• Title/Summary/Keyword: Early-age

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Segmental Resection and Rotationplasty of Malignant and Aggressive Bone Tumors Around Knee (슬관절 주위 악성 및 침윤성 골종양의 분절 절제술 후 회전 성형술)

  • Hahn, Soo-Bong;Park, Hong-Jun;Kim, Hyoung-Sik;Kim, Sung-Hun;Shin, Kyoo-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.7 no.2
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    • pp.51-58
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    • 2001
  • Purpose : In patients having malignant and aggressive bone tumors around knee joint requiring amputation, segmental resection and rotationplasty were performed and the clinical results were analyzed. Materials and Methods : Twenty-six patients underwent segmental resection and rotationplasty between February 1988 and June 1994, because limb salvage with tumor prosthesis after removal of tumor was impossible. The mean follow-up of malignant tumors was 57(6~120) months and the average age of patients was 21.4(5~37) years old. Out of 26 patients, there were 18 osteosarcoma(${\geq}$stage IIB), 2 synovial sarcoma, and 6 giant cell tumor. Results : Clinical results were evaluated by the Shriner's rating system. Four patients were excluded due to death or amputation and remaining 22 patients were included for assessment. Eighteen patients had excellent result, 3 good, and 1 fair. Range of motion of ankle joint was -11(dorsiflexion)~80(plantarflexion) degrees and daily walking activity with prosthesis was possible. Local recurrence developed in 2 patients and distant metastasis in 10. Early complications had 3 thrombosis and 1 sepsis, and late complications had 6 nonunion, 2 malrotation and 1 stiffness of ankle joint. Conclusion : Rotationplasty which is functionally excellent may serve as an effective partial limb salvage procedure, especially in patients less than 10 years old that lower extremity discrepancy or loosening tumor prosthesis due to enlargement of medullary cavity are anticipated or amputation is inevitable for wide resection margin.

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Study on Dietary Habit and Effect of Onion Powder Supplementation on Serum Lipid Levels in Early Diagnosed Hyperlipidemic Patients (초기진단 고지혈증 환자의 식습관 조사와 양파가루 섭취가 혈중지질에 미치는 영향 연구)

  • Lee, Kyung-Hea;Kim, Yang-Ha;Park, Eun-Ju;Cho, Sung-Rae
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.5
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    • pp.561-570
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    • 2008
  • This study aimed to determine the effects of freeze-dried onion powder (OP) which contains rich in quercetin (22 mg/10 g) on hyperlipidemic participants. Fourteen participants (total cholesterol level in plasma $270.8{\pm}21.4mg/dL$) $40{\sim}59$ years of age who were diagnosed as hyperlipidemia by a physician at Fatima Hospital in Changwon took part in this study for 12 weeks. We investigated the anthropometric data and dietary habit by using questionnaires. Also, blood samples were collected from the patients in fasting before and after this 12 weeks intervention study. 78.6% of the patients showed interest in health diet management and weight control; however, they also showed some problems in their dietary habit (meal irregularity, food choice, calorie nutrient balance, high fat and cholesterol etc.) and life style (smoking, eating out, alcohol intake) that could have adverse effect on hyperlipidemic therapy. Most participants (85.7%) thought that OP was good for their health. The total cholesterol and LDL-cholesterol significantly decreased with OP intake. The HDL-cholesterol increased and the Atherogenic index (AI) significantly decreased. Regarding the correlations of dietary habit and life style with anthropometric and biochemical factors, the alcohol intake level was significantly correlated with the frequency of eating out and body mass index (BMI). Exercise level showed positive correlation with HDL-cholesterol and negative correlation with atherogenic index (AI). These results suggest that the intake of polyphenol rich onion may decrease the risk of hyperlipidemia by reducing cholesterol level. We consider these hypolipidemic effects of OP as a possible functional food. However, further research such as a well designed longterm clinical study with experimental and placebo groups is needed.

