• Title/Summary/Keyword: Digestive system neoplasm

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Nationwide incidence estimation of colorectal cancer by subsite of origin in Korea (한국인에서 대장-직장암의 해부학적 부위별 발생률 조사)

  • Park, B.J.;Lee, M.S.;Ahn, Y.O.;Heo, D.S.;Kim, D.H.;Kim, H.;Yew, H.S.;Park, T.S.
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.3 s.54
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    • pp.555-563
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    • 1996
  • Nationwide incidence survey was conducted to estimate the annual incidence rates of colorectal cancer among Koreans between Jan 1, 1988 and Dec 31, 1989. The population of the incidence survey was the beneficiaries of Korea Medical Insurance Corporation (KMIC), which were about 4,500,000 persons. The medical records of patients with diagnosis of either ICD-9 153(colon cancer), 154(rectal caner), 197(secondary malignant neoplasm of digestive and respiratory system), or 211(benign neoplasm of digestive system) were abstracted for the period with the standard format. The diagnosis was confirmed by one oncologist through the review of these abstracts. The numerator of the rate was finally defined as the incident colorectal cancer cases diagnosed between July 1, 1988 and June 30, 1989. The crude annual incidence of colorectal cancer for men was 13.1 per 100,000 and 10.6 for women, which was still low when compared with those of Japan and China during the same period. Age-adjusted sex ratio was 1.2 for right-sided colon cancer and 1.9 for left-sided colon cancer. The excess of right colon cancer among postmenopausal women was remarkable, so further analytical approach would be needed to investigate which factors are related with this phenomenon.

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COVID-19 Vaccination in Patients with Gastrointestinal Cancer Receiving Chemotherapy (항암치료를 받는 소화기 암환자에서 코로나바이러스 감염증-19 백신접종)

  • Jonghyun Lee;Dong Uk Kim
    • Journal of Digestive Cancer Research
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    • v.10 no.2
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    • pp.107-111
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    • 2022
  • In 2019, coronavirus disease (COVID-19), which originated in Wuhan, has spread worldwide. In most people, COVID-19 symptoms are not severe. However, the mortality rate and severity were high in risk groups such as in older people and patients with underlying diseases. As patients with cancer are one of the risk groups, the vaccination for COVID-19 is emphasized in these patients. However, COVID-19 vaccines are not tested enough in special groups such as in patients with cancer because these vaccines are developed at an unprecedented speed. This causes confusion about whether patients undergoing chemotherapy should be vaccinated or not. In this study, international guidelines and studies were reviewed. Most of the studies recommended vaccination. No evidences of any negative effects for the efficacy or safety were recorded in patients undergoing cytotoxic, targeted, and immune agents. However, in critical conditions such as cytopenia, vaccination must be decided according to the patient's condition. COVID-19 vaccines were also recommended for patients on surgery or radiation therapy. If possible, vaccine is given before surgery to avoid confusion between surgical complications and side effects of the vaccine. The radiation recall phenomenon after vaccination has been reported in some cases of radiation therapy. Clinicians should consider these situations before vaccinating each patient. We hope that clearer guidelines will be established by accumulating verified data.

Clinicopathologic Implication of New AJCC 8th Staging Classification in the Stomach Cancer (위암에서 새로운 제8판 AJCC 병기 분류의 임상적, 조직 병리학적 시사점)

  • Kim, Sung Eun
    • Journal of Digestive Cancer Reports
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    • v.7 no.1
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    • pp.13-17
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    • 2019
  • Stomach cancer is the fifth most common malignancy in the world. The incidence of stomach cancer is declining worldwide, however, gastric cancer still remains the third most common cause of cancer death. The tumor, node, and metastasis (TNM) staging system has been frequently used as a method for cancer staging system and the most important reference in cancer treatment. In 2016, the classification of gastric cancer TNM staging was revised in the 8th American Joint Committee on Cancer (AJCC) edition. There are several modifications in stomach cancer staging in this edition compared to the 7th edition. First, the anatomical boundary between esophagus and stomach has been revised, therefore the definition of stomach cancer and esophageal cancer has refined. Second, N3 is separated into N3a and N3b in pathological classification. Patients with N3a and N3b revealed distinct prognosis in stomach cancer, and these results brought changes in pathological staging. Several large retrospective studies were conducted to compare staging between the 7th and 8th AJCC editions including prognostic value, stage grouping homogeneity, discriminatory ability, and monotonicity of gradients globally. The main objective of this review is to evaluate the clinical and pathological implications of AJCC 8th staging classification in the stomach cancer.

