• Title/Summary/Keyword: Death year

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Survival Analysis of Patients with Gastric Cancer Undergoing Surgery at the Iran Cancer Institute: A Method Based on Multi-State Models

  • Zare, Ali;Mahmoodi, Mahmood;Mohammad, Kazem;Zeraati, Hojjat;Hosseini, Mostafa;Naieni, Kourosh Holakouie
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6369-6373
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    • 2013
  • Background: Gastric cancer is one of the most common causes of cancer deaths all over the world and the most important reason for its high rate of death is its belated diagnosis at advanced stages of the disease. Events occur in patients which are regarded not only as themselves factors affecting patients' survival but also which can be affected by other factors. This study was designed and implemented aiming to identify these events and to investigate factors affecting their occurrence. Materials and Methods: Data from 330 patients with gastric cancer undergoing surgery at the Iran Cancer Institute from 1995-1999 were analyzed. The survival time of these patients was determined after surgery and the effects of various factors including demographic, diagnostic and clinical as well as medical, and post-surgical varuiables on the occurrence of death hazard without relapse, hazard of relapse, and death hazard with a relapse were assessed. Results: The median survival time for these patients was 16.3 months and the 5-year survival rate was 21.6%. Based on the results of multi-state model, age and distant metastases affected relapse whereas disease stage, type and extent of surgery, lymph nodes metastases, and number of renewed treatments affected death hazard without relapse. Moreover, age, type and extent of surgery, number of renewed treatments, and liver metastases were identified as factors affecting death hazard in patients with relapse. Conclusions: Most cancer studies pay heed to factors which have effect on death occurrence, but some events occur which should be taken into consideration to better describe the natural process of the disease and provide researchers with more accurate data.

Influence of Positive Psychological Capital and Death Awareness on Terminal Care Performance of Hematooncology Unit Nurses (혈액종양내과 병동간호사의 긍정심리자본과 죽음인식이 임종간호 수행에 미치는 영향)

  • Jung, Seo Yeon;Kim, Jeong Hye
    • Journal of Hospice and Palliative Care
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    • v.22 no.2
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    • pp.77-86
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    • 2019
  • Purpose: The purpose of this study was to confirm the influence of hematoonchology unit nurses' positive psychological capital and death awareness on their terminal care performance. Methods: This descriptive study data were collected from self-reported questionnaire filled by 127 oncology nurses at a tertiary hospital in Seoul, Korea. The variables were positive psychological capital, death awareness, and terminal care performance. Data were analyzed using SPSS version 22.0 software. Results: The participants scored $3.93{\pm}0.83$ on positive psychological capital, $3.68{\pm}0.99$ on death awareness and $2.86{\pm}0.65$ on terminal care performance. The three variables were positively correlated. The factors affecting the nurses' terminal care performance were hope and resilience in the subcategory of positive psychological capital and experience of death of family members, relatives or friends within the past year; The explanatory power was 32.1%. Conclusion: It is necessary to develop educational programs to foster hope, resilience, etc. in hematooncology unit nurses to improve their quality of terminal care performance.

Standardized Breast Cancer Mortality Rate Compared to the General Female Population of Iran

  • Haghighat, S.;Akbari, M.E.;Ghaffari, S.;Yavari, P.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5525-5528
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    • 2012
  • Introduction: Breast cancer is the most common cancer in women. Improvements of early diagnosis modalities have led to longer survival rates. This study aimed to determine the 5, 10 and 15 year mortality rates of breast cancer patients compared to the normal female population. Materials and Methods: The follow up data of a cohort of 615 breast cancer patients referred to Iranian Breast Cancer Research Center (BCRC) from 1986 to 1996 was considered as reference breast cancer dataset. The dataset was divided into 5 year age groups and the 5, 10 and 15 year probability of death for each group was estimated. The annual mortality rate of Iranian women was obtained from the Death Registry system. Standardized mortality ratios (SMRs) of breast cancer patients were calculated using the ratio of the mortality rate in breast cancer patients over the general female population. Results: The mean age of breast cancer patients at diagnosis time was 45.9 (${\pm}10.5$) years ranging from 24-74. A total of 73, 32 and 2 deaths were recorded at 5, 10 and 15 years, respectively, after diagnosis. The SMRs for breast cancer patients at 5, 10 and 15 year intervals after diagnosis were 6.74 (95% CI, 5.5-8.2), 6.55 (95%CI, 5-8.1) and 1.26 (95%CI, 0.65-2.9), respectively. Conclusion: Results showed that the observed mortality rate of breast cancer patients after 15 years from diagnosis was very similar to expected rates in general female population. This finding would be useful for clinicians and health policy makers to adopt a beneficial strategy to improve breast cancer survival. Further follow-up time with larger sample size and a pooled analysis of survival rates of different centres may shed more light on mortality patterns of breast cancer.

