• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.2019-2022
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• 2013

Purpose: To investigate the safety and efficacy of pemetrexed combined with chemotherapy as second or third line in patients with stage IV colorectal cancer (CRC). Patients and Methods: This trial was conducted to evaluate the effectiveness and safety of pemetrexed given to patients with recurrent or metastatic colorectal carcinoma who previously received 5-FU-based chemotherapy. All patients were required to have a histological diagnosis of colorectal adenocarcinoma with measurable metastatic disease and prior chemotherapy. Patients received pemetrexed at a dose of 500 $mg/m^2$ by 10 minute infusion on day 1, repeated every 21 days. Doses were modified depending on nadir counts. Combined chemotherapy included Oxaliplatin, Irinotecan and cis-platinum. Results: Thirty patients were enrolled and twenty-nine were evaluable for response. One patient did not have repeat radiological testing to determine response because he went off study after only one cycle of treatment for economic reasons. For 29 evaluable patients, 1 partial response, 6 stable disease and 22 progressive disease were recorded. Response rate was 3.45% (1/29). All responses occurred in patients receiving a starting dose of pemetrexed 500 $mg/m^2$. Median time to progression for all eligible patients was 2.5 months. The most common toxicities experienced were mild to moderate fever, hepatic damage, myelosuppression, nausea, vomiting, constipation, abdominal pain, diarrhea, and skin rash. Conclusion: Pemetrexed at 500 $mg/m^2$ given every three weeks combined with chemotherapy is associated with moderate response and good tolerability in patients with stage IV CRC.

• Journal of the Korean Magnetics Society
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• v.26 no.4
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• pp.142-148
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• 2016

To evaluate the effect of flip angle on flow rate measurements obtained with phase contrast MRI according to the flip angle degree in ascending aorta and velocity encoding (VENC) was (150 m/s). 1.5T MRI in patients 17 (female: 8, male: 9, mean age $57.9{\pm}15.4$) as a target by applying a non-breath holding techniques to flip angle VENC (150 cm/s) in each of the ascending aorta was measured by changing $20^{\circ}$, $30^{\circ}$ and $40^{\circ}$. Blood was obtained a peak velocity, average velocity, net forward volume, net forward volume/body surface area. Ascending aorta from average velocity (AV) measured the average value of the flip angle $20^{\circ}$ (9.87 cm/s), $30^{\circ}$ (9.6 cm/s) and $40^{\circ}$ (10.05 cm/s). Blood flow VENC in was blood flow change in flip angle change was high most blood flow measurement when the flip angle $30^{\circ}$ in VENC, crouching each blood flow is also proportional to the increases in the $20^{\circ}$ to $40^{\circ}$ and was increased, the deviation of the peak velocity and the average velocity is the smallest deviation from the flip angle $30^{\circ}$. Flip angle $20^{\circ}$, $30^{\circ}$ and $40^{\circ}$ in peak velocity, average velocity, net forward volume, net forward volume/body surface area was no statistically significant difference (p > .05). Blood flow velocity and blood flow is measured by applying to adjust the flip angle accurately calculate the blood flow is important information for diagnosis and treatment of cardiovascular diseases, and can help in the examination on the blood flow measurement.

• The Korean Journal of Rehabilitation Nursing
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• v.4 no.2
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• pp.219-231
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• 2001

The purpose of this study was to investigate the relationship among percieved social support, hope and quality of life of the cancer patients and to gain the baseline data for development of nursing intervention program for promoting quality of life in cancer patients. The design of this study was a cross sectional correlational survey. The subjects were 220 out and in-cancer patients in 5 general hospitals in Pusan. The data were collected from July 2 to August 1, 2001. The instruments were the Percieved social support scale(16 items, 5 point scale) had developed by Tae(1986), Hope scale(12 items, 4point scale) developed by Nowotny(1989) and Quality of life scale(31 items, 10 point scale) developed by Tae et al.(2000). The data was analyzed by the SPSS/PC+ program using frequency & percentage, item mean & standard deviation, t-test, ANOVA & Scheffe test, Pearson's correlation coefficient. The results of this study was as follows: 1) The item mean score of quality of life was $6.05{\pm}1.16$ (range 0-10). The highest score of subarea of the quality of life was the spiritual wellbeing area ($7.09{\pm}1.63$) and the lowest score was social wellbeing area ($5.53{\pm}1.65$). The mean score of perceived social support was $52.65{\pm}10.32$ (최저 1, 최고 80). The mean score of family support was $32.71{\pm}6.66$ (range 1-40) and the mean score of medical team support was $19.93{\pm}5.95$ (range 1-40). The mean score of Hope was $37.02{\pm}5.64$ (range 1-48). 2) There were statistically significant difference in the score of quality of life according to the life effect of religion(F=3.97, p=0.00), treatment method(F=2.94, p=0.01), area of diagnosis(F= 3.48, p=0.01), stage of disease (F=13.74, p=0.00). 3) There was significant correlation between perceived social support(r=0.44, p=0.000 ; family support ; r=0.334, p=0.000, medical support; r=0.395, p=0.000), hope(r=0.563, p=0.000) and quality of life. In conclusion, there was a significant relationship among perceived social support, hope and quality of life. Therefore perceived social support, hope intervention programs should be developed to improve the quality of life in cancer patients.

