• Title/Summary/Keyword: Fisher grade

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The Effects of Hospice & Palliative Care Education Program on Spiritual Well-Being and Knowledge Regarding Advance Directives of Nursing Students (호스피스·완화의료 교육프로그램이 간호대학생의 영적안녕감 및 사전의료의향서 지식에 미치는 효과)

  • Kim, In Sook;Jang, Sun Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.1
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    • pp.732-738
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    • 2020
  • This study examined the effects of hospice & palliative care education programs for nursing students, in terms of spiritual well-being and knowledge concerning advance directives. This is a quasi-experimental study of non-equivalent control groups, and includes a pre-test and post-test design. Data was collected between September to December 2018, enrolling third grade nursing college students attending a university in C city: 22 subjects in the experimental group and 27 subjects in the control group. The experimental group was provided the education as a regular subject, 2 hours a week for 7 weeks, for a total of 14 hours. Ed. Notes: I suggest you maintain any one unit for mentioning time. Hence, I changed 120 mins to 2 hours. Data were analyzed by X2 test, Fisher's exact, t-test, independent t-test, and paired t-test, using the SPSS 21.0 program. After attending the program, spiritual well-being showed a significant increase (t=2.80, p=0.009). However, there was no significant difference between groups in knowledge regarding advance directives (t=1.33, p=0.190). Our results indicate that the hospice & palliative care education program helps nursing students improve their score of spiritual well-being. We believe that these results contribute basic data for the future development of hospice-palliative care curriculum.

Clipping of the Anterior Communicating Artery Aneurysm without Sylvian Fissure Dissection

  • Yun, Ji-Kwang;Kang, Sung-Don;Kim, Joon-Moon
    • Journal of Korean Neurosurgical Society
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    • v.42 no.5
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    • pp.388-391
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    • 2007
  • Objective : The focus of aneurysm surgery is eliminating unnecessary operative manipulations and preparing the surgeon for any crises that might arise. With this concept in mind, we have tried resection of the gyrus rectus without routine sylvian fissure dissection in selected patients with anterior communicating artery (ACom) aneurysms, and compared these results with those from the conventional transsylvian approach. Methods : This retrospective study included 231 surgically treated patients with ACom aneurysms from March, 1997 to May, 2005. The patients were divided into two groups : Group A (96 with sylvian fissure dissection, March, 1997-December, 2000) and Group B (135 without sylvian fissure dissection, January, 2001-May, 2005). Overall surgical outcomes were compared, and operative times have been prospectively recorded since January, 04 to evaluate how this maneuver affected the length of surgical procedures. Results : All aneurysms were satisfactorily clipped, and there was no evidence of increased number of procedure-related retraction injuries in group B. Overall outcome was good in 186 (80.5%); 76 (79.2%) in group A, and 110 (815%) in group B ($x^2$ test, p=0.79). In good clinical grade of group A, good outcome was observed in 60 patients (89.6%) and in group B, 97 patients (94.2%) (Fisher's exact test, p=0.38) (Fig. 2). Conclusion : In this study, eliminating the step of sylvian fissure dissection by gentle lateral basal-frontal retraction to the side of the sylvian fissure did not increase morbidity and mortality. However, we do not intend to modify the standard approach to the ACom aneurysm that is familiar to and has been mastered by many others. Rather, we report our experience on the basis of our anatomic understanding of the technique and its results.

Multivariate Analysis of the Prognosis of 37 Chondrosarcoma Patients

  • Yang, Zheng-Ming;Tao, Hui-Min;Ye, Zhao-Ming;Li, Wei-Xu;Lin, Nong;Yang, Di-Sheng
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1171-1176
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    • 2012
  • Objective: The current study aimedto screen for possible factors which affect prognosis of chondrosarcoma. Methods: Thirty seven cases were selected and analyzed statistically. The patients received surgical treatment at our hospital between December 2005 and March 2008. All of them had complete follow-up data. The survival rates were calculated by univariate analysis using the Kaplan-Meier method and tested by Log-rank. ${\chi}^2$ or Fisher exact tests were carried out for the numeration data. The significant indexes after univariate analysis were then analyzed by multivariate analysis using COX regression model. Based on the literature, factors of gender, age, disease course, tumor location, Enneking grades, surgical approaches, distant metastasis and local recurrence were examined. Results: Univariate analysis showed that there were significant differences in Enneking grades, surgical approaches and distant metastasis related to the patients' 3-year survival rate after surgery (P<0.001). No significant difference was not found in gender, age, disease course, tumor location or local recurrence (P>0.05). Multivariate analysis showed that Enneking grade (P=0.007) and surgical approaches (P=0.010) were independent factors affecting the prognosis of chondrosarcoma, but distant metastasis was not (P=0.942). Conclusion: Enneking grades, surgical approaches and distant metastasis are risk factors for prognosis of chondrosarcoma, among which the former two are independent factors.