Medical Convergence Analysis of Complaint about Medical Service in an Affiliated Hospital (일 상급종합병원 의료서비스 불만족 내용의 의료 융합적 분석)

  • Kim, Jung-Suk;Eom, Ae-Hyun;Yu, Moon-Sook
    • Journal of the Korea Convergence Society
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    • v.7 no.5
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    • pp.117-125
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    • 2016
  • Implementation of patient feedback is considered as a critical part of effective and efficient management. This study is a retrospective survey after to ensure the medical convergence analysis of contents on customer dissatisfaction using medical services. The data were collected from dissatisfaction 319 case at a affiliated hospital. The result indicate that a repeat visit than the initial visit, outpatients were more dissatisfied than the inpatients. The type of dissatisfaction were more dissatisfied of the in communication and explanation of medical service, nursing service and procedure of administrative services. In the classification of disease the percentages of dissatisfaction in the digestive system and neoplasm were high in both groups(p<0.05). Based on the study to improve the quality of medical service. Prevent the recurrence of dissatisfaction and to establish a customer-oriented business strategy. Characterized by dissatisfaction factors and contents of each patient and should be structured to specific disease types of services through continuous medical convergence research.

Selection of Manageable Diseases for Quality Assessment in Korean Medicine by Delphi Method (한방분야 적정성 평가 대상 질환 선정을 위한 전문가 Delphi 조사)

  • Park, Chang-Hyun;Lim, Hyung-Ho
    • Journal of Korean Medicine Rehabilitation
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    • v.26 no.3
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    • pp.129-141
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    • 2016
  • Objectives As awareness of the public about Korean medicine health care and the social demand about improvement for quality of health care service is constantly rising, the quality evaluation of Korean medicine health care service is needed to improve the quality. Through trial of Delphi method, we tried to set the priority in short, medium, long term among the disease which is the subject of quality assessment. Methods Carrying out the delphi survey to 50 experts of korean medicine who were recommended by the 41 member societies of Korean medicine and related organizations, we selected final candidates for quality assessment. It is composed with total 2 rounds, and we investigated the priority in three aspects; the importance of the matter, possibility quality assessment, potential about if there's any chance of improvement. Results By delphi method, we set the priority of quality assessment. Base on the result of the second round, we classified importance of the questions into above average, average, below average, and categorized items as short, medium, long term according on the final priority. We classified of musculoskeletal diseases and diseases of connective tissues and musculoskeletal injury as short term and cerebrovascular disease and disease of nerve system and malignant neoplasm as medium term, disease of digestive organs and diseases, symptoms and abnormal findings in clinical field or inspections which are not categorized as long term. Conclusions We set the subjects of quality assessment by delphi survey by experts, and classified into short, medium, long term. Further research is necessary for execution the Quality Assessment to each of the candidate. Also, we can send feedback to medical institution base on the result of Quality Assessment. then it would be able to induce the improvement in quality of medical institution by itself.

A Case of Pancreatic Cancer Recurred in Liver after Surgical Resection, in Complete Response after Chemotherapy and Tumorectomy (수술적 절제술 후 간에 재발한 췌장암에서 항암화학요법과 종양절제술로 완전 관해를 보인 증례)

  • Jun Hyuk Son;Jae Woo Lee;Dong Kee Jang;Sang Hyub Lee;Ji Kon Ryu;Yong-Tae Kim
    • Journal of Digestive Cancer Research
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    • v.3 no.2
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    • pp.105-107
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    • 2015
  • Pancreatic cancer is commonly presented with distant metastasis. However metastasis to central nervous system (CNS) of pancreatic cancer was rarely reported. 79-years-old man was hospitalized with sudden onset right arm dysesthesia and weakness. In brain magnetic resonance imaging, multifocal high signal intensity lesions in cerebral and cerebellar cortices were observed. Leptomeningeal and parenchymal enhanced lesions were also noted in contrast-enhanced T1 images suggesting a metastasis from the pancreatic cancer. Stroke like manifestation of CNS metastasis of pancreatic cancer is extremely rare. Careful history taking and evaluation should be performed to find the origin of the sudden neurologic deficit.