• Tuberculosis and Respiratory Diseases
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• v.57 no.3
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• pp.273-277
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• 2004

Methotrexate is commonly used in rheumatoid arthritis as an anti-inflammatory agent, but treatment with methotrexate can lead to severe side effects, especially pulmonary complication. Interstitial pneumonitis is one of the most important pulmonary adverse effects of methotrexate and most patient present with a subacute febrile illness and peripheral eosinophilia is seen in about a half of patients. Almost all patients have abnormal chest roentgenograms and bibasilar interstitial infiltration with alveolar pulmonary consolidations is the most characteristic finding. Interstitial inflammation with mononuclear cell infiltration is a characteristic pathologic feature and findings that suggest acute hypersensitivity pneumonitis, such as bronchiolitis, granuloma formation with giant cells, and infiltration with eosinophils are often present. Methotrexate-induced pneumonitis is a potentially life threatening and unpredictable complication but it is difficult to make a definite diagnosis in the absence of high index of clinical suspicion. Early recognition and appropriate management may avoid the serious outcome. Herein we report a case of methotrexate-induced pneumonitis in a patient with rheumatoid arthritis.

• Pediatric Infection and Vaccine
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• v.21 no.2
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• pp.150-156
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• 2014

Despite its rare occurrence, early diagnosis and appropriate treatment for neonatal herpes simplex virus infection are mandatory due to its high morbidity and mortality. In Korea, there has been no epidemiologic data on neonatal herpes simplex virus infection, and even case reports are rare. We observed a 16-day-old neonate who presented with fever and seizures. We diagnosed her with meningoencephalitis caused by herpes simplex virus type 2 based on the polymerase chain reaction test, and treated her with intravenous acyclovir and anticonvulsants. The seroprevalence of herpes simplex virus type 2 sharply increases in women in their 30s, and the average age for childbirth has increased to older than 30 years of age in Korea; we therefore expect that the incidence of neonatal herpes simplex virus type 2 infection will rise in Korea, and more attention should be directed to neonatal herpes simplex virus type 2 infection. We report this newborn patient's case along with a literature review.

• The Journal of Korean Academic Society of Nursing Education
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• v.4 no.1
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• pp.66-80
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• 1998

With the opening of healthcare market, the health care environment in Korea is anticipating a drastic change. In this Internationally open market environment, it is necessary to introduce a systematic health care plan and DRG system which offer qualitative medical services as well as reduced cost. Purpose of this study is to develop and test the critical pathway for Cesarean section patient in the way to be possible the integrated inpatient management. It was adopted the process of six phases to develop the critical pathway as the theoretical framework implemented by Johns Hopkins Hospital, Maryland, U.S.A. In the first phase, make a selection of diagnosis/procedures to develop. In the second phase, organize a development team consisted of eight expertises working in maternity nursing area. In the third phase, analyze the overall medical service offered to patient through review medical records and decided the service content and the implementation period for the Cesarean section patient. In the forth phase, make out a preliminary critical pathway after verification of expert group on content validity. In the fifth phase, validity operate to ten Cesarean section patients to test implementation in practice by using the preliminary critical pathway, In the sixth phase, defined the final critical pathway. The result of this study was as follows. 1. There were classified 8 categories as monitoring/assesment, treatment, medication, activity, diet, test, consult, education/discharge plan for vertical axis and showed hospital stayed from admission to discharge for horizontal axis of critical pathway through analysis 68 Cesarean section patients medical records. 2. After critical review 68 medical records to make out a preliminary critical pathway, hospital stays for horizontal axis were showed 6 days, mean hospital stays were 7.5 days, 2.1 days were to be taken operation after admission and 4.2 days were stayed until discharge after operation. 3. After making out a questionare in 90 items of a medical service content of eight categories and verifying the content validity of expertises, the 85 items of the preliminary critical pathway were selected by expertises agreement over 88% and modified or deleted 5 items showing agreement below 75%. 4. After verifying a validity to 10 patients for 4 weeks, hospital stays were 5.9 days. There were deleted 1 item and modified or supplemented the 9 items of the 10 items.

