• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.465-470
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• 2010

The number of long-term survivors is increasing in the western countries due to remarkable improvements in the treatment of childhood cancer. The long-term complications of childhood cancer survivors in these countries were brought to light by the childhood cancer survivor studies. In Korea, the 5-year survival rate of childhood cancer patients is approaching 70%; therefore, it is extremely important to undertake similar long-term follow-up studies and comprehensive long-term care for our population. On the basis of the experiences of childhood cancer survivorship care of the western countries and the current Korean status of childhood cancer survivors, long-term follow-up study and long-term care systems need to be established in Korea in the near future. This system might contribute to the improvement of the quality of life of childhood cancer survivors through effective intervention strategies.

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.471-476
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• 2010

The majority of childhood cancer survivors and their families will be psychologically healthy, but may desire and benefit from preventive care. A significant portion of the survivor population will be psychosocially distressed in various aspects by their harsh experience of long cancer treatment, and may warrant professional intervention and treatment. Pediatricians should be aware of the late psychological effects that can occur a year or 2 after treatment, possibly in many aspects of a survivor's life. Not only the cancer diagnosis, but also treatments such as chemotherapy, irradiation, and surgical intervention may exert different long-term effects on the psychosocial outcomes of survivors. Pediatricians need to be more concerned with maintaining and improving the psychological health of this growing number of childhood cancer survivors through long-term follow-up clinics, community support, or self-help groups. Research on all of the psychosocial aspects of childhood cancer survivors is important to recognize the reality and problems they face in Korea.

• Clinical and Experimental Pediatrics
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• v.62 no.3
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• pp.108-112
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• 2019

Subacute sclerosing panencephalitis (SSPE) is a rare, progressive, and fatal central nervous system disorder resulting from persistent measles virus infection. Long-term data are scarce, with a maximum follow-up period of 10 years. Interferon-alpha ($IFN-{\alpha}$) is a protein that exerts its antiviral activity via enhancement of cellular immune response and is reported to be an effective drug for the treatment of SSPE. However, there is currently no consensus regarding the optimal duration of $IFN-{\alpha}$ therapy. Here, we present a case report of a patient with SSPE treated with long-term intraventricular $IFN-{\alpha}$ therapy, which facilitated clinical improvement and neurological stabilization without causing serious adverse effects. To the best of our knowledge, this is one of the longest follow-up studies investigating a patient with SSPE receiving intraventricular $IFN-{\alpha}$ treatment. Further studies are necessary to validate the benefits and safety of long-term intraventricular $IFN-{\alpha}$ treatment in patients with SSPE.

• Safety and Health at Work
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• v.10 no.4
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• pp.428-436
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• 2019

Background: Metalworking fluids (MWFs) are mixtures with inhalation exposures as mists, dusts, and vapors, and dermal exposure in the dispersed and bulk liquid phase. A quantitative risk assessment was performed for exposure to MWF and respiratory disease. Methods: Risks associated with MWF were derived from published studies and NIOSH Health Hazard Evaluations, and lifetime risks were calculated. The outcomes analyzed included adult onset asthma, hypersensitivity pneumonitis, pulmonary function impairment, and reported symptoms. Incidence rates were compiled or estimated, and annual proportional loss of respiratory capacity was derived from cross-sectional assessments. Results: A strong healthy worker survivor effect was present. New-onset asthma and hypersensitivity pneumonitis, at 0.1 mg/㎥ MWF under continuous outbreak conditions, had a lifetime risk of 45%; if the associated microbiological conditions occur with only 5% prevalence, then the lifetime risk would be about 3%. At 0.1 mg/㎥, the estimate of excess lifetime risk of attributable pulmonary impairment was 0.25%, which may have been underestimated by a factor of 5 or more by a strong healthy worker survivor effect. The symptom prevalence associated with respiratory impairment at 0.1 mg/㎥ MWF was estimated to be 5% (published studies) and 21% (Health Hazard Evaluations). Conclusion: Significant risks of impairment and chronic disease occurred at 0.1 mg/㎥ for MWFs in use mostly before 2000. Evolving MWFs contain new ingredients with uncharacterized long-term hazards.