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Stroke-like Manifestation in a Patient with Leptomeningeal Metastasis of Pancreatic Cancer (급성뇌졸중 양상으로 발현된 췌장암의 연수막 전이)

  • Boo Suk Na;Soo Jin Song;Jong Min Song;Ho Geol Woo;Young Nam Kwon;Dokyung Lee;Tae-Beom Ahn
    • Journal of Digestive Cancer Research
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    • v.3 no.2
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    • pp.113-115
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    • 2015
  • Pancreatic cancer is commonly presented with distant metastasis. However metastasis to central nervous system (CNS) of pancreatic cancer was rarely reported. 79-years-old man was hospitalized with sudden onset right arm dysesthesia and weakness. In brain magnetic resonance imaging, multifocal high signal intensity lesions in cerebral and cerebellar cortices were observed. Leptomeningeal and parenchymal enhanced lesions were also noted in contrast-enhanced T1 images suggesting a metastasis from the pancreatic cancer. Stroke like manifestation of CNS metastasis of pancreatic cancer is extremely rare. Careful history taking and evaluation should be performed to find the origin of the sudden neurologic deficit.

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The Future Direction of Learning Objectives and National Nurse's Licensing Examination in Adult Health Nursing (성인간호학 교육의 학습목표와 국가고시 문제 개선방안)

  • Song, Rha-Yun;Shin, Su-Jin;Suh, Yeon-Ok;Shin, Sung-Rae;Park, Yeon-Hwan;Kang, Youn-Hee;Kim, Yeong-Kyeong
    • Korean Journal of Adult Nursing
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    • v.23 no.5
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    • pp.503-513
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    • 2011
  • Purpose: The purpose of this study was to identify a model based on f the learning objectives in adult health nursing curriculums. The model can be eventually reflected in Korean National Nurse's Licensing Examination (KNNLE). Methods: The model was developed through a series of practical analysis by the task force team from June to October, 2011. The research team conducted the data synthesis and analysis from the learning objectives of adult health nursing drawn from selected national and international universities, from the adult health nursing areas in KNNLE, and from the current disease prevalence from clinical data in the representative university hospitals in Korea. Results: The current disease prevalence and mortality rates are on the increase especially for malignant neoplasm, heart diseases, suicide and diabetes. The items on the KNNLE of adult nursing are categorized by body systems into digestive system (15%), introduction (13.8%), respiratory system (11.3%), and cardiac system (11.3%). While the current system-based learning objectives covers extensive areas of adult health nursing, the core items are required to be selected based on core competences and core learning objectives to restructure the items of KNNLE. The first revised model is to consolidate and restructure the items microscopically in the subjects of adult health nursing by system. The second proposed model from macroscopic perspective is to build a comprehensive scheme of nursing curriculum by encompassing 8 subjects under current KNNLE and adjust the number of items accordingly. Conclusion: The items of KNNLE need to be gradually redesigned by considering the intervention need at clinical practice and the modified learning objectives of adult health nursing. Based on the job analysis on core competences for newly employed nurses performed by the Korean Accreditation Board of Nursing, it is necessary to establish the core learning objectives of adult health nursing and set up standards for core items in KNNLE.

Audit of Appropriateness of Fresh Frozen Plasma Transfusion (신선동결혈장의 적정수혈 분석)

  • Seo, Youkyung;Kim, Moon Jung;Kim, Sinyoung;Kim, Hyun Ok
    • The Korean Journal of Blood Transfusion
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    • v.23 no.2
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    • pp.136-144
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    • 2012
  • Background: Fresh frozen plasma (FFP) transfusion is administered primarily for management of acquired bleeding disorders. However, in practice, FFP transfusion is increasing without a solid rationale. Methods: We conducted an audit to evaluate the appropriateness of the indications for FFP transfusion during the period from July 2010 through June 2011. Assessment of the appropriateness of the indications was based on the national transfusion guidelines and the transfusion criteria promulgated by the Severance Hospital. Results: In total, 17,733 units of plasma were transfused to 1,949 patients over 4,982 events. We found that administration of FFP was not in compliance with the recommended guidelines in 1,990 events. The number of total FFP transfusions was higher in medical departments (Gastroenterology) than in surgical departments (Thoracic and cardiovascular surgery, General surgery). However, the proportion of cases of inappropriate transfusion was higher in surgical departments than in medical departments. Both the total number of FFP transfusion and the proportion of inappropriate transfusion were high in patient with neoplasm, disease of the digestive system, and diseases of the circulatory system. Conclusion: Continuous monitoring on appropriateness for FFP transfusion and feedback to the physician are critical in securing the transfusion safety as well as maintaining the quality of FFP transfusion. New-found indication for FFP transfusion should be investigated and applied in timely manner.