Prognostic Role of PTEN Gene Expression in Breast Cancer Patients from North-East Iran

  • Golmohammadi, Rahim;Rakhshani, Mohammad Hassan;Moslem, Ali Reza;Pejhan, Akbar
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.9
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    • pp.4527-4531
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    • 2016
  • Background: PTEN protein is one of the most important tumour suppressor factors which is detectable by immunohistochemistry. The goal of the present study was to investigate the prognostic role of PTEN gene expression in breast cancer patients. Materials and Methods: This descriptive-analytical study was conducted on 100 breast cancer patients referred to Sabzevar hospitals in the north-east of Iran between 2010 and 2011, who were followed up to 2015. PTEN gene expression in tissue samples was determined using specific monoclonal antibodies and data were analyzed using Chi-square test and Fisher's exact test. Patient survival was analyzed after 4 years of follow-up using the Cox regression model. Results: PTEN gene expression was evident in 70 of 100 cnacer samples but was found at high levels in all non-cancer samples. There was an inverse significant relationship between PTEN gene expression and tumour stage or tumour grade (p<0.001). The expression of PTEN in invasive ductal tumours was lower than in non-invasive tumours. There was also an inverse significant relationship between the hazard of death and PTEN gene expression (p<0.001). In addition, there was an inverse significant relationship between tumour stage and hazard of death (p<0.001). Conclusion: These findings indicate that lack of PTEN gene expression can be a sign of a worse prognosis and poor survival in breast cancer cases.

Operation Characteristics of Pilot-scale Acid Gas Removal Process (Pilot 규모 산성가스 제거공정 운전 특성)

  • Lee, Seung-Jong;Yoo, Sang-Oh;Chung, Seok-Woo;Yun, Yong-Seung
    • 한국신재생에너지학회:학술대회논문집
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    • 2009.11a
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    • pp.533-536
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    • 2009
  • The gasification technology is a very flexible and versatile technology to produce a wide variety products such as electricity, steam, hydrogen, Fisher-Tropsch(FT) diesels, Dimethyl Ether(DME), methanol and SNG(Synthetic Natural Gas) with near-zero pollutant emissions. Gasification converts coal and other low-grade feedstocks such as biomass, wastes, residual oil, petroleum coke, etc. to a very clean and usable syngas. Syngas is produced from gasifier including CO, $H_2$, $CO_2$, $N_2$, particulates and smaller quantities of $CH_4$, $NH_3$, $H_2S$, COS and etc. After removing pollutants, syngas can be variously used in energy and environment fields. The pilot-scale coal gasification system has been operated since 1994 at Ajou University in Suwon, Korea. The pilot-scale gasification facility consists of the coal gasifier, the hot gas filtering system, and the acid gas removal (AGR) system. The acid gas such as $H_2S$ and COS is removed in the AGR system before generating electricity by gas engine and producing chemicals like Di-methyl Ether(DME) in the catalytic reactor. The designed operation temperature and pressure of the $H_2S$ removal system are below $50^{\circ}C$ and 8 kg/$cm^2$. The iron chelate solution is used as an absorbent. $H_2S$ is removed below 0.1 ppm in the H2S removal system.

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Evaluation of dietary behaviors of preschool children in Seoul and Gyeonggi-do associated with the level of parents' health consciousness: using nutrition quotient for preschoolers (NQ-P)

  • Kim, Soo-Youn;Cha, Sung-Mi
    • Nutrition Research and Practice
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    • v.15 no.2
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    • pp.248-265
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    • 2021
  • BACKGROUND/OBJECTIVES: This study aimed to assess the dietary behaviors of preschool children using the nutrition quotient for preschoolers (NQ-P) and analyzed the difference in the scores of the children's dietary behaviors in regards to the parents' health consciousness. SUBJECTS/METHODS: The subjects were 257 children aged 3-5 years and their parents residing in Seoul and Gyeonggi-do, South Korea. The questionnaire is composed of demographic characteristics, the NQ-P questions, and health consciousness. All data were statistically analyzed by SPSS program (ver. 25.0) and the statistical differences in variables were evaluated by χ2 test, Fisher's exact test, t-test, 1-way analysis of variance and Tukey's multiple comparison test. RESULTS: There was a significant difference on the intake frequency of processed meat by region and fast foods by age, region, and weight status (P < 0.05). There was also a significant difference in not moving around while eating by weight status and parents' effort to have healthy eating habits by sex (P < 0.05). The mean score of NQ-P of the total subjects was 59.47, which was within the medium-low grade. The mean score of balance was 61.62, and the boys were significantly higher than girls (P < 0.05). As the age of children increased, the mean score of the moderation was significantly decreased (P < 0.05). The scores of NQ-P (P < 0.05), balance (P < 0.01), and environment (P < 0.05) were significantly higher in the high group of parents' health consciousness than the low group. CONCLUSIONS: According to the results of the evaluation by NQ-P, the dietary behaviors of preschoolers residing in Seoul and Gyeonggi-do need to be improved. For improving their eating behavior and nutritional health status, parents and children need customized nutrition education programs based on sex, age, region and weight status of preschool children as well as the degree of parents' health consciousness.