• Asian Oncology Nursing
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• v.10 no.1
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• pp.19-29
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• 2010

Purpose: The purpose of this article was to review and discuss the current status, issues, and nursing perspectives of cancer survivorship. Methods: A comprehensive literature review was conducted. Results: The major areas of concern for the survivors included recurrence, secondary malignancies, and long-term treatment sequalae which affect their quality of life. The four essential components of survivorship are prevention, surveillance, intervention, and coordination. Cancer survivorship care plan should address survivor's long-term care, such as types of cancer, treatment modalities, potential side effects, and recommendations for follow-up. It also needs to include preventive practices, health maintenance and well-being, information on legal protections regarding employment and health insurance, as well as psychosocial services in the community. Survivorship care for cancer patients requires multidisciplinary efforts and team approach. Conclusion: Nurses are uniquely positioned to play a key role in ensuring quality services for cancer survivors and family members. Nurses should review the care plans for cancer survivorship with patients and families by instructing them when to seek medical treatment, promoting any recommended surveillance protocols, and encouraging healthy life styles for health promotion and quality of life.

• Journal of Gastric Cancer
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• v.2 no.3
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• pp.157-162
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• 2002

Purpose: The prognosis of stage IV gastric cancer is very grave. However, some of these patients survive long periods after surgery. This study was undertaken to investigate various clinico-pathological profiles related to the prognosis for these long-term survivors. Materials and Methods: One hundred fifty-five patients with stage IV gastric cancer who underwent a gastric resection from 1992 to 1997 at Hanyang University Hospital were evaluated. Thirty-three patients who survived more than 5 years after surgery were designated as long-term survivors (LTS); on the other hand, one hundred twenty-two patients who died within 5 years after surgery were named as short-term survivors (STS). Results: The rate of the patients with T4, preoperative serum level of CA19-9 greater than 37 U/g protein, and peritoneal dissemination was lower for the LTS than in for the STS (P=0.002, P=0.045, and P=0.0000, respectively). Tumors were smaller (7.3 cm vs. 8.9 cm, P=0.030) and metastatic lymph node were fewer (19.7 vs. 28.8, P=0.019) for the LTS than for the STS. Curative surgery ($\76\%\;vs.\;\46\%$, P=0.002) and a subtotal gastrectomy ($\76\%\;vs.\;46\%$, P=0.026) were performed more frequently for the LTS than for the STS. From a univariate survival analysis, depth of invasion, distant metastasis, extent of gastric resection, postoperative chemotherapy, and curability were statistically significant factors. From a multivariate survival analysis, curability, depth of invasion, and extent of gastric resection were independent prognostic factors. Conclusions: If feasible, we have to exert our efforts to achieve curative surgery although the tumor is considered to be a stage IV gastric cancer. Thereafter, multi-modality treatments including chemotherapy can be considered to improve the prognosis.

• Investigative Magnetic Resonance Imaging
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• v.22 no.3
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• pp.158-167
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• 2018

Purpose: To investigate the surgical, perfusion, and molecular characteristics of glioblastomas which influence long-term survival after treatment, and to explore the association between MR perfusion parameters and the presence of MGMT methylation and 1p/19q deletions. Materials and Methods: This retrospective study was approved by our institutional review board. A total 43 patients were included, all with pathologic diagnosis of glioblastoma with known MGMT methylation and 1p/19q deletion statuses. We divided these patients into long-term (${\geq}60\;months$, n = 7) and short-term (< 60 months, n = 36) survivors, then compared surgical extent, molecular status, and rCBV parameters between the two groups using Fisher's exact test or Mann-Whitney test. The rCBV parameters were analyzed according to the presence of MGMT methylation and 1p/19q deletions. We investigated the relationship between the mean rCBV and overall survival using linear correlation. Multivariable linear regression was performed in order to find the variables related to overall survival. Results: Long-term survivors (100% [7 of 7]) demonstrated a greater percentage of gross total or near total resection than short-term survivors (54.5% [18 of 33]). A higher prevalence of 1p/19q deletions was also noted among the long-term survivors (42.9% [3 of 7]) than the short-term survivors (0.0% [0 of 36]). The rCBV parameters did not differ between the long-term and short-term survivors. The rCBV values were marginally lower in patients with MGMT methylation and 1p/19q deletions. Despite no correlation found between overall survival and rCBV in the whole group, the short-term survivor group showed negative correlation ($R^2=0.181$, P = 0.025). Multivariable linear regression revealed that surgical extent and 1p/19q deletions, but not rCBV values, were associated with prolonged overall survival. Conclusion: While preoperative rCBV and 1p/19q deletion status are related to each other, only surgical extent and the presence of 1p/19q deletion in GBM patients may predict long-term survival.