• Journal of Gastric Cancer
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• v.7 no.2
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• pp.67-73
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• 2007

Purpose: There have been several comparative studies that have focused on elderly groups of patients with gastric cancer. However, new criteria are needed for this elderly group because of the longer life span of Korean people. The diagnosis of gastric cancer has sometimes been missed in the young age group. The perioperative risk is high in the elderly age group because of their combined diseases. This study was designed to determine the differences of the clinicopathologic features and the prognosis between young and elderly patients with gastric cancer. Materials and Methods: Eighty patients were divided in two groups and these patients were selected for making comparison between young and elderly groups of patients with gastric cancer. The young age group consisted of 31 patients who were aged 35 years old or less. The elderly age group was made up of 49 patients who were aged 75 years old or above. Results: For the clinicopathologic features, the young age group was characterized by a high incidence of the poorly differentiated type of adenocarcinoma and the diffuse type too, according to the Lauren classification. On the other hand, the elderly group was characterized by a high incidence of poorly to moderate differentiated adenocarcinoma and also the intestinal type according to the Lauren classification. The other clinical differences were unremarkable. Additionally, there was no survival advantage in the young age group compared to the elderly group. Conclusion: There were no clinicopathologic and prognostic differences between both extreme age groups. So, active surgical treatment is recommended even for the elderly patients group.

• Investigative Magnetic Resonance Imaging
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• v.21 no.1
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• pp.9-19
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• 2017

Background: Normalized cerebral blood volume (nCBV) can be measured using manual or semiautomatic segmentation method. However, the difference in diagnostic performance on brain tumor differentiation between differently measured nCBV has not been evaluated. Purpose: To compare the diagnostic performance of manually obtained nCBV to that of semiautomatically obtained nCBV on glioblastoma (GBM) and primary central nervous system lymphoma (PCNSL) differentiation. Materials and Methods: Histopathologically confirmed forty GBM and eleven PCNSL patients underwent 3T MR imaging with dynamic susceptibility contrast-enhanced perfusion MR imaging before any treatment or biopsy. Based on the contrast-enhanced T1-weighted imaging, the mean nCBV (mCBV) was measured using the manual method (manual mCBV), random regions of interest (ROIs) placement by the observer, or the semiautomatic segmentation method (semiautomatic mCBV). The volume of enhancing portion of the tumor was also measured during semiautomatic segmentation process. T-test, ROC curve analysis, Fisher's exact test and multivariate regression analysis were performed to compare the value and evaluate the diagnostic performance of each parameter. Results: GBM showed a higher enhancing volume (P = 0.0307), a higher manual mCBV (P = 0.018) and a higher semiautomatic mCBV (P = 0.0111) than that of the PCNSL. Semiautomatic mCBV had the highest value (0.815) for the area under the curve (AUC), however, the AUCs of the three parameters were not significantly different from each other. The semiautomatic mCBV was the best independent predictor for the GBM and PCNSL differential diagnosis according to the stepwise multiple regression analysis. Conclusion: We found that the semiautomatic mCBV could be a better predictor than the manual mCBV for the GBM and PCNSL differentiation. We believe that the semiautomatic segmentation method can contribute to the advancement of perfusion based brain tumor evaluation.

• Clinical and Experimental Pediatrics
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• v.53 no.2
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• pp.248-252
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• 2010

Anomalous origins of coronary arteries are a rare type of disease among children. These anomalies can be categorized into 3 types according to the anatomical relationship of the aorta and pulmonary trunks. Among these types, the interarterial type, as observed in our case, needs early diagnosis and treatment, because it can increase the risk for the patient, causing sudden cardiac death in young individuals. Although there are controversies concerning the management of anomalous origins of the left coronary artery (LCA) in children, the result can be very beneficial, if treated accurately. Three well-known methods for correction of anomalous origins of LCA are re-implantation, coronary arterial bypass grafting (CABG), and unroofing. We report on the case of a 12-year-old girl who had chest discomfort and syncope with physical exercise and was later diagnosed with an anomalous origin of LCA by transthoracic echocardiography (TTE) and heart computed tomography (CT). She underwent a corrective operation by re-implantation, CABG, and unroofing.

• The Journal of Internal Korean Medicine
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• v.26 no.1
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• pp.265-274
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• 2005

Diabetic gastroparesis is a disorder in a diabetic of delayed gastric emptying in the absence of mechanical obstruction. It is estimated that about 20%-50% of diabetics suffer from gastroparesis. Clinical Sympoms include early satiety, bloating, nausea, anorexia, vomiting, abdominal pain, and weight loss. Severe gastroparesis might result in recurrent hospitalization, malnutrition, and even death, but, no exact treatment has yet been established. Electrogastrography has been known to be a simple, non-invasive, and effective method in assessing gastric motility and EGG has been used to diagnosis diabetic gastroparesis and to estimate its prognosis. Recently, two cases of diabetic gastroparesis were observed. For this cases, manual acupucture, electroacupucture, lumbar skin warming and herb medicine were applied. After application of these therapies, gastrointestinal symptoms improved and these therapeutic effects were confirmed in EGG. Moreover, blood glucose control improved, so patients were able to discontinue insulin injection and change to p.o.medication. In light of this encouraging application of oriental medicine, this is reported along with investigation of the literature.