A New Scale(NS) Score System to Predict Outcome of Intracranial Aneurysm Using TCD (TCD를 이용한 두개강내 동맥류의 예후 예측 가능한 New Scale(NS) Score System)

  • Park, Sang Hoon;Park, Chong Oon;Park, Hyeon Seon;Hyun, Dong Keun;Ha, Young Soo
    • Journal of Korean Neurosurgical Society
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    • v.30 no.8
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    • pp.970-975
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    • 2001
  • Objective : By conducing a review of clinical outcomes for patients with aneurysm treated using current microneurosurgical techniques and intensive care unit management, we speculated that grading systems based only on clinical condition or CT finding after admission failed to provide a significant stratification of outcome between individual grades of patients, because these systems did not include the factor for postoperative vasospasm. We hypothesized that postoperative blood flow velocity could have a significant impact on outcome prediction for patients surgically treated for intracranial aneurysms. Methods : We conducted a analysis on patient- and lesion-specific factors that might have been associated with outcome in a series of 55 aneurysm operations performed with measurements of blood-flow velocity with transcranial Doppler ultrasonography(TCD). In the new scale(NS) score system, 1 point is assigned additionally for the case with Hunt and Hess(H-H)/World Federation of Neurological Surgeons(WFNS) Grade IV or V, Fisher Scale(FS) score 3 or 4, aneurysm size greater than 10mm, patient age older than 60 years, blood-flow velocity higher than 120cm/sec, and posterior circulation lesion. By adding the total points, a 6-point scale score(score 0-6) is obtained. Results : Age of patient, size of aneurysm, clinical condition(H-H grade and WFNS), FS score, and blood flow velocity(TCD 1day after operation) were independently and strongly associated with long-term outcome. When NS scores were applied to 55 patients with at least 6 months follow-up, the correlation of individual scores with outcome was strongly validated the retrospective findings. Conclusion : It was speculated that TCD could be used to assess postoperative vasospasm and to monitor noninvasively the patients with aneurysmal SAH. This NS score system is easy to apply, divide patients into groups with different outcome, and is comprehensive, allowing for more accurate prediction of surgical outcome.

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Prognostic Value of Serum S100 Protein by Elecsys S100 Immunoassay in Patients with Spontaneous Subarachnoid and Intracerebral Hemorrhages

  • Yoon, Seok-Mann;Choi, Young-Jin;Kim, Hwi-Jun;Shim, Jai-Joon;Bae, Hack-Gun;Yun, Il-Gyu
    • Journal of Korean Neurosurgical Society
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    • v.44 no.5
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    • pp.308-313
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    • 2008
  • Objective: The serum S100 protein has been known to reflect the severity of neuronal damage. The purpose of this study was to assess the prognostic value of the serum S100 protein by Elecsys S100 immunoassay in patients with subarachnoid hemorrhage (SAH) and intracerebral hemorrhage (ICH) and to establish reference value for this new method. Methods: Serum S100 protein value was measured at admission, day 3 and 7 after bleeding in 42 consecutive patients (SAH : 20, ICH : 22) and 74 healthy controls, prospectively. Admission Glasgow coma scale (GCS) score, Hunt & Hess grade and Fisher grade for SAH, presence of intraventricular hemorrhage, ICH volume, and outcome at discharge were evaluated. Degrees of serum S100 elevation and their effect on outcomes were compared between two groups. Results: Median S100 levels in SAH and ICH groups were elevated at admission (0.092 versus $0.283{\mu}g/L$) and at day 3 (0.110 versus $0.099{\mu}g/L$) compared to healthy controls ($0.05{\mu}g/L;$ p<0001). At day 7, however, these levels were normalized in both groups. Time course of S100 level in SAH patient was relatively steady at least during the first 3 days, whereas in ICH patient it showed abrupt S100 surge on admission and then decreased rapidly during the next 7 days, suggesting severe brain damage at the time of bleeding. In ICH patient, S100 level on admission correlated well with GCS score (r=-0.859; p=0.0001) and ICH volume (r=0.663; p=0.001). A baseline S100 level more than $0.199{\mu}g/L$ predicted poor outcome with 92% sensitivity and 90% specificity. Logistic regression analyses showed Ln (S100) on admission as the only independent predictor of poor outcome (odd ratio 36.1; 95% CI, 1.98 to 656.3) Conclusion: Brain damage in ICH patient seems to develop immediately after bleeding, whereas in SAH patients it seems to be sustained for few days. Degree of brain damage is more severe in ICH compared to SAH group based on the S100 level. S100 level is considered an independent predictor of poor outcome in patient with spontaneous ICH, but not in SAH. Further study with large population is required to confirm this result.