Analysis of Diagnostic Performance of CT and EUS for Clinical TN Staging of Gastric Cancer (위암의 임상적 병기 설정을 위한 전산화단층촬영 및 초음파 내시경의 진단력 평가)

  • Shin, Ru-Mi;Lee, Ju-Hee;Lee, Moon-Soo;Park, Do-Joong;Kim, Hyung-Ho;Yang, Han-Kwang;Lee, Kuhn-Uk
    • Journal of Gastric Cancer
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    • v.9 no.4
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    • pp.177-185
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    • 2009
  • Purpose: Preoperative clinical staging of gastric cancer is very important for determining the treatment plans and predicting the prognosis. The previous reports regarding the accuracy of computed tomography or endoscopic ultrasound for the preoperative staging of gastric cancer have shown various outcomes. We analyzed the diagnostic performance of CT and EUS, which are important staging tools for the staging of TN gastric cancer. Materials and Methods: We retrospectively analyzed 1,174 patients who underwent gastrectomy for gastric cancer at Seoul National University Bundang Hostpital from May, 2003 to December, 2007. We derived the Kappa value to examine the agreement of the preoperative staging obtained from CT and EUS with the pathological staging. Results: The mean age of the 1,174 patients was $59.31{\pm}11.98$ years. Six hundred thirty seven patients had early gastric cancer and 536 had advanced gastric cancer. The diagnostic performance between CT and EUS for the T staging showed no significant difference between CT and EUS for the kappa values. The kappa values showed moderate agreement at 0.4039 (P=0.021) and 0.4201 (P=0.026), respectively. This suggests that there is no difference between the two examinations for the overall T staging. Analysis of the discrimination of mucosal and submucosal lesions with EUS showed an accuracy of 58.92% and a Kappa value of 0.206 (P<0.001), suggesting fair agreement and a lower diagnostic performance than expected. To differentiate lesions with stages higher than or equal to T2 or T3 from the lesion with stages lower than T2 or T3, respectively, adoption of the higher stage from the CT staging or the EUS staging showed a larger AUC of 0.84 than that from either stage alone. The CT-derived node stage had the higher diagnostic performance (68.55%) than that of the EUS-derived node stage (60.82%) for the node staging. Conclusion: The CT-derived stage and EUS-derived stage showed comparable results for determining the T stage of gastric cancer. Yet the higher stage of the two stages from CT and EUS most accurately discriminated between those lesions with stages higher than T2 and those lesions with stages lower than T2.

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Laparoscopy-assisted Total Gastrectomy for Advanced Upper Gastric Cancer - Comparison with Open Total Gastrectomy - (진행위암의 복강경 보조 위 전절제술 - 개복 위 전절제술과의 후향적 비교 -)

  • Lee, Jun Hyun;Nam, Yoo Hee;Hur, Hoon;Jeon, Hae Myung;Kim, Wook
    • Journal of Gastric Cancer
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    • v.8 no.3
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    • pp.141-147
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    • 2008
  • Purpose: The aim of this study was to compare the short-term operative outcomes of laparoscopy-assisted total gastrectomy (LATG) with those of open total gastrectomy (OTG) for patients suffering with advanced upper gastric cancer. Materials and Methods: Of the 47 patients who underwent LATG with $D1+{\beta}$ or D2 lymphadenectomy from July 2004 to March 2008, 29 patients with pathologically proven advanced gastric cancer were compared with 35 patients who underwent conventional OTG during the same time period. The comparison was based on the clinicopathological characteristics, the surgical outcome, the follow-up survival and tumor recurrence. Results: The patients' age, gender and body mass index were similar between the two groups. However, there were statistically differences in tumor size ($9.2{\pm}3.9$ vs $6.1{\pm}3.6cm$, P=0.002) and the proximal resected margin ($2.1{\pm}2.0$ vs $3.6{\pm}2.1cm$ P=0.004). There was no significant difference in most of the peri- and post-operative courses such as the time to first flatus, the time to starting a solid diet and the length of the hospital stay, except for a longer operating time (289.0 vs. 361.3 minutes, P<0.001) in the LATG group. The complication rate was higher in the LATG group (13.8%) than that in the OTG group (5.7%). The mean overall survival and disease free survival times were 32 and 31 months, and 24 and 28 months, respectively, with an average 18.8 months follow-up duration. The main recurrent sites were peritoneum and lymph node in both groups. Conclusion: The early results of the current study suggest that LATG for AGC is technically feasible and it does not show any inferiorities of the postoperative outcomes as compared to those of conventional open total gastrectomy.

