• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.5
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• pp.489-498
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• 2018

The purpose of this study is to examine whether there is a difference in the awareness of death based on happiness (since attitude or way of life differs among the general public, depending on the perception of death), and to investigate whether there is a difference in the interest in hospices between a group with a high happiness index and a group with a low happiness index. A survey was conducted on 200 men and women aged over 20 who participated in a walking event held in a metropolitan city on April 22, 2017. The survey consisted of eight demographic items: gender, age, education, occupation, marital status, family cohabitation, religion, and health status. It included 29 questions regarding happiness and nine questions regarding the perception of death. For the statistical tests, a chi-square test, an independent sample t-test, correlation analysis, and canonical correlation analysis were performed on the items of the survey based on a happiness index. The results of the study showed that, for a suitable place for death, medical institutions was the highest score (46.3%) for the group with a low happiness index, and own house was highest (59.4%) for the group with a high happiness index. This was a significant difference. It is thought that management systems should be supplemented by professional manpower, educating people so as to increase the utilization rates of home-based hospice as a way for patients to die in a comfortable and familiar place because, for Korea, death is much more common in hospitals. It is also necessary to increase the awareness of death and to make effective use of hospices through individual and various other approaches, considering the demographics of the subjects.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.7
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• pp.208-218
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• 2017

Objective: This study examined the caregiver burden, depressive symptoms, and mental-related quality of life of 226 caregivers of stroke patients, who had been hospitalized in 7 general hospitals located in Cheongju and Daejeon Metropolitan city. Methods: Data were collected from August 5, 2014 to October 5, 2014 and a structured self-administered questionnaire was used. The results were analyzed using a t-test, ANOVA for different comparisons of the mental related quality of life in the sociodemographic characteristics, care-related characteristics, health-related behavioral characteristics, caregiver burden, and depressive symptoms. Hierarchical multiple regression was conducted to determine the explanatory power of the independent variables on the dependent variables, with the variables showing significant differences in univariate analysis as independent variables. Results: According to the results of hierarchical multiple regression analysis, the relevant factors that influenced the mental-related quality of life were the relationship with a patient, burden by 'care', burden by sacrifice of 'personal life', and depressive symptoms. Conclusion: To enhance health-related quality of life, not only is a systematic complement on such factors needed, but the development and implementation of an intervention program to the caregiver burden and depressive symptoms is also urgently required.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.2
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• pp.293-301
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• 2018

This study examined the effects of a multifaceted intervention program on the psychological condition, empowerment, work readiness, and functional capacity for job performance of industrially injured workers. Twelve injured workers in C hospital were included in this study. The subjects participated in a social rehabilitation program 2 hours a day, twice a week, for 8 weeks in total, as well as a work hardening program 3 to 4 hours a day, 5 times a week, for 8 weeks in total. The study was conducted from March to September, 2017. A multi-dimensional psychological examination, empowerment scale, work readiness interview and functional capacity evaluation were conducted and the test scores compared before and after the program with the Wilcoxon signed rank test. In the multi-dimensional psychological examination, there were significant differences in the levels of anxiety, depression, lack of social support, and somatization symptoms (p<.05) except anger. The participants also showed significant differences in the empowerment scale, work readiness scale, and functional capacity evaluation. This study suggests that a multifaceted intervention program can be effective in improving the psychologic condition, empowerment, work readiness, and functional capacity of industrially injured workers and, in turn, may improve their rate of returning to work.

• Journal of Korean Neurosurgical Society
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• v.29 no.10
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• pp.1316-1321
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• 2000

Objectives : The authors analyzed the surgical series of Cushing's disease to evaluate the proper treatment policy and to verify the possible prognostic factors. Material and Methods : Of 50 patients diagnosed as Cushing's disease and operated at Department of Neurosurgery of our institute between 1988 and 1999, 48 patients with available medical records were analyzed retrospectively. Mean follow-up period was 48 months(3 to 109 months). Preoperative diagnosis was made after evaluating the patients with multiple-stage endocrinological studies and 31 selective patients were evaluated with inferior petrosal sinus sampling(IPSS). Magnetic resonance imaging(MRI) and/or high resolution computerized tomography(CT) was done in all patients. A total of 51 transsphenoidal adenomectomy(TSA) were performed including 3 revision for initial surgical failure cases. Remission was decided on the basis of both endocrinological criteria and clinical status. Radiation and/or ketoconazole therapy were applied to failed cases. For the verification of prognostic factors, the authors evaluated the statistical significance of multiple variables over remission rate by chi-square test. Result : Sensitivity of IPSS for central localization was 93.5% which was better than that of MRI(87.5%). But for lateralization, it was 72.4% for IPSS versus MRI 90.5%. Success rate of TSA was 82%(42/51) and recurrence rate was 9%(4/48). When including adjuvant treatments for surgically failed cases, overall success rate was 89.6% and all of 3 reoperated cases(TSA) due to recurrence were successful. Significant complication occurred in 7.8%(4/51) after TSA including hypopituitarism, diabetes insipidus, and visual loss. Non-existence of tumor in MRI and prolonged symptom duration(>3 years) were significant prognostic factors. Conclusion : TSA can be considered as initial treatment for Cushing's disease. In surgically failed cases, multiple treatment modality may improve the overall outcome and repeated TSA for recurrent cases seem to provide similar success.