Clinical Results of Double Mitral and Aortic Valve Replacement (승모판과 대동맥판의 중복치환수술의 임상적 평가)

  • 김종환
    • Journal of Chest Surgery
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    • v.18 no.1
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    • pp.54-61
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    • 1985
  • One-hundred-and-seven patients were the consecutive cases of double replacement of the mitral and the aortic valves at the same time using the lonescu-Shiley bovine pericardial xenograft valve during the period between May, 1979 and June, 1984. They were 64 males and 43 females, and their ages ranged from 13 to 62 years [mean age, 34.011.9 years]. Eight patients died within 30 days after surgery [operative mortality rate, 7.5%], and 7 others thereafter [late mortality rate, 6.5%; or 4.21%/patient-year]. Ninety-nine early survivors were followed up for a total duration of 166.1 patient-years [mean duration, 20.116.1 months]. Two patients experienced thromboembolic complication with no death [1.20%/patient-year]; five developed prosthetic valve endocarditis [3.01%/patient-year] with one death; and three had a new development of aortic regurgitant murmur and they were, along with a mortality from endocarditis, classified into the cases of tissue valve failure [2.41%/patient-year]. The actuarial survival rate including the operative mortality was 82.24.7% at 6 years after surgery. The probabilities of freedom from thromboembolism and from valve failure were 97.61.7% and 88.67.6% at 6 years respectively. Symptomatic improvement was excellent in most of the cases at the follow-up end, showing the mean of the postoperative NYHA Classes of 1.120.33 from the preoperative one of 2.860.54. These results compares favorably with the ones reported from the major institutions. Clinical results of isolated replacement of the mitral valve and of the aortic valve were previously reported. The clinical results of a total and consecutive patients with replacement of single mitral and single aortic and double mitral and aortic valves on the mortality rate, survival rate, complication frequency, and symptomatic improvement all fully stands for the good therapeutic modalities of the valvular heart diseases with severely damaged lesions.

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Thromboembolic Complications After Ionescu Shiley Valve Replacement: Seven Years* Experience (IonescuShiley 조직판막 이식수술후 발생한 혈전전색증에 관한 연구 -7년간의 장기성적-)

  • Na, Myung-Hoon;Chae, Hurn;Suh, Kyung-Phil
    • Journal of Chest Surgery
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    • v.20 no.1
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    • pp.48-54
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    • 1987
  • This report provides follow-up data on 557 patients [73 aortic, 357 mitral, and 127 multiple valve replacements] undergone lonescu-Shiley pericardial Xenograft valve replacement at Seoul National University Hospital between January, 1979 and December, 1985. There were 35 early death [6.3%] and 522 operative survivors were observed, and the cumulative follow-up is 1,140 patient-years [mean: 2.18 years per patient] The thromboembolic complications occurred in 34 cases [3.0% per patient-year] and the rate was 2.1% per patient-year for mitral and 0.3% per patient-year for aortic valve replacement in the presence of anticoagulation therapy. Among the 34 embolic episodes, 9 patients were dead [0.8% per patient-year] and the cause of death were 5 cerebral thromboembolism, 2 pulmonary embolism, and 2 intracerebral hemorrhage due to inappropriate anticoagulation after thromboembolic episode. Actuarial probability [+ SEM] of remaining free of thromboembolism for AVR is 88.1 x 11.1% at 5 years, for MVR 79.1 a 13.4% at 7 years and for multiple valve replacement 77.2 e 5.21% at 7 years. The incidence rate of thromboembolic complications after AVR is not less than that of MVR [0.3 Among the potential thromboembolic risk factors, atrial fibrillation is possible risk factor to increase the thromboembolic complication [0.05 < P < 0.1], but the importance of other factors, such as atrial clot, large left atrial size, mitral position, NYHA functional class, and age is less definite. A careful follow-up and the proper control of anticoagulation without omission, poor control, and arbitrary withdrawal is important for the successful management of the thromboembolic complications and the anticoagulation-related morbidity and mortality.