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The Effects of Family Structure and Socialization Influences on Compulsive Buying: A Life Course Study in Thailand (가족구조와 사회화가 강박구매에 미치는 영향에 관한 연구: 태국의 인생행로연구를 중심으로)

  • Nguyen, Hung Vu;Moschis, George P.;Shannon, Randall;Gotthelf, Kristian
    • Journal of Global Scholars of Marketing Science
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    • v.19 no.2
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    • pp.27-39
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    • 2009
  • Compulsive consumption is regarded as a global phenomenon that can adversely affect consumer well-being. Although the topic has been studied in different cultural settings, we have seen relatively little theory development and explanations of compulsive behavior Nearly all previous empirical studies attempt to explain this behavior by correlating measures of compulsive behavior with independent variables taken within the same time frame. However, recent developments in social sciences suggest that such a phenomenon may best understood in the context of the person's earlier-in-life experiences. Using the life course paradigm as an overarching framework, the present research extends previous work on this topic. Following hypotheses were drawn from literature review: H1: The earlier in childhood and adolescence a person experiences family dislocation, the greater his or her likelihood of exhibiting compulsive behaviors in adulthood. H2: The earlier in life the young person experienced family dislocation, the greater the number of family disruption events the young person experienced prior entering adulthood years. H3: Family dislocation leads to (a) increased frequency of socio.oriented family communications and (b) decreased frequency of concept-oriented family communication. H4: Young adults who were raised in families characterized by a strong socio-oriented communication structure are more likely to exhibit compulsive consumption tendencies than those who were raised in families characterized by a weak socio-oriented family communication structure. H5: Young adults who were raised in families characterized by a strong concept-oriented communication structure are less likely to exhibit compulsive consumption tendencies than those who were raised in families characterized by a week concept-oriented family communication structure. H6: The relationship between family disruption events experienced during adolescence and perceived stressfulness of these events is moderated by (a) global family support, (b) emotional family support, and (c) material family support. Those reporting higher levels of family support as teenagers are less likely to report experiencing stress due to family disruption events. H7: Perceived stressfulness of family disruption events experienced during adolescent years are associated with compulsive consumption tendencies in early adulthood. H8: The greater the number of family disruption events young adults experienced during their adolescent years the more frequent was their communication about consumption with their peers. H9: The more frequent was the young persons' communication with their peers about consumption during their adolescent years, the more likely they are to report compulsive buying tendencies as young adults. We use a sample of 120 Thai undergraduate students attending classes taught in English as part of a four-year international program. Product-moment correlations, hierarchical regression analysis and partial correlation were used to analyze data. Results of testing hypotheses showed that hypothesis 2, 4, 7 and 9 were supported and hypothesis 1, 3, 5, 6 and 8 were not supported. Our study did not find a significant relationship between the age when a person experienced family dislocation and their compulsive behavior tendencies expressed as young adults. We did not find a significant relationship between family dislocation and family communication structures. But we found a significant positive relationship between socio-oriented communication structure and compulsive buying and a significant relationship between our peer communication and compulsive buying measures. Also we found perceived stressfulness due to the disruptive events to have a significant positive relationship between the perceived stressfulness and compulsive buying. Implications from these findings, limitations of this research and future research suggestions were discussed.

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Stressful Life Events, Health Symptoms, Social Support and Coping/in Early Adolescents (스트레스생활사건, 건강문제, 대응, 사회적 지지의 관계 -청소년을 대상으로-)