• 한국노년학
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• v.30 no.4
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• pp.1239-1261
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• 2010

The main purposes of the study were to identify factors affecting health-related quality of life of elderly stroke survivors, and to suggest social work interventions for improving their quality of life. The participants were 328 elderly stroke survivors over 55 years old recruited from 18 long-term care hospitals and 13 nursing care facilities in Chung-Nam Province, Korea. The data was collected through a direct survey method from Dec. 16, 2008 to Jan. 17, 2009. Statistical analysis revealed that the overall health-related quality of life among participants was relatively low, especially in the social relationships domain. As a result of hierarchical multiple regression analysis, depression emerged as the most significant predictor of elderly stroke survivors' health-related quality of life, followed by financial burden in future, activities of daily living, acceptance of disability, comorbidity, and major financial supporter(spouse). Health-related quality of life of elderly stroke survivors in long-term care facilities was affected by a variety of variables from disease-related factors to environmental ones. Particularly psychosocial variables were the most powerful factors to predict HRQOL of elderly stroke survivors. Based on the results, social work implications were discussed in the context of developing clinical strategies to alleviate elderly stroke survivors' health-related quality of life in long-term care facilities. Living with chronic illness and disability is a great challenge to the elderly. Most of all long-term residence in care facilities can cause deterioration of quality of life in old age. From now on, studies on health-related quality of life of elderly with chronic illness and disability should be activated in social work field.

• Journal of Korean Academy of Nursing
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• v.35 no.2
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• pp.407-418
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• 2005

Some fifty survivors participated in the narrative therapy sessions from March 2003 to December 2004, and thirty cases were analyzed using the transcripts. Each participant's surviving story was summarized, and then interpreted and reinterpreted by the survivors themselves in collaboration with the researcher. The two main principles in narrative analysis were hermeneutical distanciation and hermeneutical circulation. Result and Conclusion: First, nursing involvement should play active roles from the early stages of disaster incidents. Specifically, emergency nursing and flexible coping plans are to be available according to the specific properties of each case. Secondly, it is necessary to try to understand the extreme emotional experiences of disaster survival. The horror and pain people feel at an incident cannot simply be generalized, and it requires that each case be approached individually to help stop social alienation. Thirdly, more constant and long-term studies are required to set up nursing strategies for disaster survivors. Forming a trusting relationship with survivors is basic, and formally registering as participants is necessary for continuous interventions. Fourthly, we should deeply appreciate the danger and complexity of modern society and understand the complex nature of disaster. Fifthly, interdisciplinary activities and studies are necessary in combination with various other fields to establish a framework of total nursing care for disaster incidents. Lastly, it is urgently necessary to educate families and friends of the survivors and the society as a whole about life after a disaster.

• Asian Oncology Nursing
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• v.1 no.2
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• pp.217-228
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• 2001

Cancer survivor's self-help group may promote psychosocial adjustment in cancer patients. Self-transcendence has been shown to be related with crisis and adjustment in women with breast cancer. The purpose of this study is to determine the effectiveness of self-transcendence promoting program to facilitate self-transcendence, physical, and emotional well-being in women with breast cancer. Thirty patients who received mastectomy were recruited, but 9 subjects of experimental group and 14 subjects of control group participated in this study. Subjects of experimental group attended the self-help group for self-transcendence once a week for 6 weeks. Each session of program was proceeded for 2hours and the program contained activities for promoting self-transcendence, stress management, communication skill, exercise and relaxation, symptom management, and family support. Data were collected by self-reporting questionnaires within seven days after mastectomy and after the program was finished in experimental group, within 7 days after mastectomy and after 3 months in control group. Self-transcendence was assessed using the self-transcendence scale (STS) developed by Reed. Physical well being was assessed using Symptom distress scale (SDS) developed by McCorkle and Young and emotional well being was assessed using Profile of mood states (POMS). As a result, no significant differences were found between both groups in changes of self-transcendence, emotional well-being, and physical well-being. Self-transcendence score was significantly decreased in control group (p =0.16). But that of experimental group showed no decrease. In conclusions, when the self-transcendence promoting program is provided to the patients with breast cancer, it can be helpful for promoting self- transcendence. For the further study, repeated research with appropriate sample size and more intensive nursing intervention to promote self-transcendence is suggested. And reassessment after 6 months is recommended for testing long term effects of the program.