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Estimating Values of Statistical Lives using Choice Experiment Method (선택실험법을 이용한 확률적 인간생명가치의 추정)

  • Shin, Young Chul
    • Environmental and Resource Economics Review
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    • v.16 no.3
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    • pp.683-699
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    • 2007
  • This study applied the choice experiment (CE) method to measure values of statistical lives from multi-attributed mortality risk reduction choices. The four characteristics of mortality risk (i.e. cause of death, voluntariness of mortality risk, timing of death, magnitude of mortality risk reduction) are utilized to design the alternatives of choice sets. The estimation results for the multinomial logit model show that individuals are willing to pay 27,930 won per year for a change from the status quo to a $\frac{1}{100}$ mortality risk reduction for 10 years, 116,773 won per year for mortality risk reduction associated with adults, 97,682 won per year for voluntary mortality risk reduction, 77,234 won per year for involuntary mortality risk reduction. There were several estimates of VSL related to different attributes of mortality risk. The mean VSLs of infant/child/young adult ranged from 1,165 million won to 1,367 million won. The mean VSLs ranged from 1,631 million won to 1,833 million won for adult, and were between 1,128 million won and 1,330 million won for old person.

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Mid term experience with CarboMedics Medical Valve (CarboMedics 기계판막의 임상경험)

  • 김기출
    • Journal of Chest Surgery
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    • v.26 no.10
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    • pp.753-760
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    • 1993
  • The CarboMedics valve is a bileaflet prosthesis with excellent hemodynamic characteristics, but the long term surgical experience with this valve, its durability and its biocompatibility are unknown. During a 5 year period from october 1988 to July 1993, 748 prostheses [402 mitral, 261 aortic, 58 tricuspid, 27 pulmonic] were inserted in 552 patients [mean age 40.2 years]. The operative mortality was 6.6% [37/560, 13.2% in age group below 15 years and 5.7% above 15 years]. and the main causes of death were complex congenital malformation and left ventricular failure. Follow up was totaled 1182 patient- years and mean follow up was 28.3 months/patient. No structural failure has been observed. Hemorrhage was the most frequent valve related complication[1.78% / Patient-year]. Embolism occurred at a rate of 0.93% / Patient-year. There were 5 cases of valve thrombosis [0.42% / Patient-year, two fatal]. There occurred 11 late deaths[6 valve related] and 42 valve related complications. Actuarial survival at 5 years is 97.18 0.94% and actuarial complication free survival at 5 years is 89.07 1.54%. In summary, the CarboMedics valve stands for a durable valve substitute, with low valve related complications.

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Four Year Experience with Valve Replacement of Valvular Heart Diseases (심장판막 치환술후 단기 추적성적)

  • 류한영
    • Journal of Chest Surgery
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    • v.23 no.6
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    • pp.1180-1190
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    • 1990
  • 96 patients underwent cardiac valve replacement for valvular heart diseases consecutively between February 1986 to February 1990 in the Department of Thoracic and Cardiovascular Surgery of Yeungnam University Hospital. The follow up period was between 6 months and 4.5 years postoperatively[mean 23.4$\pm$13.1 months]. 75 cases got mitral valve replacement, 6 cases, aortic valve replacement, 15 cases, double valve replacement. 30[31.2%] patients were male and 66[68.8%] were female and the age ranged from 14 to 66 years old. Early hospital death within 30 days postoperation were 5 patients[5.2%], consisting of by low cardiac output in 2, infective endocarditis in 1, multiple organ failure with sepsis in 1 patient. There was no late postoperative death. Most common early postoperative complication was wound disruption [8.7%] and then low cardiac output, pneumothorax, pleural effusion in order. Most common late postoperative complications were minor bleeding episodes[8.7%] related to anticoagulant therapy which were consisted of frequent epistaxis in 3, gum bleeding in 2, hemorrhagic gastritis in 1, hypermenorrhea in 1, hematoma in right arm in 1 patient. Valve-related complications included valve thrombosis [1.6%/ patient-year], valve failure due to pannus formation[1.1% /patient-year], prosthetic valve endocarditis[1, 1%o/patient-year] and minor anticoagulant hemorrhage[4.4% /patient-year]. 5 cases of reoperations were performed in 4 patients due to valve failure and all of them were in the mitral positions[2.7% /patient-year]. Cardiothoracic ratios in the chest X-ray decreased at the 6th month and 1st year postoperation in all patients. But in New York Heart Association[NYHA] functional class IV, no change in cardiothoracic ratio was found between 6 months and 1 year postoperation. In the echocardiogram, the size of the cardiac chambers decreased, but ejection fraction increased postoperatively in each functional class. In the electrocardiogram, decreases were found in the incidence of atrial fibrillation, left atrial enlargement, left ventricular hypertrophy with right bundle branch block increasing postoperatively in each functional class. The actuarial survival rate was 98.4% for all patients, 98.7% for mitral valve replacement, 83.8% for aortic valve replacement, and 80% for double valve replacement at the end of a 4.5 year follow up period. Meanwhile the actuarial freedom rate was 91.5% for prosthetic valve endocarditis, 91.6% for thromboembolism, 89.0% for prosthetic valve failure and 83.7% for minor anticoagulant hemorrhage. Preoperative NYHA class III and IV were 75% of all patients, but 95% of all patients were up graded to NYHA class I and II postoperatively.