  • 오가실;한정석
    • Journal of Korean Academy of Nursing
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    • v.20 no.3
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    • pp.414-429
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    • 1990
  • Numerous research reports have substantiated the role of stressful life events in relation to the onset of health changes. The relationship tends to hold across different age groups. Theoretically, adolescence has been considered a developmental crisis period of great stress, impoverished coping skills and high vulnerability to biological, social and psychological demands. The research problem addressed by this study was to examine the relationships between stressful life events and health symptom patterns, and the effect of two variables, coping and social, support, theoretically considered to mediate the relationship between stress and health symptoms in adolescents. The following five hypotheses were tested in this research : 1. Health symptoms are positively related to stressful life events in adolescents, 2. Health symptoms are negatively related to coping in adolescents, 3. Health symptoms are negatively related to social support in adolescents, 4. When coping is controlled, the relationship between health symptoms and stressful life events will decrease, and 5. When social support is controlled, the relationship between health symptoms and stressful life events will increase. The study subjects consisted of 1090 high school students of the metropolitan city of Seoul. The following sampling procedure was used : 1. Of the 169 high schools in nine school administrative districts in the city, a proportional sample of ten schools was selected. 2. One class from each of the freshman and sophomore was randomly selected and all the students who were in the sampled class were used as the study sample. The study was limited to freshman and sophomore adolescents, aged 15 to 18(mean=16.6). Of the 1090 subjects 688(63%) were boys and 402(37%) were girls. An Adolescent Inventory of Stressful Life Events, a Health Symptom Questionnaire and an Adolescent Coping Inventory were adapted for this study. The Norbeck Social Support questionnaire was utilized to collect the data on perceived social support. Five high school teachers in the areas of school health and counselling reviewed the items of each questionnaire for content validity. A pilot study was undertaken to ascertain reliability. Fifty three high school students responded to the questionnaires and gave their opinions on the items. For stressful life events, health symptoms, coping, and social support, the Cronbach's alpha's on the study were .70, .94, .77, and .76, respectively. Research assistants attended all the sampled classes with the school proctor to explain the purpose and procedures of the study to the students. The questionnaires along with a ballpoint pen were distributed to the students who were asked to complete each item. The research assistants left the ballpoint pen with the students as a gift for their cooperation. An average of 50 minutes was required to complete the questionnaires. Using an SPSS, the first, three hypotheses were tested using Gamma, a measure of association for ordinal variables. Partial gamma was used to test the fourth and fifth hypotheses. Patterns of elaboration described by Babbie were selected to interpret the relationship of the three variable analyses. The significance of gamma was determined by Chisquare at a .05 level of significance. There was a positive relationship between health symptoms and stressful life events(Gamma=.35, p=.000). Thus the first hypothesis was supported. Unexpectedly, coping was positively related with health symptoms(Gamma=.13, p=.000). That is, the higher the coping levels, the greater number of health problems. The third hypothesis, the higher the level of social support, the fewer the health symptoms, was not accepted in this adolescent study group. When coping was controlled, under the condition of low coping the association between health symptoms and stressful life events increased significantly to a partial gamma of .39, and under the condition of high coping it was .30. According to the elaboration model, when one partial relationship is the same or greater than the original and the other is smaller, the control variable should be considered to be specifying the conditions. When social support was controlled the relationship between stressful life events and health symptoms increased under the condition of low social support, but with high social support, the relationship decreased. Both partial gamma were statistically significant at .05 level(.43 and .26 relatively). It can be interpreted that stressful life events are strongly and positively related to health symptoms under the condition of low social support, however this relationship can not be expected with high social support. Thus, the last two hypotheses were conditionally sustained. In this study, the relationships between stressful life events and health symptoms, and the specified me diating roles of coping and social support were found to have statistical interaction. This finding supports the theoretical position of this study. It suggests that stressful life events would create high susceptability to biological social and psychological health symptoms and coping and social support buffering the relationship between stressful life events and health symptom. The findings of this study have implications for nursing practice. When adolescents are confronted with non-developmental life events that are perceived as stressful, nurses should recognize the evidence of the stress-buffering effect of coping and social support on health symptoms and utilize the diverse sources of social support that are readily available to adolescents.