• Journal of Yeungnam Medical Science
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• v.3 no.1
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• pp.201-207
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• 1986

159 histologically proved cases of lung cancer have been reviewed at the Department of Internal Medicine, Yeungnam University Medical School for the past two years and six months from January, 1984 to July 1986. 1. The age distribution ranged from 27 to 87 years and 69.2% of the patient were distributed between the ages of 51 and 70. 2. The ratio of male and female was 4.6 : 1(131 males, 28 females) 3. Chief complains were in order of dyspnea, chest pain, cough, hemoptysis and weight loss. 4. Localization on chest film, right was more than left(right 58.6%, left 36.2%) and the most frequent site is right upper lung field (33 case, 21.7%) 5. Histologically squamous cell type(54.7%) was most common and next was small cell type(19.5%), adenocarcinoma(9.4%) large cell(6.4%). 6. 76.8% of case was diagnosed histologically under the bronchoscopic biopsy. 7. Pulmonary tuberculosis was the most common associated disease on admission time. 8. The most common treatment was conservative therapy In general. However chemotherapy was most common treatment of the small cell type carcinoma.

• Journal of Yeungnam Medical Science
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• v.10 no.1
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• pp.127-134
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• 1993

Percutaneous needle biopsy of pulmonary lesion with use of fluoroscopic guidance is well established as a diagnostic tool but limited by the small size and inaccessibility of certain lesions. However, percutaneous needle biopsy has been used increasingly in relation to advance and the safty of smaller biopsy needle and new imaging modalities such as ultrasound and CT. CT, because of its characteristics of high resolution, allows tissue sampling with considerable safety from area that heretofore could not be visualized under fluoroscopy. The authors summarized 44 pulmonary lesions that underwent CT-guided transthoracic biopsy with fine-needle over a 14 month period and analyzed the sensitivity of PTNB. CT-guided PTNB was done with 20 gauge or 22 gauge Westcott biopoy needle(Manan medical products, USA). A diagnosis was made in 27 of 44 cases(61%) including malignany in 19 of 24 cases and benignancy in 8 of 20 cases. The pulmonary mass lesions were located at the peripheral zone of the lung field in 33 cases and at the central zone in 11 cases. Complications were observed in 2 cases which were pneumothorax and hemoptysis each but specific therapy was not required. The sensitivity of PTNB by one session was 61%(27/44). The sensitivity of malignancy was 79%(19/24) and benignancy was 40%(8/20). These results suggest the usefulness of PTNB using fine needles be increased in earlier diagnosis and improved staging of pulmonary nodular lesions without significant complications.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.2
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• pp.799-805
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• 2016

Background: There is no standard treatment for patients with platinum-resistant or refractory epithelial ovarian cancer. Single agent chemotherapies have evidence of more efficacy and less toxicity than combination therapy. Most are very expensive, with appreciable toxicity and minimal survival. Since it is difficult to make comparison between outcomes, economic analysis of single-agent chemotherapy regimens and best supportive care may help to make decisions about an appropriate management for the affected patients. Objective: To evaluate the cost effectiveness of second-line chemotherapy compared with best supportive care for patients with platinum-resistant or refractory epithelial ovarian cancer. Materials and Methods: A Markov model was used to estimate the effectiveness and total costs associated with treatments. The hypothetical patient population comprised women aged 55 with platinum-resistant or refractory epithelial ovarian cancer. Four types of alternative treatment options were evaluated: 1) gemcitabine followed by BSC; 2) pegylated liposomal doxorubicin (PLD) followed by BSC; 3) gemcitabine followed by topotecan; and 4) PLD followed by topotecan. Baseline comparator of alternative treatments was BSC. Time horizon of the analysis was 2 years. Health care provider perspective and 3% discount rate were used to determine the costs of medical treatment in this study. Quality-adjusted life-years (QALY) were used to measure the treatment effectiveness. Treatment effectiveness data were derived from the literature. Costs were calculated from unit cost treatment of epithelial ovarian cancer patients at various stages of disease in King Chulalongkorn Memorial Hospital (KCMH) in the year 2011. Parameter uncertainty was tested in probabilistic sensitivity analysis by using Monte Carlo simulation. One-way sensitivity analysis was used to explore each variable's impact on the uncertainty of the results. Results: Approximated life expectancy of best supportive care was 0.182 years and its total cost was 26,862 Baht. All four alternative treatments increased life expectancy. Life expectancy of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 0.510, 0.513, 0.566, and 0.570 years, respectively. The total cost of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 113,000, 124,302, 139,788 and 151,135 Baht, respectively. PLD followed by topotecan had the highest expected quality-adjusted life-years but was the most expensive of all the above strategies. The incremental cost-effectiveness ratios (ICER) of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 344,643, 385,322, 385,856, and 420,299 Baht, respectively. Conclusions: All of the second-line chemotherapy strategies showed certain benefits due to an increased life-year gained compared with best supportive care. Moreover, gemcitabine as second-line chemotherapy followed by best supportive care in progressive disease case was likely to be more effective strategy with less cost from health care provider perspective. Gemcitabine was the most cost-effective treatment among all four alternative treatments. ICER is only an economic factor. Treatment decisions should be based on the patient benefit.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.2
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• pp.873-876
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• 2016