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A Inquiry of the Perception of Death in School Age (학령기 아동의 죽음인식에 관한 탐색적 연구)

  • Joun, Young-Ran
    • Korean Journal of Hospice Care
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    • v.8 no.1
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    • pp.13-28
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    • 2008
  • Purpose: This paper aims to examine the subjective structures and types of school age children's perception of death through an investigative study on their perception of death in order to provide a basic material for them to understand death, and develop and carry out an effective death education program. Methods: The study method used the Q Methodology which can investigate the subjective structures and types of school age children's perception of death. For Q-population, 20 school age children were used as subjects for neutral interviews and open surveys, and through documentary research, a total of 132 statements were collected, For Q-samples, 23 statements (Q-samples) were derived through a non-structural method. P-samples were 31 school age children (8-13 year olds), Q-sorting was carried out using Q-cards, and the collected data was analyzed using the PC QUANL program. Results: As a result of the study, children's perception of death was divided into five types. The first type was functional type, characterized by prominent subjective perception regarding the elements of death, such as non-reversibility, universality, non-functionality, and causality. The second was after-life type, characterized by a strong, focus on life after death in one's perception of death, and it included children with Christian background and those who had experienced death in their immediate family. The third was religious type, characterized by a strong belief in being able to still watch over one's family and friends after one's death, resulting in a positive faith in the after-life. The fourth was fearful type, characterized by a deeper fear of death in comparison to other types. The fifth was realistic type, characterized by a strong and positive assent to the perception of good death. Conclusion: The significance of the results of this paper's study to Nursing is as follows. In terms of understanding the subjectivity of school age children's perception of death in nursing practice, and understanding the compositional elements of death presented with strong emphasis in existing literature and studies, the results will expand these understandings and allow us to understand the level of perception in school age children regarding the definition of death, after-life, and good death, be utilized as useful material in developing an effective death education program for them according to their type characteristics, and become the fertilizer for enabling the children to live a proper life and preventing the tendency to make light of death that occur in adolescence and the spread of suicides. In terms of nursing theory, the description and examination of the subjective structures and the characteristics of the different, types of school age children's perception of death can be utilized as useful material for building a model of school age children's perception of death, and be further used for teaching respect for life. In terms of nursing research, the results can contribute to research describing the effects of nursing intervention strategies and developing tools for providing psychosocial nursing in terms of giving school age children a positive perception of death according to their types as well respect for life.

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Assessment of prognostic factors in dogs with mammary gland tumors: 60 cases (2014-2020)

  • Moon, Chang-Hwan;Kim, Dae-Hyun;Yun, Sung-Ho;Lee, Hae-Beom;Jeong, Seong-Mok
    • Korean Journal of Veterinary Research
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    • v.62 no.1
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    • pp.9.1-9.6
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    • 2022
  • Canine mammary gland tumors are the most common neoplasms in intact female dogs. Approximately half of all mammary tumors are malignant, and there is a risk of metastasis, which is associated with a poor prognosis. This study was to evaluate the prognostic factors of canine mammary gland tumors and the risk factors associated with the development of malignant tumors. From 2014 to 2020, 60 dogs with mammary gland tumors that underwent surgical treatment were evaluated in this retrospective study. Tumor size, TNM stage, and histopathological results were prognostic factors for 2-year survival after surgery. Every 10 mm increase in tumor size, increased the risk of death within 2 years after surgery 1.213 times. Dogs with TNM stage IV or V had 8.667 fold risk of death within 2 years after surgery. The 2-year survival rate for dogs with benign tumors was 90.2% and for malignant tumors was 67.3%. Tumor size is the most important prognostic factor for canine mammary gland tumors. As tumor size increased by 10 mm, the risk for development of malignant tumors increased by 1.487 times. Tumors larger than 30 mm are highly likely to be malignant, and metastatic evaluation and wide resection should be considered.