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Cost Analysis of Home Nursing Care Patients in Rural Hospital (농촌 지역 중소병원의 가정간호사업소 등록환자의 방문비용분석)

  • Kim, Jin-Soon;Kum, Ran;HwangBo, Soo-Ja
    • Journal of agricultural medicine and community health
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    • v.24 no.1
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    • pp.91-101
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    • 1999
  • The home nursing care system is an integral part of the health care delivery system in order to meet the various needs of consummer, in particular, early discharge patient from the hospital, patient with long term care needed and the elderly. To find out the cost of home nursing care services, the home nursing care records of patients registered by home nursing care units established in public hospital with 150beds during the period of 1996 - 1997 were analyzed. The subjects were 102patients, 45 of male patients and 57 of female patients, those who live in a rural area in Kymiggi - Do The results obtained are as follows : 1. The male patients accounted for 44.1% of the total, with 45cases : group aged 60 years and more was the largest group, accounting for 79.5%. 2. The most frequent disease revealed was the osteoporosis which constitute 35.3% of the total registered patients, followed, in order, by malignant tumor, cerebrovascular disease. 3. It revealed that the cost per visit for the male was 47,764won ; the female, 46,078 won per visit. Noteworthy the cost per visit was high in the older patient. It was clearly that the gender, years of age and the cost per visit were statistically significant at 0.01 level and 0.05 level. 4. The cost per visit for the non complicated disease was slightly higher than the complicated disease, but it is not statistically significant, the cost per visit by type of disease varied, the cost per visit for COPD was the highest, followed, in order, by in malignant tumor, cancer, diabetes, osteoporosis etc. 5. It revealed that home nursing care cost for a eligible disease for home nursing care was less than the cost for hospitalization of the same disease, therefore, we expect that the home nursing care is cost efficiency. In conclusion, the home nursing care costs are needed to analyze further in comparison with the hospitalization costs for a certain disease.

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Relationship Between Internet Addiction and Circadian Rhythm in Adults (성인 인터넷 중독과 일주기 리듬의 연관성)

  • Kang, Do Won;Soh, Minah;Lee, Tae Kyeong
    • Sleep Medicine and Psychophysiology
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    • v.22 no.2
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    • pp.57-63
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    • 2015
  • Background and Objectives: Internet addiction is an increasing problem in Korea. The previous studies in this area have targeted adolescents and young adults. This study was conducted to examine the risk of internet addiction in Korean adults and the effect of internet addiction on circadian rhythm. Materials and Methods: For this study, 508 subjects were chosen through population proportional sampling to represent the adult population in Korea, 325 of whom were included based on the Alcohol Use Disorder Identification Test-Korea (Audit-K), Zung's Self-Rating Depression Scale (SDS), drug use in the past year, and suicide attempts. In these subjects, sociodemographic factors including age, gender, and residential area were analyzed, and Young's Internet Addiction Scale (IAS), Morningness-Eveningness Questionnaire (MEQ), and an online survey examining sleep onset time on weekdays and weekends, wake-up time, and caffeinated drink intake were executed. Results: Of the 325 subjects, 136 (41.8%) belonged to a high-risk internet addiction group ($IAS{\geq}40$), and 189 (58.2%) belonged to a normal group (IAS < 40). There was a high proportion of male subjects (p = 0.03) in the high-risk group compared to the normal group. There was a high proportion of younger subjects (p = 0.055) in the high-risk group compared to the normal group, but this difference was not statistically significant. Compared to the normal group, there was a high proportion of the evening type ($MEQ{\leq}41$) in the high-risk group (p = 0.024), who also showed a high proportion of caffeinated drink intake (p < 0.001). Also, the high-risk group was found to go to bed and wake up late, but there was no statistically significant difference with the normal group. Conclusion: This study showed that many adults have a high-risk of internet addiction, and there was a significant correlation between internet addiction and sleep in adult, as has been found in adolescents and early adults. In the future, a longitudinal study will be needed to verify the causal relationship between internet addiction and morningness-eveningness.

Laparoscopy Assisted Total Gastrectomy with Lymph Node Dissection-77 Consecutive Cases (복강경 보조 위 전절제술-연속된 77예의 경험)