Background: Studies of quality of life (QoL) of oncological patients is carried out using questionnaires approved in many international clinical studies. The European Organization for Research and Treatment of Cancer EORTC QLQ-C30 (Quality of Life Questionnary-Core 30) and its special brain cancer module EORTC QLQ-BN20 are widely used in the world neurooncologic practice. They are available in more than 80 official versions of 30 languages of the world. Previously we used the official versions in Russian, which often causes difficulty in understanding for native Kazakh language speakers, who comprise more than 60% of our respondents. This was the reason for creating a version of Kazakh language. Therefore, in 2014 for the first time the process of adaptation of questionnaires to the Kazakh language was initiated. Materials and Methods: The translation process of questionnaires to Kazakh language was held in accordance with the requirements of the European Organization for Research and Treatment of Cancer EORTC on QoL and consisted of the following stages: preparation - translation - pilot testing - approval. The official permission of authors and "Guideline on translation" was obtained which was developed by the working group of the EORTC on QoL. The pilot testing of EORTC QLQ-C30 and QLQ-BN20 questionnaires was conducted on the basis of the Department of Central Nervous System Pathology of the "National Centre for Neurosurgery" in patients with malignant tumors of the central nervous system. Results: The official versions of the EORTC QLQ-C30 and QLQ-BN20 questionnaires in Kazakh language were introduced and adapted in practical neurosurgical operations in Kazakhstan. Conclusions: The approved versions of the questionnaires in Kazakh language are now available for mainstream use on the official website EORTC.com. The versions of these questionnaires can be used in domestic cohort studies and clinical practice in the Republic of Kazakhstan. The use of these tools for assessing QoL will help professionals in the planning of individual treatment strategies and selection of the necessary therapy.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.1
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• pp.321-326
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• 2014

Background: Mutations in the tyrosine kinase domain of the epidermal growth factor receptor (EGFR) in non-small cell lung cancer (NSCLC) are predictive of response to EGFR-targeted therapy in advanced stages of disease. This study aimed to determine the frequency of EGFR mutations in NSCLCs and to correlate their presence with clinical characteristics in multiethnic Malaysian patients. Materials and Methods: In this prospective study, EGFR mutations in exons 18, 19, 20 and 21 in formalin-fixed paraffin-embedded biopsy specimens of consecutive NSCLC patients were asessed by real-time polymerase chain reaction. Results: EGFR mutations were detected in NSCLCs from 55 (36.4%) of a total of 151 patients, being significantly more common in females (62.5%) than in males (17.2%) [odds ratio (OR), 8.00; 95% confidence interval (CI), 3.77-16.98; p<0.001] and in never smokers (62.5%) than in ever smokers (12.7%) (OR, 11.50; 95%CI, 5.08-26.03; p<0.001). Mutations were more common in adenocarcinoma (39.4%) compared to non-adenocarcinoma NSCLCs (15.8%) (p=0.072). The mutation rates in patients of different ethnicities were not significantly different (p=0.08). Never smoking status was the only clinical feature that independently predicted the presence of EGFR mutations (adjusted OR, 5.94; 95%CI, 1.94-18.17; p=0.002). Conclusions: In Malaysian patients with NSCLC, the EGFR mutation rate was similar to that in other Asian populations. EGFR mutations were significantly more common in female patients and in never smokers. Never smoking status was the only independent predictor for the presence of EGFR mutations.

• Clinical and Experimental Pediatrics
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• v.46 no.9
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• pp.893-897
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• 2003

Purpose : Benign childhood epilepsy with centrotemporal spikes(BECT) is characterized by an excellent prognosis. Therefore, the necessity for the use of antiepileptic drugs is controversial. The object of this study is to know about the long-term follow-up of BECT, comparing daily treatment with antiepileptic drug(AED) versus no medication. Methods : We retrospectively studied 56 cases of BECTs, examined at Pediatric Neurology Clinic, Korea University Medical Center as reference study time, August 2002. Thirty-eight patients didn't have mediation(group I), while eighteen patients received one or two AED(group II). We evaluated demographics, clinical manifestations at diagnosis, EEG findings and clinical courses in groups I & II. Results : There was no significant differences of sex, age, seizure frequency, seizure type, seizure onset time, family history and EEG findings between group I & II. The reasons to start AED were : parents' anxiety(three cases), frequent seizure(12 cases) and daytime seizure(three cases). There was no evolution of status epilepticus and no difficulty in school performance. Conclusion : AED treatment was of no advantage and long-term prognosis was good regardless of treatment strategy. So it is advisable not to choose AED as the first line of therapy, provided that the patient himself/herself or the family understands the benign nature of BECT.