survival and gait, before general condition and ambulatory function of patient become worse.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.7
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• pp.2967-2970
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• 2015

Many patients with few cerebral metastases receive radiosurgery alone. The goal of this study was to create a tool to estimate the survival of such patients. To identify characteristics associated with survival, nine variables including radiosurgery dose, age, gender, Eastern cooperative oncology group performance score (ECOG-PS), primary tumor type, number/size of cerebral metastases, location of cerebral metastases, extra-cerebral metastases and time between cancer diagnosis and radiosurgery were analyzed in 214 patients. On multivariate analysis, age (p=0.03), ECOG-PS (p=0.02) and extra-cerebral metastases (p<0.01) had significant impacts on survival. Scoring points for each patient were obtained from 12-month survival rates (in %) related to the significant variables divided by 10. Addition of the scoring points of the three variables resulted in a patient's total predictive score. Two groups were designed, A (10-14 points) and B (16-17 points). Twelve-month survival rates were 33% and 77%, respectively (p<0.001). Median survival times were 8 and 20 months, respectively. Because most patients of group A died from extra-cerebral disease and/or new cerebral lesions, early systemic treatment and additional WBI should be considered. As cause of death in group B was mostly new cerebral metastases, additional WBI appears even more important for this group.

• The Journal of the Korean dental association
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• v.57 no.8
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• pp.428-436
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• 2019

In cases of a patient referral, the general dentist should communicate the patient's dental information as clearly as possible to the specialist to whom he/she is referring his/her patient. For this reason, it is necessary to write a referral letter in an accurate and complete manner. The purpose of this study is to analyze the referral letters of patients who are referred to the department of conservative dentistry in a dental university hospital. From January, 2017 to December, 2018, we gathered the information of the patients who were referred to the department of conservative dentistry in a dental university hospital with referral letter. We evaluated the fidelity of a total of 750 referral letters and recorded the information of the referral dentist and the dental clinic. The relationship between each item and fidelity was analyzed using SPSS 18.0 program. The analysis of the contents of the referral letters yielded the following results: The fidelity of the referral letter was higher when the patient was referred during the root canal treatment, or when there was a root canal filling or when there was pain during chewing. The fidelity of referral letter was low in cases where the referring clinic is close to and has cooperative relationship with dental university hospital. Among the factors affecting the fidelity, the year of graduation of the referral dentist was the most influential. This study confirmed the fact that the clinical practice of writing patient referral letters still leaves much to be desired. In order to solve this problem, it is necessary to create more clear and standardized guidelines for writing referral letters.

• Asian-Australasian Journal of Animal Sciences
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• v.32 no.3
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• pp.366-374
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• 2019

Objective: The purpose of this study was to determine the effects of feeding ethanol on growth performances, carcass characteristics, and lipid metabolism of finishing Korean cattle (Hanwoo) steers. Methods: Thirty (30) Hanwoo steers (average 25.1 months of age, body weight 660.1 kg) were assigned to three treatments: control (0% ethanol), E-3 (1.44% ethanol for 3 months), or E-5 (0.72% ethanol for 2 months followed by 1.44% ethanol for 3 months). The animals were allotted by treatment group into six pens and fed concentrate and perennial ryegrass. Ethanol (30%, v/v) was supplemented into drinking water twice a day to meet final concentrations based on average water consumption of finishing Hanwoo steers. Results: There were no statistical differences among the groups in final body weight, average daily gain, or carcass yield grade indices such as cold carcass weight, fat thickness, and loin area. The marbling score tended (p = 0.228) to increase with the highest score (6.7) in the E-5 group followed by 6.3 and 6.0 in E-3 and control groups, respectively. The appearance frequencies of quality grades of $1^{{+}{+}}$ (the best), $1^{+}$, 1, and 2, were; 30%, 50%, 0%, and 20% for control, 10%, 80%, 10%, and 0% for E-3, and 10%, 80%, 0%, and 10% for E-5 groups, respectively, indicating improvements of quality grades by feeding ethanol. Concentrations of serum glucose tended to decrease whereas those of insulin and non-esterified fatty acid to increase by feeding ethanol (E-3 and E-5; p>0.05). Conclusion: Feeding ethanol directly into drinking water of finishing Hanwoo steers stimulated lipogenesis in intramuscular adipose tissue (marbling) and thereby improved carcass quality grade. The serum metabolites results supported the hypothesis of lipolysis of existing adipose tissue, such as abdominal fats, and lipogenesis in intramuscular adipocytes.

• Journal of Korean Academy of Nursing Administration
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• v.1 no.2
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• pp.246-267
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• 1995

Recently the request of the patients to participate in the medical courses has been expanding due to the elevated sense of right on the people's health, merchandised medical treatment by mass supply, human right declaration of the patients, generalized medical informations by the mass media and the change of human relation between the medical personnels and the patients. Under these phenomena the patients have been in the thought of solving such accidents only by regulation of the laws which they think to be all powerful, Such trends are same in the area of nursing service. Also today the accident by the nurses have been increasing by the area of the nurses having been expanded and their independent roles having been increased. Such nursing accidents are the important subject which the professional occupation of the nurse has been facing but legal protective capability of the nurses has been very weak. Therefore this study has examined the degree of the experience of the nursing accident that happens in the clinical nursing scenes in the general hospital to provide the basic materials for the protection and the counter measures of the nursing accident. The following is the conclusion based by the above examination. 1) The experience degree of the whole nursing accidents has been appeared as 1.90 in average. And the degree according to service area has been 1.77 in the area of supervising management of patients, 1.54 in the area of the same management of patients by head-nurses, 1.84 in the area of doctors' treatment performances, 14 in the enforcement and education areas of the nursing technology, 2.04 in the area of observing patients and judgement and 2.07 in the area of nursing records and maintaining confidentials. Accordingly there has been higher degree of accidental experiences in the independent service areas of the patients than in the dependent ones directed by the doctors. 2) The perception of the nurses showed that the cause of the nursing accident has been due to the heavy work of the nurses with the 60.4% of the response rate, the highest rate. They report the accident to the head nurse first by 2/3 nurses after accident. And the hour of the accident has been frequently happened regardless of service hours with 48.1% in response rate, the highest rate, and the nursing accident happens in the night more than the daytime with the rate of 37.5% at night while 14. 4% daytime. 3) The nurses are in the perception that the patients are responsible for the accident with 48.2% response rate while 43.9% rate in response showed that it has been caused by many people. They are in the perception that 41.7% when the nursing power was lacking, 46.7% lower recognition of actual state about indivitual patient in the section of technical speciality and 35.8% when the patients were not cooperative and 37.8% when the wards were dirty and in disorder. 4) the attitude of the patients after the various nursing accidents has been violent words in 72.7%, violence in 17.4% and 3.9% in attending the court by the sue of the patient's side(18 nurses). 5) The action of the hospital has been : requesting the submission of the story of the accident in 22.8%, the report of the accidents in 14.4%, thus the written statement disposal was most, 4.5% was the transfer to the other departments when the accident was larger or the patients' guardians protested strongly and 0.6% of the dismissals of the nurses. 6) In regard to the responsiblity of the nurse accidents, 78.9% was the highest rate of supplying the nursing manpowers, 48.4% of mutual cooperation of the medical personnels, 37.2% of strengthening the education for the nurses and hospital facilities reformation in 32.7%. 7) The review of relation between the general characters of the object of the study and the degree of experience of nursing accidents showed the significant differences in ages (F=4.04, p=0.000).