  • Lee, Joong-Ho;Song, Jye-Won;Oh, Sung-Jin;Kim, Sung-Soo;Choi, Won-Hyuk;Cheong, Jae-Ho;Hyung, Woo-Jin;Choi, Seung-Ho;Noh, Sung-Hoon
    • Journal of Gastric Cancer
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    • v.7 no.4
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    • pp.206-212
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    • 2007
  • Purpose: The number of laparoscopy assisted distal gastrectomies (LADG) is gradually increasing for the treatment of early gastric cancer (EGC) patients as a surgical modality for improving quality of life. However, there are few reports on laparoscopy-assisted total gastrectomy (LATG), mainly because this procedure is performed relatively infrequently, and the procedure is more complicated than LADG. This study was performed to evaluate the technical feasibility, safety, and surgical results of LATG with lymphadenectomy through a review of our experience. Materials and Methods: From July 2003 to June 2007, 77 LATG with Roux-en-Y esophagojejunostomy were performed for patients with a preoperative diagnosis of EGC. The clinicopathological features and surgical outcomes were analyzed. Results: There were 49 males and 28 females in the study with a mean age of 61 years (range $30{\sim}85$ years). The mean operation time was 210 minutes (range $100{\sim}400$ minutes) and the operation time was gradually decreased as the case numbers increased. There were 13 operative morbidities (16.9%) and no operative mortalities. The restoration of bowel motility was noted at 3.2 postoperative days; a soft diet was started at 4.4 postoperative days and the duration of hospital stay was 10 days. There were 20 mucosal lesions, 32 submucosal lesions, 15 proper muscle lesions, 7 subserosal lesions and 3 serosal lesions. A total of 20 patients were treated by D2 lymph node dissection, 55 patients were treated by D1+$\beta$ lymph node dissection, and two patients were treated by D1+$\alpha$ lymph node dissection. The mean number of retrieved lymph nodes was 42 (range $11{\sim}86$). Lymph node metastases were noted in 12 patients. Conclusion: This study indicated LATG could be applied safely and effectively for patients with EGC. However, a prospective study comparing laparoscopy-assisted versus open gastrectomy for short-term and long-term surgical outcome is needed.

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A Study on Clinical Progress of the Metastatic Adenocarcinoma of Pleura (전이성 흉막선암의 임상 경과에 관한 연구)

  • Yang, Seong-Wook;Lee, Tae-Kwan;Lee, Tae-Heon;Cho, Deok-Su;Baek, Hyeon-Seon;Kim, Ji-Young;Lee, Hye-Kyung;Kim, Kwi-Wan
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.2
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    • pp.156-164
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    • 1995
  • Background: We had undergone this study to investigate clinical progress of this disease and to decide the role of aggressive diagnostic approaches, the efficacy of treatments and prognoses. Methods: A retrospective study was done on 113 patients who had been diagnosed to metastatic adenocarcinoma of pleura by pleural fluid cytology(106 cases) or pleural needle biopsy(22 cases), at Presbyterian Medical Center, from Jan. 1990 to Dec. 1994. Results: 1) The patients were composed of 59 males(52.2%) and 54 females(47.8%), and the mean age distribution was $57.4{\pm}12.1$ years. 2) The site of origin was lung cancer 46.9%(53/113), stomach cancer 20.4%(23/113), breast cancer 11.5%(13/113), and unknown primary site 6.2%(7/113 cases), as a whole. In male, lung cancer was 55.9%(33/59), stomach cancer was 28.8%(17/59), and in female, lung cancer was 37%(20/54), breast cancer was 24.1%(13/54) of cases. 3) The cardinal symptoms were dyspnea(69%), cough(61%), chest pain(50%), weight loss(50%), anorexia(49%), sputum(43%), malaise(30%). 4) The pleural fluid findings were exudative in 94.4%(102/108), serosanguinous or bloody in 36~53%, unilateral involvement in 74.3%(84/113) of cases, and lymphocyte predominance($71{\pm}27%$) in differential count of WBC. 5) CEA levels in pleural fluid or plasma were over 10ng/ml in 60.6%(40/66), and ADA levels in pleural fluid were under 40U/L in 95%(57/60) of cases. 6) The patients were managed by various methods, but the efficacy of treatment was uncertain. 7) The mean survival time was $12.7{\pm}13.5$ weeks. Conclusion: It seems to be no effective treatment methods yet and the prognosis was very poor in this disease, so the objectives of diagnostic approaches and treatment methods should be directed to early diagnosis, treatment and prevention of curable disease. And we must make our best endeavors to lengthen the survival time and improve the quality of patients' life.

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