Association of Histopathological Markers with Clinico-Pathological Factors in Mexican Women with Breast Cancer

  • Bandala, Cindy;De la Garza-Montano, Paloma;Cortes-Algara, Alfredo;Cruz-Lopez, Jaime;Dominguez-Rubio, Rene;Gonzalez-Lopez, Nelly Judith;Cardenas-Rodriguez, Noemi;Alfaro-Rodriguez, A;Salcedo, M;Floriano-Sanchez, E;Lara-Padilla, Eleazar
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8397-8403
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    • 2016
  • Background: Breast cancer (BCa) is the most common malignancy in Mexican women. A set of histopathological markers has been established to guide BCa diagnosis, prognosis and treatment. Nevertheless, in only a few Mexican health services, such as that of the Secretariat of National Defense (SEDENA for its acronym in Spanish), are these markers commonly employed for assessing BCa. The aim of this study was to explore the association of Ki67, TP53, HER2/neu, estrogenic receptors (ERs) and progesterone receptors (PRs) with BCa risk factors. Materials and Methods: Clinical histories provided background patient information. Immunohistochemical (IHC) analysis was conducted on 48 tissue samples from women diagnosed with BCa and treated with radical mastectomy. The Chi square test or Fisher exact test together with the Pearson and Spearman correlation were applied. Results: On average, patients were $58{\pm}10.4$ years old. It was most common to find invasive ductal carcinoma (95.8%), histological grade 3 (45.8%), with a poor Nottingham Prognostic Index (NPI; 80.4%). ERs and PRs were associated with smoking and alcohol consumption, metastasis at diagnosis and Ki67 expression (p<0.05). PR+ was also related to urea and ER+ (p<0.05). Ki67 was associated with TP53 and elevated triglycerides (p<0.05), and HER2/neu with ER+, the number of pregnancies and tumor size (p<0.05). TP53 was also associated with a poor NPI (p<0.05) and CD34 with smoking (p<0.05). The triple negative status (ER-/PR-/HER2/neu-) was related to smoking, alcohol consumption, exposure to biomass, number of pregnancies, metastasis and a poor NPI (p<0.05). Moreover, the luminal B subty was associated with histological type (p=0.007), tumor size (p=0.03) and high cholesterol (p=0.02). Conclusions: Ki67, TP53, HER2/neu, ER and PR proved to be related to several clinical and pathological factors. Hence, it is crucial to determine this IHC profile in women at risk for BCa. Certain associations require further study to understand physiological/biochemical/molecular processes.

Expression Pattern of the Trefoil Factor Family 1 in Gastric Adenoma and Carcinoma (위 선종 및 선암에서 Trefoil Factor Family 1 단백의 발현 양상)

  • Park Won Sang;Kim Young Sil;Yoo Nam Jin;Park Cho Hyun;Yoo Jin Young;Lee Youn Soo;Lee Jung Young
    • Journal of Gastric Cancer
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    • v.1 no.1
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    • pp.4-9
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    • 2001
  • Purpose: The trefoil factor family 1 (TFF1) has a protective effect against gastric mucosal damage induced by nonsteroidal anti-inflammatory drugs or ethanol. In addition, a TFF1 knockout mouse model has exhibited circumferential adenomas with high-grade dysplasia, of which $30\%$ progressed into frankly invasive carcinomas. We tried to determine whether the expression pattern of the TFF1 could be involved in the development of sporadic gastric carcinomas. Materials and Methods: We examined TFF1 expression in a series of 43 sporadic gastric carcinomas and 18 gastric adenomas by immunohistochemistry. Results: Strong positive TFF1 staining was identified primarily in the normal gastric mucosa, mainly in the cytoplasm of the superficial and foveolar epithelium. We found TFF1 expression in $55.8\%$ (24 out of 43) of the gastric carcinomas and in $16.7\%$ (3 out of 18) of the gastric adenomas. Statistically, TFF1 immunoreactivity was significantly higher in diffuse-type ($82.4\%$) than in intestinal-type ($38.5\%$) carcinomas(p=0.0058, Fisher's exact test). Conclusion: Our findings provide sufficient evidence that the expression of TFF1 in gastric cancer may simply disclose gastric-type differentiation of neoplastic cells and provide further support for the existence of at least two pathways of malignant transformation of the gastric mucosa: one via intestinal metaplasia and adenomatous dysplasia, leading to glandular carcinomas with intestinal-type differentiation, and the other via hyperplastic changes or de novo changes, leading to diffuse carcinomas and to a subset of glandular carcinomas displaying gastric-type differentiation.

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